Case Studies

There are many types of health and dental coverage strategies that Canadian companies utilize. Listed below are a few scenarios or Case Studies that explain how the Western Life Health Spending Account can be effectively used.

Your company does not have a medical or group benefit plan

The Western Life Health Spending Account can be used as a stand-alone plan or it can be used in conjunction with a traditional insured program of group benefits. As a stand-alone plan, each employee classification is assigned an annual reimbursement limit. Different classifications of employees (i.e. Executives, part-time staff, etc.) may have different reimbursement limits. Employees will be reimbursed for all eligible claims until they reach their assigned limit, at which point no further reimbursement will be provided. If there are unused balances in the employees accounts at year end they will be forfeited, or there is an option available to carry these amounts forward for one calendar year.

You already have individual health care coverage (ie. Blue Cross)

The Western Life Health Spending Account will enable reimbursement of health and dental expenses (or portions of unpaid claims) not covered by Blue Cross (or similar Insurance coverage). For example, your Blue Cross type plan may reimburse your dental expenses at 60% up to an annual total of $1,000. With the Western Life Health Spending Account in place, any dental expenses above the $1,000 annual limit, as well as the remaining 40% not reimbursed, could be claimed through the HSA. You can now effectively cover up to 100% of your family’s medical and dental expenses through your corporation.

You are covered under your spouse’s benefit plan

If your incorporated company implements a Western Life Health Spending Account, it will cover expenses either partially paid by your spouse’s benefit plan or disallowed due to plan design. In addition, you may cover your spouse so that any of his/her expenses, which may have been partially covered or disallowed due to plan design, are now 100% reimbursed. In this situation, you, your spouse, and your dependents would first process any claims through your spouse’s plan (attaching all the original receipts). Once the Explanation of Benefits Statement arrives from your spouse’s group insurance company, attach this to the Claim Form and remit to National HealthClaim Corp.

You are the sole employee of your corporation

An incorporated business with one employee (eg. Owner) can be set up with a Western Life Health Spending Account. In this instance, an executive class is formed and the “employee” and their dependents can claim all eligible health or dental expenses through the HSA, up to the annual maximum. The annual maximum HSA claim limit is recommended to be a reasonable amount proportional to your annual income.

You have many employees in your corporation

For companies with many employees, the Western Life Health Spending Account is an innovative solution to the challenge of providing cost-effective benefits to employees. The Western Life Health Spending Account can be structured to provide varying reimbursement limits to different classifications of employees (i.e. executives, full-time staff, etc.). These limits can be tailored to coordinate with your company's overall compensation philosophy. If your company has a traditional benefits program already in place, you can use the HSA to cover items not included in your insured program, such as orthodontics, laser-eye surgery, or cosmetic surgery. The Western Life Health Spending Account can even be used to cover items that are only partially covered by an insured program (because of co-insurance amounts or deductibles) to receive full reimbursement of these expenses.

You would like to enhance your company’s existing benefit plan.

If your company has a traditional benefits program already in place, you can use the Western Life Health Spending Account to cover items not included in your insured program, such as orthodontics, laser-eye surgery, or cosmetic surgery. Any items that qualify as medical expenses in the Income Tax Act will qualify for reimbursement under this Plan. The Western Life Health Spending Account can even be used to cover items that are only partially covered by an insured program (because of co-insurance amounts or deductibles) to receive full reimbursement of these expenses. Employees can even coordinate their HSA with coverage provided under a spouse’s benefit plan.