General Questions

PHSPs are a uniquely Canadian mechanism that allows your business to provide tailored health coverage. A PHSP is a Health Spending Account (HSA) that offers flexibility and cost savings compared to traditional insurance plans.

Benefits are not a taxable benefit to your employees; they become an income-offsetting expense for your business, and you only pay for what is spent. No more paying thousands of dollars a month for underused health insurance premiums.

Enrollment is simple, and you will receive all the necessary reports to give to your accountant every year.

A Private Health Services Plan (PHSP) is a self-funded health plan typically established by businesses or professionals for their employees or themselves. It provides flexibility in cost control and coverage customization, making it suitable for unique health needs. PHSPs are subject to regulations by the Canada Revenue Agency (CRA) to maintain their tax-exempt status.

In contrast, regular health insurance is offered by insurance companies with fixed premiums and is available to individuals and employees. While it provides standardized coverage options, it may offer less flexibility in tailoring benefits to specific needs. The choice between the two depends on your organization’s or personal health insurance needs and financial considerations.

Yes, Private Health Services Plans (PHSPs) are recognized and approved by the Canada Revenue Agency (CRA). This approval confirms the legitimacy and compliance of PHSPs with government regulations. PHSPs offer flexibility and customization in healthcare coverage, making them a valuable option for businesses and individuals seeking tailored health benefits.

Your Private Health Services Plan (PHSP) works by providing a flexible and customized approach to healthcare coverage for your business or for yourself and your employees. Here's how it typically operates:

1. Enrollment: The employer, establishes and enrols in a PHSP, tailoring it to the specific healthcare needs of the business and its employees.

2. Expenses: When employees incur eligible medical expenses, such as dental, vision, prescription drugs, or other health-related costs, they pay for these expenses out of pocket.

3. Reimbursement: After paying the expenses, the employee submits the receipts and documentation directly to HealthRabbit, ensuring privacy. The employer does not know the details of any claims made, unless ordered by a court or auditor.

4. Review, Approval, and Billing: HealthRabbit reviews the submitted claims to ensure they meet the plan's guidelines and CRA regulations and then invoices the employer for the claim amount plus fees.

5. Reimbursement: Once your employer pays the invoice, HealthRabbit reimburses the eligible expenses to the plan member.

Overall, a PHSP offers a convenient way to provide healthcare benefits, offering a personalized approach to coverage for you, while also allowing for cost control and flexibility in choosing the healthcare services that matter most to you.

All claims can be made by logging into your HealthRabbit.ca account (provided upon signup) and clicking on "Submit a Claim". 

Enter the details into the form and upload a picture of your receipt (under 2MB file size). Please ensure the image includes the practitioner, patient, and service details, along with the total price paid. Ideally, size the longest side of the image to 1024px.

If there are any issues with your submission, we'll contact you via email in order to process your claim.

A lot! PHSPs allow what the CRA includes in medical reimbursements, so you'll find that not many things are excluded. You can see more detail on our What's Covered page.

Of course. If you need to check how much room you have left for the year and/or if a specific cost is eligible for coverage, email us at hello@healthrabbit.ca. We do our best to respond within one business day, but on occasion, it might take a second day.

Employees covered by the plan can request reimbursements for expenses incurred by individuals living in their residence. Your 'household' refers to your primary place of residence at a single address, where all occupants, regardless of age, depend on you for their financial support. It's worth noting that this definition of 'household' sets it apart from the more common 'dependent' classification found in many tax-related discussions.

To ensure a smooth claims process within your Private Health Services Plan (PHSP), claim receipts require the following essential information:

1. Date: The date of the healthcare service or purchase.

2. Provider Information: Details about the healthcare service provider, including their name, address, and contact information.

3. Patient Information: Information about the person who received the service, including their name and date of birth.

4. Description of Service: A clear and detailed description of the healthcare service or expense. This should include the nature of the service, any products purchased, or prescribed medications.

5. Cost: The total cost of the service or expense, including any applicable taxes.

6. Payment Confirmation: Proof of payment, which can be in the form of a paid stamp, credit card receipt, or bank statement showing the transaction.

Ensuring that these elements are present on the receipt helps expedite the claims process and avoids any potential issues during reimbursement.

Yes, it is required to retain your original receipts for healthcare expenses when participating in a Private Health Services Plan (PHSP). These original receipts serve as crucial documentation for verification and tax purposes. As HealthRabbit does not require the original receipts, you are required to keep these receipts for a period of seven years, as they may be needed to substantiate your claims during audits and when filing your income tax returns. Retaining organized records of your original receipts is essential to ensure compliance with your PHSP and local tax regulations.

HealthRabbit will store the digital version of your receipts for a minimum of seven (7) years in case of any audit or verifications required by law. HealthRabbit will cooperate with any audit or investigation as required under Canadian law.

When you make a claim with HealthRabbit, your employer does not receive specific information about your health issues. What HealthRabbit provides to your employer is the total claims amount and an auditable claims number. They do not know who made the claim*, who the patient was, the type of provider, or any other details. 

Your personal medical history and sensitive health details are not disclosed to your employer through HealthRabbit. Your privacy and medical information are well-protected.

The auditable claims number allows a CRA or court-ordered audit of claims for an employer to be completed, but it does not allow the employer to query any details. 

*In cases where you are the sole employee of a business that has a PHSP with HealthRabbit, but you are not the owner, the owner will obviously know who made the claim and the amount it was for. No other details are provided to them.

In these cases, the claim should be submitted to insurance first and any remainder can then be processed through HealthRabbit. For these types of claims, we will need the practitioner's documentation and a copy of the insurance statement showing the portion paid out and the portion remaining.

In most cases, Private Health Services Plans (PHSPs) are designed to cover eligible medical and healthcare expenses, and they may not typically extend to cover travel insurance premiums. Travel insurance is generally considered a separate and distinct category of coverage.

If your anticipated annual healthcare expenditures are expected to exceed the annual limit set by your HealthRabbit Private Health Services Plan (PHSP), here are some steps you can consider:

1. Review Your Plan:

   • First, carefully review the terms and conditions of your PHSP to understand the limitations and annual limits that apply.

2. Prioritize Expenses:

   • Consider prioritizing your healthcare expenses to make the most of your available coverage. Focus on essential or high-cost healthcare needs.

3. Seek Additional Coverage:

   • Depending on your circumstances, you may explore options for supplementary or secondary health insurance coverage that can help cover expenses beyond your PHSP's annual limit.

4. Negotiate with Providers:

   • Try negotiating with healthcare providers for discounted rates or payment plans to manage your healthcare costs more effectively.

5. Spread Expenses Over Time:

   • If possible, consider spreading out non-urgent healthcare expenses over multiple years to stay within the annual limit.

6. Consult Your Plan Administrator:

   • Contact your PHSP administrator to discuss your situation. They may have options or guidance on how to handle expenses that exceed the annual limit.

It's essential to be proactive and informed about the limits and coverage of your PHSP. Consulting with your plan administrator or seeking advice from a financial or insurance advisor can provide valuable guidance on managing healthcare costs that surpass the annual limit while making the most of your available benefits.

Yes. GST/HST on medical expenses can be included in your claim and will be reimbursed to you.

Private Health Services Plans (PHSPs) are primarily designed to cover eligible medical and healthcare expenses, and they do not typically cover gym memberships, fitness classes, or other athletic fees. These types of expenses are often considered personal health and wellness expenditures rather than medical treatments.

Even if gym memberships and fitness classes are not typically covered by a PHSP, you may be able to claim these expenses as eligible medical expenses for tax purposes when filing your income tax return. Consult with a tax professional or refer to the Canada Revenue Agency (CRA) guidelines for details on eligible medical expenses.

Visit our enrolment form to see what information is requested from the business. But generally, the business name, address, fiscal year end date, and a list of employees cover it. There is a one time $99 enrolment fee that is charged at the end of the enrolment process.

For employees, including owners with coverage, we require the full name, address, email address, telephone number, a PHSP class, and an effective start date for the plan.

A Private Health Services Plan (PHSP) in Canada must include all employees, but the Planholder can control costs by organizing employees into different coverage classes. Owners, principals, or key personnel can be assigned higher coverage limits. Middle management or supervisors can be placed in a class with moderate coverage. Clerical staff or laborers can have a lower coverage class. Temporary, seasonal, or part-time employees can be managed through probationary periods, minimum hour requirements, and lower coverage limits. Additionally, the PHSP can be structured as optional, allowing employees to opt out.

The rules for classes are as follows:

• All full-time permanent employees must be included unless they choose to opt out, with opt-outs documented.
• Employees must be actively working in the business and receive the plan as employees, not shareholders.
• Coverage limits must be reasonable and consistent within similar employee groups.
• The highest coverage limit should not exceed 10 times the lowest limit to meet CRA reasonableness standards.
• The plan must be formally documented, either through a third-party provider or an internal written policy.
• Temporary, seasonal, or part-time employees can be excluded or subject to probation periods, minimum hour requirements, and/or lower coverage.
• All employees in the same class must receive the same benefit offering.

Yes, as a sole proprietor or partner in a partnership, you are generally eligible to establish and participate in a Private Health Services Plan (PHSP) in Canada. PHSPs are a popular choice for self-employed individuals and business owners, including those operating as sole proprietors or in partnerships. Here are some key points to consider:

1. Sole Proprietorship: If you are a sole proprietor, you can set up a PHSP for yourself, and your eligible dependents can also be covered under the plan.

2. Partnership: In a partnership, each partner can typically establish their own individual PHSP, and the plan can cover the partner and their eligible dependents.

3. Eligible Expenses: PHSPs are designed to cover eligible medical and healthcare expenses, and they offer a tax-efficient way to provide health benefits to yourself and your family.

4. CRA Compliance: It's essential to ensure that your PHSP complies with the guidelines set by the Canada Revenue Agency (CRA). This includes maintaining proper documentation, following CRA regulations, and adhering to annual limits.

5. Tax Benefits: Contributions made to the PHSP are tax-deductible for your business, which can result in tax savings. Additionally, the reimbursements to plan members are typically not considered taxable income.

While sole proprietors and partners are eligible for PHSPs, the specific structure and operation of your plan may vary based on your business type, the number of participants, and your individual needs. Consulting with tax professionals, insurance advisors, or legal experts can help you manage your PHSP in a way that aligns with your business structure and provides health benefits while maximizing tax advantages.