Cost plus benefit coverage

Group benefit plans provided by Sun Life Assurance Company of Canada include coverage for many medical and dental services. Reimbursement for these services is generally subject to some level of coinsurance and/or deductible, and there may be a maximum amount paid for certain services. In addition, there may be some expenses that are not covered under a group plan.

For unexpected medical expenses that are not covered under the group plan, plan sponsors can provide Medical and Dental Cost Plus Benefit Coverage (“Cost Plus”) for covered plan members and their eligible dependents to alleviate financial hardship. These expenses can be reimbursed on a “Cost Plus” basis if such expenses qualify as medical, dental or hospital expenses under the Income Tax Act (Canada).

The process is simple. The plan sponsor completes the Cost Plus claim form and sends it and the original receipts to the designated Sun Life claims office along with a cheque for the claim amount, administration fee and applicable taxes. Sun Life will process the request and issue a claim payment to the plan member.

To determine if Cost Plus benefit coverage is the right solution for your business, please seek the appropriate tax advice.