knowledge topics
Private Health Services Plans
KNOWLEDGE EXPECTED OF: Both CFP® Professionals and QAFPTM Professionals
- Identify types of private health services plans.
- Individual plans
- Group plans
- Identify how private health services plans in Canada are funded.
- Identify that insurance companies provide individual private health services plans.
- Identify sources of group private health services plans, such as:
- Insurance companies
- Employer-sponsored
- Association-sponsored
- Identify parties who may be eligible for coverage under a private health service plan, such as:
- Plan member
- Plan member’s spouse or common-law partner
- Plan member’s dependents
- Identify types of coverage generally provided by private health services plans, such as:
- Extended health coverage (above and beyond government-provided benefits)
- Prescription drug coverage
- Ambulance service coverage
- Increased level of hospital accommodation
- Out-of-country medically required care coverage
- Vision coverage
- Auditory coverage
- Paramedical services coverage
- Special medical supplies (E.g. Artificial limbs, prosthetics, medical equipment)
- Dental coverage
- Employee Assistance Programs, where services are provided by an authorized medical practitioner, as defined by the CRA
- Extended health coverage (above and beyond government-provided benefits)
- Identify circumstances when an individual health services plan may be suitable, such as:
- No group insurance in place through employer
- Self-employed
- Unemployed
- Retired
- Individual or dependent requires special or additional coverage not covered under current group plan
- Define factors that impact the value of benefits that may be received under a private health services plan, such as:
- Deductible
- Coinsurance
- Maximum
- Waiting periods
- Limitations
- Pre-existing condition clauses
- Identify how benefits are coordinated between private health service plans.
- When an individual is eligible to receive benefits under multiple plans (i.e. their own plan and their spouse’s plan, or their own multiple plans)
- When dependents are eligible to receive benefits under multiple plans (i.e. their own plan, and their parents’/guardians’ plans)
- Identify the concept of a health and welfare trust.1
- Identify factors that may impact the premium of a private health service plan, such as:
- Value of coverage (e.g. deductibles, coinsurance, benefit maximums)
- Age
- Geographic location
Glossary of Verbs (mouse over to see definition)
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Define
To state exactly the meaning of
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Identify
To be aware of / to recognize and correctly name / to locate an appropriate resource
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Explain
To make clear the meaning of / to describe something in more detail or reveal relevant facts or ideas related to it
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Compare
To note the similarities and differences between two or more things
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Estimate
To determine an approximate value for
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Calculate
To find the value using mathematics
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Convert
To change from one form or purpose to another
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Evaluate
To reach a conclusion or make a judgement through careful study
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Interpret
To give the meaning of / to construe or understand / to translate orally
Read more about the Taxonomy used in the FP-BoK
