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What is a Private Health Services Plan?
A Private Health Services Plan (PHSP), also known as a Cost Plus Plan, is a tax–efficient way for incorporated companies to cover additional health and dental expenses for their owners and/or employees.
Advantages of a PHSP
A major benefit of a PHSP is that it works as a stand-alone plan or with your existing group benefits coverage. It covers items not included or paid for in other group insurance programs. Additionally, a PHSP creates a tax-deductible business expense for your company.
Why consider a PHSP for your company?
No setup fee and no monthly premiums are just a few of the reasons that make a PHSP an ideal option. Employers also have the option of setting up a range of employee classes with different spending limits.
Enrolled members are reimbursed for qualifying expenses (health and dental related expenses eligible under the Income Tax Act) and a 10% Adjudication Fee is charged on eligible claims (GST is charged on adjudication fee only). Plans are based on the calendar year and benefit levels can be prorated for the first year.
Frequently asked questions
How does a PSHP work?
As a reimbursement plan, the PHSP requires that services be paid up front by the member. The receipt is then submitted to Pacific Employee Benefits (PEB) along with a claim form identifying the covered service or product.
The policy holder (incorporated company) then receives an invoice for the submission, plus a 10% administration fee. The total amount is paid to PEB from the named company’s bank account. Once payment is received by PEB from the company, the claimed expenses are reimbursed to the plan member either by EFT or cheque.
Does the plan member have to pay tax on the reimbursement?
No. Reimbursements are generally a non-taxable benefit for the enrolled member (except in Quebec, where provincial taxes apply).
What if I have a group plan that will partially cover the initial claim?
If the member has coverage under a group plan or their spouse is a member of a group plan, co-ordination of benefits is an option. This can be accomplished by first submitting the claims to the group plan(s), then submitting an explanation of benefits statement to PEB.
The explanation of benefits statement will be sent to you after they group plan made payment to you. If there are any items that was rejected please send a copy of the receipt along with your claim.
Do I have to send original documents in the mail?
No. Copies of the paid invoices and the claims form can be sent by email to service@pebplans.com. If you prefer to send them manually our address is:
Pacific Employee Benefits
Box 3249
3756 First Ave.
Smithers, B.C.
V0J 2N0
What if I need help and would like to speak to a real person?
Please call our office at (250) 847-2883, we would be happy to hear from you! Alternatively, call us toll-free at (877) 822 4209.
What is an allowable expense?
Any medical or dental expense accepted by the Canada Revenue Agency (CRA). Please visit the following website for eligible expenses as they are subject to change frequently.
What if I still have questions?
Please reach out to us by email at service@pebplans.com or by phone at (250) 847-0887. One of our knowledgeable group benefits specialists will be happy to help you.
Frequently asked questions
How does a PSHP work?
As a reimbursement plan, the PHSP requires that services be paid up front by the member. The receipt is then submitted to Pacific Employee Benefits (PEB) along with a claim form identifying the covered service or product.
The policy holder (incorporated company) then receives an invoice for the submission, plus a 10% administration fee. The total amount is paid to PEB from the named company’s bank account. Once payment is received by PEB from the company, the claimed expenses are reimbursed to the plan member either by EFT or cheque.
Does the plan member have to pay tax on the reimbursement?
No. Reimbursements are generally a non-taxable benefit for the enrolled member (except in Quebec, where provincial taxes apply).
What if I have a group plan that will partially cover the initial claim?
If the member has coverage under a group plan or their spouse is a member of a group plan, co-ordination of benefits is an option. This can be accomplished by first submitting the claims to the group plan(s), then submitting an explanation of benefits statement to PEB.
The explanation of benefits statement will be sent to you after they group plan made payment to you. If there are any items that was rejected please send a copy of the receipt along with your claim.
Do I have to send original documents in the mail?
No. Copies of the paid invoices and the claims form can be sent by email to service@pebplans.com. If you prefer to send them manually our address is:
Pacific Employee Benefits
Box 3249
3756 First Ave.
Smithers, B.C.
V0J 2N0
What if I need help and would like to speak to a real person?
Please call our office at (250) 847-2883, we would be happy to hear from you! Alternatively, call us toll-free at (877) 822 4209.
What is an allowable expense?
Any medical or dental expense accepted by the Canada Revenue Agency (CRA). Please visit the following website for eligible expenses as they are subject to change frequently.
What if I still have questions?
Please reach out to us by email at service@pebplans.com or by phone at (250) 847-0887. One of our knowledgeable group benefits specialists will be happy to help you.