Frequently Asked Questions about First Line

1. Who is Federated Life Insurance?
Operating in Canada since 1920, the Federated Insurance Companies of Canada are 100% Canadian owned subsidiaries of Fairfax Financial Holdings Limited. Licensed in all provinces, Federated offers property, automobile, general liability, life, and health insurance products for commercial businesses and the personal lines markets. Federated Insurance enjoys a rating of "A excellent" from A.M Best Company. Federated Life has the highest rating of 8 in solvency test measures by TR.A.C.

2. Who is eligible for coverage?
Any employee under the age of 65 and actively working a minimum of 2O hours per week, and a resident of Canada and insured under a provincial healthcare plan. Inactive business owners can be covered if they own at least 20% of the business, are residents of Canada, and are insured under a provincial healthcare plan.

3. Is family coverage available?
Yes, First in Line is available to both the spouse and dependent children of each insured. The critical illness component can vary within a family.

4. What is the minimum group size?
The minimum group size is 3.

5. How is First in Line underwritten?
There is no medical underwriting for First in Line.

6. Are pre-existing conditions excluded?
A pre-existing condition, which is defined as any condition for which a reasonable individual would have received medical treatment, consultation, care or services and/or have been prescribed medication for, 24 months immediately prior to their date of eligibility, is not covered. However, benefits are payable if the diagnosis of the pre-existing critical illness occurs after 24 months of consecutive coverage for that person.

A person can still obtain coverage for all of the other critical illnesses covered by First in Line.

7. How do I make a claim?
A claimant will notify Federated Insurance that they have a claim and will be provided with the appropriate forms to be filled out by the claimant and their physician.

8. Can an insured claim more than once?
Yes. First in Line is fundamentally different from traditional Critical Illness insurance in that a covered person can access their benefits more than once. After the first claim, each subsequent time that an insured accesses the First in Line benefits through the claims process, they will receive 50% of the original critical illness lump sum benefit (up to a lifetime maximum of 200% of the critical illness benefit), access to an additional $30,000 for diagnosis, and access to $350,000 less the total amount of their prior claims, up to a limit of $250,000 per occurrence.

9. Who decides whether a claimant gets treatment?
Federated Insurance has contracted with several third party medical firms who work together with the claimant's own physician(s) as necessary to case manage individual claims. In other words, at least three physicians will jointly decide whether a claimant is referred for diagnosis or treatment in the US, eliminating the chance of bias and ensuring that each claimant gets access to appropriate care.

10. Are there standards for when a delay for treatment or testing is considered unacceptable?
No specific standards have been set, as every patient's needs are unique. A team of specialists, including the patient's own physician, will decide if a delay is medically unacceptable in their case.

11. Can patients seek treatment in any US facility?
No, the treatment facility will be chosen by the team of specialists handling the patient's case, based on Federated's PPO network, and the presence of a Best Doctor.

12. Who are Best Doctors?
Best Doctors uses a stringent peer-based quality assessment to identify the best medical practitioners by specialty in order to most effectively match patient needs with the appropriate specialist. Federated has contracted with Best Doctors to provide access to their network of specialists in Canada and the US.

13. Who pays for drugs prescribed by a US physician?
If the drugs are available in Canada, the patient's normal drug plan will pay for the cost. However, if the drugs are only available in the US or are not covered by the patient's drug plan, the drug expense will be considered part of the same claims occurrence as their treatment and/or diagnosis.

14. Will FIL pay for a companion to travel with the patient for treatment and/or diagnosis?
Yes, FIL pays for travel and accommodation expenses for one companion.

15. What is the tax status of First in Line benefits?
In general, FIL is treated as other health benefits-the premium is tax deductible to the company and the benefits received are not taxable to the employee. This information is not warranted by Federated - it is recommended that each insured firm obtain advice from their own tax consultant.

16. How frequently will I be billed for First in Line?
First in Line is normally billed on a monthly basis, but annual billing is also available