Business owner and employees benefit plan

 

Niklife offers companies of any size smarter alternatives to maximize their benefit plans with fair and affordable premiums. We can design a plan for companies with as few as one employee.

 

In traditional group benefit plans, companies pay a certain amount of premium for each employee and the employee enjoys the benefit of health and dental insurance. The problem with these group insurances is that they are not available for companies with less than three employees( normally with less than ten employees the insurance companies might ask for underwriting). The cost of these plans increases over time. And last but not the least, there is always a limitation on each category.

Drawing from a combination of Private Health Services Plans (PHSP) and traditional benefits plans, Niklife helps prepare a solution that is custom-fit just for your business.

 

What is a Private Health Services Plan?

 

A Private Health Services Plan (PHSP) is a flexible alternative to group insurance that has been part of the income tax act for more than 30 years. A PHSP is designed to offset and reduce medical expenses, benefiting both employees and employers alike.

PHSP’s can be leveraged by a number of entities. Corporations use them to save on benefits costs with increased options. Such plans cover business owners, employees, spouses, children under the age of 18, and active shareholders in a corporation. For unincorporated individuals operation businesses, there are some limitations, with a household maximum of $1,500 per adult and $750 per child.

For organizations or individuals facing additional medical expenses that group insurance doesn’t cover in full, a PHSP can be an effective supplement.

 

Benefits of a Private Health Service Plan

 

Upon setting up a PHSP, expenses from personal healthcare visits, dental, and vision that paid with out of pocket cash (after taxes) can be submitted to the plan.

These expenses can then be reimbursed as a non-taxable medical benefit by the organization. These claims, when submitted during the fiscal year are fully tax-deductible and provide a valuable benefit to employees.

Many companies are using the PHSP to supplement or even replace parts of their group insurance.

Because business owners can deduct the costs reimbursed and employee benefits are expanded beyond what a group plan might normally cover, it’s a benefit for all parties. Specific benefits to business owners include:

  • Customizable benefits that provide a more robust set of solutions for employees
  • Limit and cost varies based on the class of employees
  • More cost-effective than purchasing additional insurance supplements for health and dental coverage
  • The positive account balance can be rolled over
  • There is no immediate cost to enroll employees, no annual recurring costs, and no inactivity costs for having such plans

While one of the primary uses of a PHSP is to supplement existing insurance, there are several key advantages over traditional group plans for those that would replace part or all of their existing insurance plans. These include:

  • No recurring fees or monthly premiums. Payments are only made for expenses incurred.
  • Limits can be decided at the employer level.
  • There are no deductibles, dispensing fee caps, or limits on prescription drug options.
  • Pre-existing conditions do not interrupt or block coverage.
  • In addition to the core benefits of a PHSP, additional benefits can be added by employers to cover issues that can arise. These include:

Benefit add ons

  • Travel Coverage – If someone on the plan requires medical or surgical treatment while traveling outside of their own province, this additional policy will cover expenses up to the policy limit.
  • In-Province Catastrophic – If coverage is treatment or surgery is required for a catastrophic illness, injury, or disease, this add-on will provide coverage up to the policy limit, within the lifetime maximum.
  • These add-ons can help further fill gaps for employees that traditional coverage or a PHSP on its own may not. These add-ons do require an additional premium but are optional.

 

How to Implement a Private Health Services Plan

 

A PHSP can be used to replace parts of your existing group insurance or to supplement coverage offered to your employees. Business owners can also directly enroll themselves or shareholders in such a plan, even if there are no employees in the company beyond senior executives.

You’ll maximize the value of a PHSP for your leadership team and employees by offering benefits that are not traditionally offered. This can be a strong incentive for employees, especially as larger and older companies continue to offer traditional plans without options for vision and many dental solutions.

Because a PHSP is highly customizable, it can be set up to match the specific needs of your business and isn’t required to follow the guidelines of an existing insurance plan. The result is a plan that fits how your business operates. To get the most from a PHSP and ensure it fits the unique needs of your business, work with a consultant that specializes in setting up and customizing plans.

 

Private Health Services Plan Traditional Group Insurance Plans
  • No premiums or deductibles
  • Monthly premiums; Deductibles may apply
  • No annual fees or signup costs
  • Fees associated with the creation of group insurance plans and ongoing administration
  • No dispensing fee caps
  • There are a number of potential limits imposed by insurance companies
  • No limitations due to pre-existing health conditions
  • Pre-existing conditions can lead to denial of coverage for some services
  • No estimates are required for dental or other specialty care
  • Dental work typically requires an estimate to schedule
  • No third-party enforcement of employee limits – the employer determines category and employee limits
  • Insurance companies set limits based on their documented fee guides. Employees frequently pay additional out of pocket costs.
  • No out of pocket limits on prescription drug purchases
  • The coverage of prescription drugs is limited to the cost of generic alternatives.

 

What is covered under PHSP?

  • Acupuncture
  • Alcoholism treatment
  • Ambulance
  • Anesthetist
  • Artificial limbs
  • Attendant Care
  • Birth control pills
  • Blood tests
  • Braces
  • Cardiographs
  • Cat scan
  • Chinese medicine
  • Chiropractor
  • Contact lenses
  • Contraceptive devices
  • Crowns
  • Crutches
  • Dental implants
  • Dental insurance
  • Dental plan
  • Dental treatment
  • Dental X-rays
  • Dentures
  • Dermatologist
  • Detoxification Clinic
  • Diagnostic fees
  • Diapers for incontinence
  • Dietician
  • Drug addiction therapy
  • Drugs (prescription)
  • Eyeglasses
  • Fees paid to health institute prescribed by a doctor
  • Fertility Treatments
  • Fluoridation unit
  • Guide dog
  • Gynecologist
  • Hair Transplant
  • Hearing aid and batteries
  • Hospital bills
  • Hydrotherapy
  • Implants
  • Incontinence Products
  • Insulin treatments
  • IVF Treatments
  • Lab tests
  • Laser eye surgery
  • Laser treatments
  • Lodging (away from home for outpatient care)
  • Metabolism tests
  • MRI
  • Naturopath
  • Naturopath supplements
  • Neurofeedback
  • Neurologist
  • Nursing home (incl. board & meals)
  • Obstetrician
  • Operating room costs
  • Ophthalmologist
  • Optometrist
  • Oral surgery
  • Organ transplant (including owners expense)
  • Orthodontist
  • Orthopedic shoes
  • Orthopedist
  • Orthotics
  • Osteopath
  • Out-of-Country Medical Expenses
  • Oxygen and oxygen equipment
  • Pediatrician
  • Physician
  • Physiotherapist
  • Post-natal treatments
  • Pre-natal care
  • Prescription drugs
  • Private surgery
  • Psychiatrist
  • Psychoanalyst
  • Psychologist
  • Psychotherapy

Contact us to learn more or schedule your consultation with a member of the Niklife team to get started.