What’s the problem and what can be done?
Parents with “special needs” children encounter significant challenges in covering the cost of various therapy services required by their children. Many are forced to take out additional mortgages or loans against the equity in their homes, or borrow from family and friends. Most service providers have no idea of the level of indebtedness of their typical client and do not appear to care. Employer or Individual health insurance plans provide very limited relief as they have “defined benefit” maximums that often limit the benefit payable to perhaps $500 per eligible practitioner per year.

Isn’t there some kind of tax relief available?
Until now, very little, unfortunately. The parents of special needs children typically claim their expenses utilizing the standard Medical Expense Deduction and the Disability Amount Tax Credit on their personal Income Tax Return and receive only a Tax Credit, not a 100% tax deduction from their taxable income!

What’s the answer?
Clearly, an alternative approach is required and the best solution is proving to be the enVia Health Spending Account Program. The eHSA program offers a cost and tax-effective solution that can provide coverage with 100% reimbursement, limited only by the amount of the account contributions per year (made on a monthly basis). So, for example, the parents of an autistic child can claim the cost of the child’s therapy / tutoring (which can easily run $50,000 or more per year) as a qualifying medical expense.

And because the eHSA works essentially like a “medical & dental bank account” participants can use it to claim a wide range of medical, dental & other expenses that are simply not covered or severely limited by a typical group insurance plan. See what’s covered by a Health Spending Account.

Who qualifies for the eHSA Program?
The enVia Health Spending Account Program is best suited to the following:

• Business Owners, their families and their employees;
• Incorporated self-employed entrepreneurs;
• Sole Proprietors (subject to CRA deduction limits)
• Employees (who work for a “flexible” employer - learn what this means here)
• Employer Groups, but on an individual basis

A real-world alternative to Traditional Insurance
Health Spending Accounts (also known as HSA’s) have become an increasingly popular means of providing Medical and Dental benefits protection because they offer many advantages to the self-employed as well as employers and employees over a traditional group insurance program. 

Simply put – an HSA is equivalent to a “medical & dental bank account” established by the employer for each employee. Participants submit claims for reimbursement from their individual account. Each employee, or class of employees, is designated an annual spending limit that can be claimed until the maximum is reached. As an option, some plans offer Catastrophic Insurance protection on top of the amount contributed to the HSA.

The HSA operates on a “Policy Year” basis. Prior to the start of each policy year the contributing “employer” (or yourself if self-employed) determine how much to contribute to cover their employees’ anticipated medical expenses for the following year.  This amount can range from as little as $1,000 per year up to $50,000 or more.

What are the key features of an enVia eHSA?

• Not a traditional insurance plan, rather a tax-deductible “private health services plan” allowing you to write off your health & dental expenses
   
• Much wider range of claimable expenses
   
• No wasted premiums - you only pay for the health & dental benefits you actually use
   
• Pay-Direct drug & dental car included at no extra charge for efficient, speedy claims payment
   
• automatically includes “Catastrophic Insurance” to cover any sudden, unanticipated expensive claims for prescription drugs, hospital or private duty nursing
   
• advance ruling from CRA confirms eligibility of special therapy expenses as typically encountered by families of “special needs” children

A tax break that actually amounts to something:
A “Health Spending Account”  is a vehicle permitted under the Income Tax Act which qualifies as a “private health services plan” described in Revenue Canada’s Interpretation Bulletin IT-339R2. It enables employers (or incorporated self-employed entrepreneurs) to cover employees’ eligible medical and dental expenses as defined under Section 118.2 (2) of the Act and in Interpretation Bulletin IT-519R2.  Net funds contributed after the administration fee may be used to pay for any eligible medical or dental expense.

It is not an “insurance plan”, rather a unique tax sheltered approach that individuals can use to control the cost of medical and dental benefits. “Employees” cannont contribute directly to the eHSA per CRA rules and that is why the contribution must be made by and “employer”.

It can be used by self-employed individuals and contract employees to secure medical and dental benefits in a more cost-controlled manner, and to avail themselves of a much wider range of claimable benefits.

What expenses can you claim from your eHSA?
Probably a lot more than you’d think, and definitely a lot more than any traditional group insurance plan. Here’s just a partial list of eligible expenses (including your dependent’s expenses) as defined in the Federal Income Tax Act, and notice how you can claim expenses not reimbursed under other medical and dental plans because of deductibles, maximum limits and co-insurance:

By now, you probably have some questions!
For most people, the enVia Health Spending Account Program represents a new way of covering your Health & Dental Expenses, and you likely have questions about how it can best work for you. We’re here to help and will be pleased to offer any assistance you require in setting up an eHSA Program that meets your family’s needs:

Learn more about the enVia Health Spending Account Program

View the Frequently Asked Questions about the Program

Contact Us for additional information and assistance