Private Health Services Plan |
Traditional Group Benefits Plans |
| No monthly premiums, No annual fees | Monthly premiums regardless of activity |
| No deductibles | Deductibles can apply to many categories |
| One time set up fee | Typical 80% coverage |
| No dispensing fee caps | Limits – ie. Dispensing fee caps |
| No RX required for Paramedical expenses | RX required for all paramedical expenses |
| Prescription Drugs –regardless of the Generic cost, the plan pays the out of pocket amount | Prescription Drugs are only covered at the cost of the Generic brand, not the true out of pocket amount |
| Pre-existing health conditions make no difference in regards to coverage | Pre-existing Health condition are typically not covered |
| Dental work expenses are paid as they are submitted, NO Estimates are required | Dental work expenses require an Estimate |
| Employee limit or category limit is up to Employer | Payments are based on “Reasonable and Customary” fee guides, employee is left paying the balance out of pocket |
See the full list of allowable medical expenses with a PHSP here.