Annual maximum

The ceiling a plan will pay for a benefit in one plan year.

An annual maximum caps total reimbursement for a benefit category over a plan year — commonly applied to dental, paramedical services and vision.

Maximums are the most frequently outdated element of an inherited plan. A figure set several years ago quietly becomes inadequate as service prices rise, without anything on the plan appearing to change.

What this means for a BC plan

Paramedical and counselling maximums are the ones that age worst in Vancouver, where practitioner rates have moved faster than most plans have been updated. A maximum that once covered a course of physiotherapy often no longer does.

Related terms

  • Coinsurance — The percentage of an eligible claim the plan reimburses.
  • Paramedical services — Practitioner services outside physician and hospital care.

Where this comes up

What a group plan includes · All glossary terms · Ask an advisor directly

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