We're a Canadian company, with a product for Canadian companies. Our plan was designed from the ground up by a highly experienced Canadian Benefits Consultant because no other solution addressed his clients' needs. It's been available since 2007. See here for our story.
Say an employee goes to the dentist, and incurs a bill for $500. After paying the dentist the $500, the employee sends us a claim for $500.
We review the claim per tax rules to determine what is eligible. We invoice your company for the approved amount, eg $500, plus a 10% admin fee on the approved amount ($50) plus GST/HST on the admin fee (eg $2.50). We'll then pay the $500 out to the employee.
The employee gets the $500 tax free; and your company expenses the $550 + $2.50 GST/HST.
They'll get back hardly anything. See here why.
It can be far cheaper and offer better coverage. See here why.
Send your claims to them first. Typically, there will be left-over expenses they won't pay fully. You can claim those from your company through PreTax Health! Also, if you have to pay personal premiums out of pocket, you can often claim those too. Here's more info.
When after-tax remuneration is used to pay medical expenses, it's as good as paying a 40%+ "handling charge" to the CRA (irrespective your tax rate) -- so using PreTax Health is a substantial savings! Here's an example, and here's another. Without PreTax Health, your company may be losing $2 to $4 per day per person, that it could be saving.
Your company decides. Your company sets up employee categories, with spending limits for each category. So it's quite easy to arrange that classes of employes will only have spending limits of $500, or $1000, or $5000 -- it's up to the company.
Your company can do this all on line, and get live reports showing the spending limit for each employee and the total budget for the company.
Bear in mind this is not "real" money -- this is only a limit that says how much the company is willing to reimburse per employee. It's only when employees submit claims that the company needs to send in real money, and only enough to actually pay the claims and the admin fee.
We ensure the entire plan is legal and above board. We must review each claim to make sure the claimed expenses are eligible according to the CRA rules. Companies can't do this, because there are privacy issues for a company to see the medical expense details of employees. We also track everything to make sure that employees can't get reimbursed more than the company has budgeted for them; and everybody gets live reports on the precise status of everything.
Bear in mind that even with a 10% admin fee your company will still easily save $2-$4 per person per day, because the alternative is paying a 40%+ to the CRA (even if your tax rate is far lower), as can be seen here.
Some charge more, some less. Generally, those that charge less won't give you even half of what we do. For example, you'll typically have a far larger admin burden, you won't have live reports, and you'll lose a lot of the assurance that the plan is actually run legally and properly.
Many providers will also charge you fees to set up the plan or to add employees to it.
Everything's on line. Your company logs in on line to administer the plan, and employees log in on line to file claims, see their claims history, and much more.