Economical health benefits to create competitive advantage.
Today’s health benefits are designed for your healthiest employees… not necessarily for when sickness strikes. That’s why an aging workforce is increasingly paying more for unfunded health expenses, like nutrition coaching and psychological therapy. And, it’s also why many plans cover naturopathic medicine but not therapeutic exercise classes. It is why people with good eyesight receive the same coverage as those with severely impaired vision. Over time, unfunded health needs put a dent in your company’s productivity & performance. Some employees may ignore high blood pressure or diabetes, eventually facing disability or major health events. Many of these employees are key to company operations, and require a more proactive health benefit plan.
Employer-sponsored health benefits often need to improve how they:
- Respond to emerging health risks facing employees
- Prioritize access to evidence-based health care
- Mitigate lost-time and disability
- Fund secondary prevention activities
That’s why we are here. We bring expert clinical leadership & research to conversations with human resources (HR) managers, benefit administrators and industry partners. At Consortia Care, we help employers design their own:
- Employee Support Programs (EAP’s)
- Private Health Services Plans (PHSP’s),
- Health Spending Accounts (HSA’s), and
- Employee Life and Health Trusts (ELHT’s)
So, if you need to improve productivity, reduce disability or control benefit costs… call us! You benefit from clinical leadership, strategic partnerships, lower administrative costs and self-funded health benefits that are fully tax deductible.
Frequently Asked Questions (FAQ’s) about employer-sponsored health benefits
A Private Health Services Plan (PHSP) is a tax-free account used to finance the cost of medical expenses for an employer, 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 administrative fees associated with many group health insurance plans. Employees also 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 specific criteria set forth by the Canadian Revenue Agency (CRA) and are administered acccording to CRA-defined rules. To administer an HSA-like fund, employees would simply 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 create an insurance-like contract for their employees.
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 on-call service) that provide enhanced health supports while also adjudicating claims. Partnering with health professionals can also help you to design preventative care strategies with “built-in” clinical knowledge that manages health concerns facing your employees. A well-designed PHSP has the potential to enhance your company’s productivity while also adhering to Canadian tax and accounting standards.
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.
However, in many cases, health costs are a predictable annual expense. Vision care and dental check-ups are one example of a predictable health cost. Health costs are also generally capped within Canada, as major expenses are often insured by government-funded provincial health insurance plans. Recognizing this, many health insurance companies have moved towards expanding the scope of their plans to cover alternative therapies (like naturopathy and acupuncture services) with limited evidence for their effectiveness.
Only a few insurance companies, however, are adapting to tomorrow’s health challenges. Key drug coverages are missing, yet drug benefits costs are soaring. Many highly effective health treatments go unfunded. And, less expensive health provider options are often excluded from the health insurance system. Due to the structure of insurance legislation, many health insurance companies can only 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 recently “opened up” the landscape for employer-sponsored health benefit plans. A PHSP is different in that employers retain the full risk of health costs, turning this from a fixed cost to a variable expense. Under a PHSP, employers can use this added flexibility to incentivize health expenses. These factors create some uncertainly for companies, but also give established companies the option of lower health costs while attaining optimal health with strategically designed benefits plans.
Yes — a well-designed PHSP works best when combined with economical life and health insurance coverages. To avoid any conflict of interest and focus more intently on clinical care, we do not sell any insurance products. We do, however, invite experienced insurance brokers to join our conversations to advise on specific insurance coverages while we focus on designing health-services plans to meet the needs for your organization.
For large employers, there is an option of creating a fully-managed Employee Health and Life Trust to provide comprehensive health and life benefits to their employees. We typically partner with other professionals to ensure these plans remain solvent, given annual predicted actuarial risks & claims costs.