Coordinating your Health Care Spending Account (HSA or HCSA)

We have more and more clients using HealthCare Spending Accounts (HSA or HCSA) each year.  This is a valuable benefit which has lower administrative costs than traditional benefits, and provides great flexibility to employees and their families.

In order to ensure your employees HSA is best utilized, it makes sense to coordinate usage with spousal benefit plans.  (If you are single, or don’t have spousal benefits, you can ignore this post).  The document below provides a simple example of how this process works.  Depending on the provider (insurer or TPA) you use, claims may be handled in slightly different manners, but the general order of operations shown below apply.

If you’re interested in adding an HSA to your plan, or have one and would like to increase your HSA annual limit, let us know and we can make it happen.  Most plans work on the calendar year, so there is lots of time to discuss before make changes for 2025.  Starting an HSA can be done at almost any time.

A 5-Step Guide On How To Legally Terminate An Employee

I think this is a pretty great and quick read about how to do handle termination correctly and items to keep in mind.

If you’re a Mainstay client, we have HR resources to help you with templates, policy and handbook samples etc. Our new HR ON CALL offering (paid by us) is even more timely and can be used to schedule a call for things like this.

Reach out if you’re not already signed up.

HR Resources

With employers across the country terminating employees en masse, it is important to understand how to approach terminations in a lawful way. This article sets out a five-step guide that any employer or human resource professional can follow when broaching the topic of termination.

  1. Identify the “Why”
  2. Understand Your Severance Obligations
  3. Prepare Termination Documents
  4. Conduct the Termination Meeting
  5. Issue Payments and the Record of Employment

MAINSTAY CLIENTS – Free HR just got better with HR on Call

Good Morning,

I’m excited to let you know that we’ve expanded our free HR offering.  

In addition to access to the HR Toolkit for Small Business – an online self-serve HR portal – we’re now offering an HR on Call service as a pilot over the next 2 months at which time we will assess uptake.

And we’re picking up the tab! It’s completely free for all Mainstay clients.

We recognize that while a DIY HR solution provides value, you sometimes need to get your questions answered by a professional HR Advisor.  

  • The HR on Call program will launch Monday March 18 and will be available between 9:00AM and 3:00PM EST.
  • You’ll need to sign up for the HR Toolkit to get access to HR on Call.
  • Your Program Code is CB10021.

Click here to find out more and sign up.

We are continuously working to add value to our clients and hope you’ll take advantage of this exclusive offer. 

If you have any questions at all, please let me know and I would be happy to help.


Working to improve the industry

I am asked to share my industry knowledge with; industry think tanks, insurers and TPA’s, associations, and advocacy groups throughout the year.  We are involved in, and share, through surveys, panels, advisory boards, helping write (or participate in) articles and research by dozens of organizations each year.

We participate in order to give back and try to make the industry better for our clients, but also for other stakeholders.  They come from across the country, and can include; patient groups, insurers, TPA’s, advisors and others that are in the benefits marketplace.  This is a great way for advisors to learn from others across the country, and with those that work with different size clients and varying industry sectors.

This recent event (featured below) had several great presenters sharing useful information with those in attendance.  In return, we shared what we encounter with clients, feedback about programs and sometimes discussions around the lack of solutions.  

The article below was featured in HR Reporter magazine.

MAPOL AND H3 CONSULTING co-hosted a meeting with 12 leading benefit advisors from across Canada, who collectively manage life and health plans for hundreds of employers. The event was sponsored by five pharmaceutical manufacturers. The purpose of the meeting was to exchange information and ideas on how plan members experience their benefit plans in three key areas – fertility, vaccines, and the effects of drug-claim pooling on access to high-cost drugs. National pharmacare was also discussed, given its potential to disrupt drug benefits in the mid-term. All topics generated significant and insightful discussion.

Don’t forget about box 85 when doing T4’s (if you share health and dental costs with staff)

I try and include this reminder in my newsletter and/or blog post each year…so this is a repeat…

As employers prepare T4’s, they can make like a bit easier for staff.  By reporting the employees contributions to the health and dental premium in Box 85, you are helping staff make sure they get the medical Expense Tax Credit (METC) where available.  This avoids employees being audited for proof of contributions (and you having to write out letters for them). 

You can find more about the history of box 85 and it’s intent here…

The CRA info is below, or ask your accountant.

Canadian Dental Plan update

We’ve been getting calls and notes from clients about the new Canadian Dental Care Plan (CDCP).  The reason for them generally fall under 2 categories…

  1.  How to code T-4’s as s required this time of year.  You can find info on our past blog posts here…

Canada is rolling out its dental care program. Here’s what you need to know

2. Can/Will the CDCP replace our dental benefits?  It us highly unlikely unless you want your employees to have a much reduced (or no) benefit.  So far we have identified a few issues.

  1. Most employees will not be eligible until the final phase launching in 2025
  2. Many employees will be prevented from using the plan due to the household income test
  3. Most dentists are NOT expected to sign up to provide service.  In fact, many of the provincial dental associations are advising not to sign up for the national plan.This means patients may have to search out a new dentist.
  4. The funding model has now been released and shows the dentists would be paid up to 40% less than a regular patient, so a big part of the cost is being paid for by dentists, not just the government.  I grabbed a few often used codes and compared to the last ODA fee guide I had (and adjusted for inflation) to check this.

Code 11111 scaling – Private plan would pay ~ $71.63,  CDCP would pay $63.00 –  12% LESS     

Code 02111 x-rays –  Private plan would pay ~ $38.66,  CDCP would pay $29.08 – 25% LESS

Code 21114 filing – Private plan would pay ~ $365.00,  CDCP would pay $209.54 – 41% LESS

5. The co-insurance on most private dental plans is 80%.  The CDCP varies based on income from 100% (household income of <$70k) down to 60% (household income of $70-80k) and even 40% (household income of $80-90k) before disallowing access.  This will provide substantially lower coverage for many employees.
6. At this point, the government has said they will NOT integrate the federal plan with private plans, so this is really only intended for those with no coverage.
If you’d like to discuss any part of the program, the implications to employees or employers, or jsut get a better understanding, please give me a call.
Dave 905-886-9203

CRA clarifying how employers must determine province of employment for remote workers

Since the pandemic started we’ve had employers (and advisors) reaching out for help in handling remote workers.  This usually starts around a benefits question (if the employee is in another province or country, how does emergency travel work?), and then gets more complicated quickly (taxation, safety, tech issues etc.).

This is still a very complicated issue and several professionals will need to be consulted before allowing employees to work abroad for anything more than a short time.  CRA has provided a bit of clarity in the article below.

If you need assistance with remote workers, please reach out and we can try to assist.

The Canadian Revenue Agency is providing guidance for employers to determine the province of employment for full-time employees who are working remotely.

Invitation to Mainstay Clients to attend events at NO COST!

As a Mainstay Insurance Brokerage client, you get some perks of my work within the industry.  One of those is free attendance at Canadian Group Insurance Brokers educational events (the association I started in 2003). 

We have two events in Vaughan (Hwy 400 and 407 area) coming up in May and June. Both are full day events aimed at benefit advisors, insurers, TPA’s and others in the industry, so you get  “fly on the wall” inside perspective.  These are a great way to increase knowledge, and if you’re in HR even get education credits.

The first, on May 8th, has a number of speakers including a discussion around renewals, and an employer panel sharing their stories, needs and expectations of advisors and insurers.  Details are HERE.

The second, on June 19th, is a smaller workshop on Building and using a benefit plan administration checklist.  As a client you’ve had this checklist explained to you (if not, come out for sure) and had it included in every years renewal package.  This workshop gets into the legal cases, taxation issues, areas of risk and employment/HR issues that employers see every day.  Details are HERE.

If either of these events are of interest and you can spend the day with us, please let me know and I’ll book a spot for you free of charge.

Special Note:  If you have HR consultants, friends, and/or business associates (best if they have a plan or want to start one) that may want to learn more about benefits, please feel free to share the info and have them reach out to me.  We find many are trying to find an advisor that specializes in benefits and don’t know where to turn.  I may not add too many new clients a year, but the room will have some great ones that can help, if I can’t.

Dental Fee guides out for the country…

Each year the provincial dental associations release their fee guide adjustments (see 2024 below).  Last year Ontario saw the largest increase in 25 years at an 8.5% increase.  Things have settled for 2024 at 4.8% but still the second highest I can recall in my nearly 28 years in the industry.  This is also more than double the annual trend we’d seen over the decades.

The fee guide increase is what drives the inflationary portion of claim costs.  This means that if your employees paid $100 for a service last year, the same service will cost $104.80 this year (on average – some codes are higher and others lower).  On top of that we also have trends and utilization that increase the final cost.  These are the effect we see over time for patients going into the dental office more often (like cleanings ever 3 months instead of 6) and for more things (like scaling units).  All put together we may see overall average increases of 7.5%.

Drug Access Navigators (DANs) take key financial stress away from patients

In the past, we’ve shared information about healthcare navigators (like Ray Rupert below).  Navigation experts can help with complicated health issues and assist in gaining access and resolving situations by acting as your advocate.

Raymond Rupert  – RCM Health Consultancy Inc.  – 647 350 5500 ext 105  – – 

Navigators are often used in speciality clinics to help obtain access and funding for high cost speciality drugs, and used to access testing and services as well as second opinions.  The article below shares how they may also be used when it comes to cancer treatment.

Drug Access Navigators help people with cancer get financial support for treatment and almost every cancer clinic in Canada has one.

Drug Access Navigators (DANs) or Medication Reimbursement Specialists (among other similar titles) are a critical part of the healthcare team, helping connect patients with cancer with financial support for their medications.
This means assisting them with applying for approval from a private drug plan or making an application to a government program; getting authorization from the provincial or federal government for a medication; or filling in the financial gaps where private or public plans don’t fully cover a drug’s cost.