Managed health-care to improve productivity, reduce disability & create competitive advantage.
Today’s benefits are perfectly designed for the healthy… not the sick. That’s why many patients with chronic diseases pay significant amounts out-of-pocket for unfunded health-care costs. And, it’s why many plans cover naturopathic medicine but not therapeutic exercise classes. It is also why people with good eyesight typically receive the same vision coverage as those with relatively poor vision. Over time, unfunded health needs create health disparity in your workplace. It is partly why some employees may struggle to control their blood pressure or continue to gain weight, eventually facing disability or major health events. Many of these employees are key to company operations.
Employee health benefits need to be re-invented to (1) prioritize access to evidence-based treatments, (2) respond to emerging health risks facing your employees, (3) reduce lost-time and disability, and (4) adequately fund secondary prevention activities. That’s why we are here… to bring relevant health professionals back into employee benefits conversations in collaboration with human resources (HR) managers, benefit administrators and industry partners. At Consortia Care, we can help your company design your own:
- Managed Care & Employee Support Programs
- Private Health Services Plans (PHSP’s),
- Health Spending Accounts (HSA’s), and
- Employee Life and Health Trusts (ELHT’s)
If your company dreams of creating sustainable employee health benefits that improves productivity & lowers employee costs, call us! You will benefit from expert clinical leadership, strategic partnerships with industry, reduced administrative costs and self-funded health benefits that are fully tax deductible.
Frequently Asked Questions (FAQ’s) about PHSP’s
A Private Health Services Plan (PHSP) is a tax-free account used to finance the cost of medical expenses, providing a self-insured alternative to traditional health insurance.
PHSP’s provide several tax advantages for both employees and employers. Employers can deduct 100% of medical, dental and health costs paid to employees, and avoid paying premiums (administrative fees) associated with group health insurance plans. Employees receive highly flexible, tax-free health benefits with no co-insurance requirements or deductibles.
Health Spending Accounts (HSA’s) could qualify as a PHSP if they meet stringent criteria set forth by the Canadian Revenue Agency (CRA) and are administered appropriately. To use the an HSA-like fund, employees would submit health-care expenses (eligible expenses defined by the CRA) to the PHSP for reimbursement.
Employers also have the ability to custom design their plan, and have the flexibility to create an insurance-like contract for their employees.
Health insurance transfers individual risks to an insurance company in exchange for payment of premium. This transfer of risk is possible because the total premium collected matches the pooled cost of claims, overhead expenses (administrative costs) and a small margin for profit. Insurance companies do best at protecting individuals from unexpected financial losses & major risks.
In many cases, health benefits costs are expected. For example, vision and dental check-ups are one example of a predictable health cost. Health costs are also generally capped within Canada, as major expenses are typically insured by provincial health insurance plans (government funded). Recognizing this, many health insurance companies have moved towards expanding the scope of their plans.
But… insurance companies are not well-versed in tomorrow’s health challenges. Key drug coverages are missing. Many highly effective health treatments go unfunded. And, less expensive (and equally effective health providers) are excluded from the health insurance system. That is because insurance companies are only empowered to control claims costs by excluding specific services, placing dollar limits on services, establishing co-payments and setting deductibles.
To tackle these limitations, the CRA has defined a broad list of eligible health expenses with the goal of “opening up” the landscape for employer-sponsored health funding. A PHSP is different in that employers keep the risk of health costs within the company, turning this from a “fixed” cost to a “variable” expense. Under a PHSP, employers must also assume the administrative cost of the plan. These factors create some uncertainly for companies, but also give established companies the option of lower health costs & empowering their employees to attain optimal health with strategically designed benefits plans.
Although you could design your own PHSP, we recommend working with health professionals with experience & industry partnerships for optimal benefits administration. This way you can re-distribute administrative costs towards providing on-call supports (e.g. a nurse-run claims processing service) that enhance access to health care. Partnering with health professionals can also help you in designing a plan with “built-in” clinical knowledge that is optimized for population-level risks affecting your employees. A well-designed PHSP has the potential to enhance your company’s productivity while also adhering to Canadian tax and accounting standards.