Step1. Healthcare expense is incurred by claimant

A healthcare expense is incurred by the PHSP member.

 

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Step 2. Original receipt is submitted to the employer


Employers need to be cognizant of the Privacy Act.

 

 

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Step 3. Original receipt plus premium is submitted to The Health Plan.

 

The employer sends the original receipt(s) and a cheque payable to The Health Plan in the amount of





(a) the total cost of the healthcare expense , plus

(b) a 10% administration fee, inclusive of applicable provincial premium tax.
May vary by province, plus

(c) GST/HST payable on the administration fee

*PST May be payable for a corporation providing benefits to their employees

 

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Step 4. Claim is processed


The Health Plan adjudicates and processes the claim.

 

 

 

 

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Step 5. Reimbursement sent to claimant


The Health Plan sends a cheque payable to the claimant for 100% reimbursement of their healthcare expense.

 

 

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Step 6. Claimant pays credit card account or recovers personal funds.


The claimant receives reimbursement, recovering personal funds or if applicable pays their credit card bill within 20 days,thus incurring no out-of-pocket expense.




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