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Prism: A Health and Dental Plan Focused on You

prism

In partnership with Special Benefits Insurance Services (SBIS), GSC offers Prism®, a health and dental program focused on you, no matter your coverage needs. Scroll down to read more about each plan.

This individual product offers basic coverage (a good starter plan).

This individual product offers lots of coverage.

This individual product is good if you are leaving a group plan.

<h2 data-pm-slice="0 0 []" data-en-clipboard="true">Prism Precision</h2>
<p>The Prism Precision program offers four plans focused on basic health and dental coverage for you and your family. This may be your best solution if you&rsquo;re looking for a practical alternative for basic coverage for services and treatments no longer covered by the government. There is no medical questionnaire required* and coverage is guaranteed, even for pre-existing conditions.</p>
<p><strong>Program highlights:</strong></p>
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<div>Offers coverage for pre-existing conditions</div>
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<div>Enrolment is guaranteed &ndash; no medical underwriting required for eligibility &nbsp;</div>
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</ul>
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<div><em>*Note: Eligibility for hospital accommodation is subject to approval based on your medical history.</em></div>
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<h2>Prism Spectra</h2>
<p>It offers four plans focused on giving you and your family comprehensive coverage plus high benefits maximums. You&rsquo;ll need to fill out a medical questionnaire to qualify for this coverage*. Spectra may be another option if you are leaving a company group health plan or if you don&rsquo;t have health and dental coverage.</p>
<p><strong>Program highlights:</strong></p>
<ul>
<li>
<div>Offers comprehensive coverage with a full range of benefits</div>
</li>
<li>
<div>Offers high benefit maximums</div>
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<div>Best choice for future health care needs</div>
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</ul>
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<div><em>*Note: Your application is medically underwritten for eligibility.</em></div>
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<h2>Prism Continuum</h2>
<p>It offers four plans focused on providing coverage if you are leaving a company group health plan. Continuum may be your best solution if you, your spouse or dependents are losing your company group health benefits, or have lost your company group health benefits within the last 90 days, and are looking for guaranteed coverage, even with pre-existing medical conditions*.</p>
<p><strong>Program highlights:</strong></p>
<ul>
<li>
<div>Offers comprehensive coverage for pre-existing conditions</div>
</li>
<li>
<div>Good choice for obtaining coverage for current health care expenses</div>
</li>
<li>
<div>Coverage is guaranteed if you apply within 90 days of losing your benefits</div>
</li>
</ul>
<div></div>
<div><em>*Note: While there is no medical questionnaire required for the Prism Continuum program and your coverage is guaranteed, you have the option of completing the medical questionnaire, as you may be eligible for another program with more comprehensive benefits.</em></div>
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<p class="p1">For more help selecting the Prism plan best suited to your health care needs, visit the <a href="https://www.sbis.ca/health-insurance.html" target="_blank" rel="noopener">SBIS website</a>, or contact a customer service representative at Special Benefits Insurance Services: 416.601.0429 or 1.800.667.0429 toll-free.</p>

<h2 data-pm-slice="1 1 []" data-en-clipboard="true">Frequently Asked Questions</h2>
<h2 data-pm-slice="1 1 []" data-en-clipboard="true">Application/Enrolment</h2>
<div></div>
<h3>What is medical underwriting?</h3>
<div>A process of determining an individual&rsquo;s eligibility for coverage. The underwriting department reviews the medical questionnaire and medical history to determine if coverage can be offered or if a counter-offer must be made.</div>
<div></div>
<h3>Is provincial government health care coverage required?</h3>
<div>Yes, you must have Provincial Government Health Care coverage to qualify for the Prism programs. Coverage is provided by Canadian provinces and territories so residents do not have to pay out-of-pocket expenses for some health care services. Each province has a different name for their health coverage (i.e. Ontario = OHIP, Newfoundland and Labrador = MCP, British Columbia = MSP, etc.) and coverage, conditions and limitations vary.</div>
<div></div>
<h3>What are the enrolment requirements?</h3>
<p>a) Eligibility</p>
<p>You and/or your spouse/partner and/or any covered dependents must be:</p>
<ul>
<li>
<div>a Canadian resident and</div>
</li>
<li>
<div>currently covered by your Provincial Government Health Care plan</div>
</li>
</ul>
<p></p>
<p>b) Age Restrictions</p>
<p></p>
<ul>
<li>
<div>Applicant/Spouse/Partner must be between the ages of 18 and 79 to apply.</div>
</li>
</ul>
<div></div>
<p>NOTE: Once enrolled, your coverage will not terminate. Your coverage will continue provided the monthly premiums are paid.</p>
<p></p>
<p>c) Prism Continuum Requirement</p>
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<ul>
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<div>On the Prism Continuum plans the applicant must be the individual who held the group benefits through their employer</div>
</li>
</ul>
<div></div>
<h3>Do I cancel my Provincial Government Health Care coverage once I have been accepted?</h3>
<div>No. Prism coverage does not replace your Provincial Government Health Care coverage. Your Prism plan coordinates payments for products and services with your Provincial plan.</div>
<div></div>
<h3>I am a single parent with one dependent child. Do I apply as a couple or a family?</h3>
<div></div>
<div>You would apply as a couple paying the lower rate.</div>
<div></div>
<h3>Why is it necessary to complete the Prescription drug information, Statement of health and Physician &amp; Dentist information parts on the Prism Spectra application?</h3>
<p>Our Medical Underwriting Department requires full disclosure of your health to assess your acceptance into the program. Incomplete applications will be returned and the processing of your application will be delayed.&nbsp;</p>
<p>NOTE: Failure to disclose or falsifying information regarding your health and/or that of your spouse/partner and/or dependents could result in the denial of a claim and the cancellation or modification of this coverage.</p>
<div></div>
<h3>I am already covered through another health and dental plan. If I were to change to the Prism plan, would there be a lapse or duplication in my coverage?</h3>
<div>Provided we receive and approve your application for the Prism plan 30 days prior to your current health and dental policy expiring, we will ensure that there is no lapse in your coverage during the month when you transfer over to the Prism plan. In the event you end up paying for two plans in one month, we will refund your premiums for the Prism program for the month during which you had duplicate coverage</div>
<div></div>
<h3>I have a previously diagnosed medical condition. Can I still get drug coverage?</h3>
<div>It depends on your medical condition(s). We may be able to offer you full drug coverage, however, our Medical Underwriting Department will review the information on your application to determine your eligibility. If we are unable to offer the full drug benefit, we will provide you with a counter-offer outlining the level of coverage offered or specific drug category exclusion(s).</div>
<div></div>
<h3>When are my benefits effective?</h3>
<div>Coverage begins the first of the month following application approval.</div>
<div></div>
<h3>How will I know if my application has been approved?</h3>
<div>If your application is approved, Special Benefits Insurance Services will send you an application approval letter by mail or email confirming the effective date of your Prism coverage.</div>
<div></div>
<h2>Accounting/Banking Information</h2>
<div></div>
<h3>What is needed for my initial payment?</h3>
<div>We require: A blank cheque marked &ldquo;VOID&rdquo; from the account where the monthly premiums will be withdrawn or a signed Pre-Authorized Debit (PAD) Form from your bank.</div>
<div></div>
<h3>What method of payment is accepted?</h3>
<div>Your premiums are payable 30 days in advance in advance by pre-authorized withdrawal from your bank account. Payments are withdrawn on or about the first day of each month.</div>
<div></div>
<div>NOTE: We cannot accept credit cards, credit card cheques or line of credit accounts.</div>
<div></div>
<h3>How are subsequent bank withdrawals made?</h3>
<div>Subsequent bank withdrawals will be made one month after the effective date of your plan. i.e. If the effective date was January 1, the first automatic payment will be withdrawn on February 1. The withdrawal on February 1 pays for March coverage.</div>
<div></div>
<h2>Premiums</h2>
<div></div>
<h3>Are my/our premiums guaranteed for a year?</h3>
<div>The premiums for the Prism programs are reviewed on an ongoing basis and are subject to change with thirty (30) days notice to the applicant/policy holder.</div>
<div></div>
<h3>Does my/our premium change when I/we turn age 45/55/65?</h3>
<div>When the applicant turns age 45, 55 or 65 the monthly premium will be adjusted at the end of that year. You will receive written notification of the new premiums during the month of October. The new amount will be automatically withdrawn from your bank or financial institution account on or about the first day of December to cover January&rsquo;s benefits.</div>
<div></div>
<h3>Are the Prism premiums tax deductible?</h3>
<div>Prism Health and Dental premiums may be tax deductible for individuals or businesses. Please consult your tax advisor for more information.</div>
<div></div>
<h2>Benefits</h2>
<div></div>
<h3>Can I upgrade or downgrade after I enroll?</h3>
<div>You may apply (subject to medical underwriting) to upgrade on the Prism Spectra or Prism Precision plans. You may not upgrade on the Prism Continuum plans at any time. You may only downgrade on any plan after a period of one year.</div>
<div></div>
<h3>Can I add the optional hospital accommodation coverage as a benefit to Prism Spectra or Prism Precision?</h3>
<div>Yes. You can apply to add the hospital accommodation as a benefit to Prism Spectra or Prism Precision for an additional premium upon approval.</div>
<div></div>
<h3>What if my trip length exceeds the number of travel days I have on my plan?</h3>
<div>You may contact our office for a free top-up quote.</div>
<div></div>
<h3>Is Prescription Drug coverage available to individuals age 65 and over?</h3>
<div>Yes. Once you are covered under a Prism plan that includes prescription drug coverage, it will continue to pay for prescription drugs that are not covered by a Provincial Drug Benefit program.</div>

Prism

Want help finding a plan that fits you?

Prism plan options

Prism Precision®

Prism Spectra®

Prism Continuum®

Prism Precision

Prism Spectra

Prism Continuum

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