Contractual Arrangements

The employer, whether a corporation or a proprietor, must first decide that it wishes to establish a Private Health Services Plan (PHSP) for its employee(s). Note that a PHSP is just the name used under the Income Tax Act for what is commonly called an employee drug and dental benefit plan.

The employer should ensure that it is eligible and what class of employees it wishes to cover. Please see Who Qualifies?

The employer also has to decide what benefits it wishes to be reimbursable under its own Self-Directed Benefit Plan TM . Should it provide coverage only in Canada or worldwide? A good way to avoid very large out of Canada medical bills is to restrict the PHSP to Canada only, and include the premiums paid for Travel Medical Insurance to be eligible in its Self-Directed Benefit Plan TM.

The employer completes the the  Employer Form (either online email or by downloading an Adobe document and mailing it to Bene-D-Duct ). This form instructs Bene-D-Duct to prepare a Benefit Plan Text that describes your own Self-Directed Benefit Plan TM.

This Self-Directed Benefit Plan TM  Text is merely a document that precisely outlines the covered benefits, the eligible employees and other terms that the employer is agreeing to provide to its employees. The employer should formerly adopt the Plan and tell the employees of its existence. The employee has the right to see a copy of the Benefit Plan Text and ultimately can enforce payment of benefits under its terms from the employer. For this reason, when it is announced to the employees or as new employees are hired, the employer may want to formally retain the right to cancel the Benefit Plan upon written notice to the employee. Once a Plan is cancelled no further liability accrues.

Bene-D-Duct is not a party to the Benefit Plan Text . It merely is the Plan Administrator, carrying out the administrative duties required under the Plan on behalf of the employer.

Bene-D-Duct has no contractual relationship or liability to the employees of the employer.

As the Plan Administrator , Bene-D-Duct and the employer sign what is called a PHSP Administration Agreement . This Agreement outlines the duties of the two parties, the administrative charges made by Bene-D-Duct , and other terms regarding the funding of the benefit cheques and other legalities. The Agreement includes a copy of the Benefit Plan Text as an Appendix since this describes the plan that is to be administered.

The duties of Bene-D-Duct are:
insurance Administer the Benefit Plan by promptly processing and paying valid benefits to the extent of cleared funding provided by the employer.
insurance Provide quarterly accounting reports of its administration.

The duties of the employer are:
insurance Notify Bene-D-Duct of any changes to the list of eligible employees or their eligible family members.
insurance Provide sufficient funding for the benefit cheques, the administration fees, and the applicable taxes (e.g. GST) to be paid.
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