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Glossary
A C D E
F H M
N O P
R S
Administrative services only contract
Administrator
Administrative services
only contract
Means
the contract between the Directors
and the Administrator setting out the services to be
provided by the Administrator in respect of the Plan,
as amended from time to time.
Administrator
Means
the organisation selected to adjudicate
and pay claims in accordance with the Plan Document
and/or direction from the Directors.
calendar
year
chiropodist
chiropractor
chronic
disease
Compendium
of pharmaceuticals and specialities (CPS)
co-payment
calendar year
Means
January 1 to December 31.
chiropodist
Means
a person licensed by the appropriate provincial/territorial
licensing authority or in those provinces/territories
where there is no licensing authority, members of the
Canadian Association of Foot Professionals, or in the
absence of such association, a person with comparable
qualifications as determined by the Administrator.
chiropractor
Means
a member of the Canadian Chiropractic Association or
of a provincial/territorial association affiliated with
it, or in the absence of such association, a person
with comparable qualifications as determined by the
Administrator.
chronic
disease
Means
a condition that exists beyond the usual course of an
acute disease or beyond a reasonable time for tissue
damage to heal. Any condition that lasts longer than
six months may be considered chronic.
Compendium
of pharmaceuticals and specialities (CPS)
Means
the reference manual as amended from time to time, containing
information about products intended for human use, which
is compiled annually and produced by the Canadian Pharmacists
Association for the benefit of health professionals.
co-payment
Means
the proportion of eligible expenses, net of deductible,
not reimbursed by the Plan which remains the responsibility
of the Plan member.
deductible
dentist
dependant
dependant child
designated officer
durable equipment
deductible
Means
the specific dollar amount that a member must satisfy
each calendar year before they may receive reimbursement
by the Plan.
dentist
Means
a person licensed to practise dentistry by the provincial/territorial
licensing authority, or in the absence of such authority,
a person with comparable qualifications as determined
by the Administrator.
dependant
Means
a member's spouse, a dependant child of a member or
the dependant child of the member's spouse.
dependant
child
Means
the person who is an unmarried child of a member or
of the member's spouse, including an adopted child,
a stepchild and a foster child in respect of whom the
member stands in loco parentis, provided such person
is:
- under
21 years of age,
- under
25 years of age and attending an accredited school,
college or university on a full-time basis, or
-
over 20 or 24 years of age who was a dependant child
as defined above when they became incapable of engaging
in self-sustaining employment by reason of mental
or physical impairment, and is primarily dependent
upon the member for support and maintenance.
designated
officer
Means
a person designated by a deputy head to be responsible
for receiving and actioning application requests upon
verification of eligibility.
durable
equipment
Means
an eligible device that does not achieve any of its
primary intended purposes by chemical action or by being
metabolised.
electrologist
employee
electrologist
Means
a person who, as determined by the Administrator, qualifies
as a certified electrologist.
employee
Means:
- a
person who holds an office, or position, or performs
services for which the remuneration is payable out
of the Consolidated Revenue Fund of Canada or by an
agent of Her Majesty in right of Canada,
- a
person designated by the Treasury Board of Canada
as being eligible to join the Plan as listed in Schedule
III of the Plan Document, as amended from time to
time by the Treasury Board of Canada,
- a
person who is an employee of a participating employer
as listed in Schedule I of the Plan Document, as amended
from time to time by the Treasury Board of Canada,
- a
person who is a member of a civilian component of
the forces of a state that is a party to the North
Atlantic Treaty Status of Forces Agreement, 1949 who
is serving in Canada.
family
member
family unit
Federal Superannuates National Association
fee guide
family member
Means
a member or a covered dependant.
family
unit
Means
a member and their covered dependants.
Federal
Superannuates National Association
Means
an association of federal retirees representing all
pensioner members of the Plan.
fee
guide
For
services provided by dentists, refers to charges established
by the provincial/territorial dental association in
the province/territory in which the expense is incurred
or, in the absence of such association, comparable charges
considered
reasonable and customary, as determined by the Administrator.
hospital
Means
a legally licensed hospital which provides facilities
for diagnosis, major surgery and the care and treatment
of a person suffering from disease or injury on an in-patient
basis, with 24-hour
services by registered nurses and physicians. A hospital
also is a legally licensed hospital providing specialised
treatment for mental illness, drug and alcohol addiction,
cancer, arthritis and convalescing or chronically ill
persons. This does not include nursing homes, homes
for the aged, rest homes or other places providing similar
care.
massage
therapist
member
member
of the Canadian Forces (CF)
month
massage therapist
Means
a person licensed by the appropriate provincial/territorial
licensing body or in the absence of a provincial/territorial
licensing body, a person whose qualifications the Administrator
determines to be comparable with those required by a
licensing body.
member
Means:
- an
employee or a pensioner who has applied for and has
been granted coverage under the PSHCP by a designated
officer, or
- a
member of the CF or the RCMP who has applied for and
has been granted coverage for their dependants under
the PSHCP.
member of the Canadian Forces
(CF)
Means
a person who is:
- a
member of the regular force of the CF,
- a
member of the CF, other than a member of the regular
force, and as an individual or as a member of a class,
has been designated by the Treasury Board of Canada
as a member of the CF for the purposes of the Plan,
- a
member of the forces of a state that is a party to
the North Atlantic Treaty Status of Forces Agreement,
1949 who is serving in Canada.
month
Means
the period of time from a date in one calendar month
to the same date in the following calendar month.
National
Joint Council (NJC)
naturopath
nurse
National
Joint Council (NJC)
Means
a consultative body established pursuant to Treasury
Board Minute T.272382B of March 1945, providing regular
consultation between the government and employee organisations
certified as Bargaining Agents on common employee issues.
naturopath
Means
a member of the Canadian Naturopathic Association or
any provincial/territorial association affiliated with
it, or in the absence of such association, a person
with comparable qualifications as determined by the
Administrator.
nurse
Means
a registered nurse, registered nursing assistant, registered
practical nurse, licensed practical nurse, or certified
nursing assistant who is listed on the appropriate provincial/territorial
registry and in the absence of such registry, a nurse
with comparable qualifications as determined by the
Administrator.
ophthalmologist
optometrist
osteopath
ophthalmologist
Means
a person licensed to practise ophthalmology.
optometrist
Means
a member of the Canadian Association of Optometrists
or of a provincial/territorial association associated
with it, or in the absence of such association, a person
with comparable qualifications as determined by the
Administrator.
osteopath
Means
a person who holds the degree of doctor of osteopathic
medicine from a college of osteopathic medicine approved
by the Canadian Osteopathic Association, or in the absence
of such association, a person with comparable qualifications
as determined by the Administrator.
participant
pharmacist
physician
physiotherapist
podiatrist
psychologist
participant
Means
a person covered under the PSHCP.
pharmacist
Means
a person who is licensed to practise pharmacy and whose
name is listed on the pharmacists' registry of the licensing
body for the jurisdiction in which such person is practising.
physician
Means
a doctor of medicine (M.D.) legally licensed to practise
medicine.
physiotherapist
Means
a member of the Canadian Physiotherapy Association or
of a provincial/territorial association affiliated with
it, or in the absence of such association, a person
with comparable qualifications as determined by the
Administrator.
podiatrist
Means
a person licensed by the appropriate provincial/territorial
licensing authority or in those provinces/territories
where there is no licensing authority, members of the
Canadian Association of Foot Professionals, or in the
absence of such association, a person with comparable
qualifications as determined by the Administrator.
psychologist
Means
a permanently certified psychologist who is listed on
the appropriate provincial/territorial registry in the
province/territory where the service is rendered, or
in the absence of such registry, a person with comparable
qualifications as determined by the Administrator.
reasonable
and customary
RCMP
reasonable
and customary
Means
that amount which is usually charged to a person without
coverage and which does not exceed the general level
of charges for the specific service or product in the
geographic location where the expense is incurred, as
determined by the Administrator. Published fee guides
of national, provincial/territorial associations of
practitioners will be consulted for this purpose where
applicable.
RCMP
Means
Royal Canadian Mounted Police.
social
worker
speech language pathologist
spouse
social
worker
Means
a person who holds a master's degree in social work
(MSW) and is listed on the appropriate provincial/territorial
registry in the province/territory where the service
is rendered, or in the absence of such registry, a person
with comparable qualifications as determined by the
administrator.
speech
language pathologist
Means
a person who holds a master's degree in speech language
pathology and is a member or is qualified to be a member
of the Canadian Speech and Hearing Association or any
provincial/ territorial association affiliated with
it, or in the absence of such registry, a person with
comparable qualifications as determined by the Administrator.
spouse
Means
the person who is legally married to the member, or
a person with whom the member has lived for a continuous
period of at least one year, whom the member has publicly
represented to be their spouse and continues to live
with as if that person were their spouse, as designated
by the member.
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