PPE COVERAGE UNDETERMINED

Benefits & Pension Monitor

PPE COVERAGE UNDETERMINED

As things start to slowly return to a new normal, services such as massage, dental ,and other medical services are starting to open up. With this increased usage comes claims, says Dave Patriarche, president of Mainstay Insurance and founder of the Canadian Group Insurance Brokers (CGIB). And with the increase in claims, questions are arising about COVID surcharges. While organizations like the Ontario Dental Association (ODA) have added PPE (personal protection equipment) codes to their fee guide in preparation for the expected increased costs being borne by their members, the Canada Revenue Agency (CRA) has yet to determine if the claims for these can be reimbursed by employer benefit plans. Generally, he says, extra charges over the reasonable and customary (R&C) fees and over provincial dental fee guides are not eligible for reimbursement by plans. This is to protect benefit plans from abuse and overcharging, thereby keeping them affordable. Currently PPE is not an eligible medical expense so CRA would need to make some changes before plans would be allowed to pay. It is not as simple as asking for an exception, or running all of these amounts (if over 10 per cent of spend) through an healthcare spending account, as it could be offside and potentially make plans taxable, he says. What is needed is some clear direction.