Canadian Life and Health Insurance Association Inc.

CLHIA Reference Documents

Screening Agents for Suitability and Reporting Unsuitable Agents: CLHIA Model Reporting Form (re: Guideline G8)
The CLHIA Model Reporting Form can be used by companies when reporting an unsuitable agent.
The CLHIA Standardized MGA Compliance Review Survey provides a means for insurers to assess the controls that exist within the entities to which they have delegated screening and other compliance tasks. It is a Reference Document related to Guideline G8.
CLHIA Standardized MGA Compliance Review Survey [PDF]
CLHIA Standardized MGA Compliance Review Survey [Word]
Understanding Claims for Footwear and Orthotics

This reference document has been developed by member companies of the Canadian Life and Health Insurance Association Inc. This reference document is intended for general information only and will assist plan members and plan sponsors by providing some guidance on:

  • the terminology commonly used in describing footwear and orthotics, and -
  • the information which may typically be required by insurance companies and benefit plan administrators in order to adjudicate footwear and orthotic claims.
Service Provider Receipt Best Practices for Group Insurance Reimbursement
The following is a list of suggested receipt detail best practices for service providers. The best practices have been developed by member companies of the Canadian Life and Health Insurance Association (CLHIA) and provide a reference for providers. Following these best practices is an important tool in helping to reduce claims fraud and the reprocessing of submitted receipts due to incomplete information provided.
Understanding claims for treatment of obstructive sleep apnea with positive airway pressure (PAP) devices

This Reference Document is meant for informational purposes only. All claims for PAP devices will be adjudicated in accordance with the terms of the group benefit plan under which they are being claimed. In the event of a discrepancy between this Reference Document and the group benefit plan, the provisions of the group benefit plan will apply.