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The answer will depend on several factors, including whether you have an employer-sponsored health insurance plan or are self-employed and buy your own health insurance. With an employer-sponsored ...
A self-funded plan has fixed components similar to an insurance premium; but in contrast, the self-funded plan pays the claims incurred by the plan participants, and the employer's risk is not capped. Even with stop-loss insurance, the employer still retains one hundred percent of the risk of claims payments in a purely self-funded scenario.
The plan is entirely self-directed, including its initial setup and compliance with the plan thresholds. The plan enables a participant dual to fund a tax-exempt account for medical expenses incurred before an associated 'high deductible' insurance plan begins to cover those expenses.
Qualified claims must be described in the HRA plan document at inception: before reimbursing employees for the medical expenses. Arrangements (medical services, dental services, co-pays, coinsurance, deductibles, participation) may vary from plan to plan, and an employer may have multiple plans in place, allowing much flexibility.
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Self-insured Private Health Services Plans are often referred to as Health Spending Accounts. The Canada Revenue Agency states that Self-insured Private Health Services Plans (Health Spending Accounts) are NOT AVAILABLE to any self-employed unincorporated employers without arms-length employees. Their only option is an Insured Plan with an Insurer.
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