A Health & Welfare account balance in excess of 36 months of the current year’s deduction amount to a maximum of 12 months of the current year’s deductions will be transferred to a Health Spending Account to be used to pay medical and dental expenses that are not covered under your Benefit Level 02, 03 or 04 Health Care & Dental Benefits, but are considered eligible expenses under provisions of the Income Tax Act. The Health Spending Benefit can be used to pay eligible medical and dental expenses for member and dependents.  

The Health Spending Benefit like almost all of our other benefits, is a tax free benefit providing that it is paid for by the employer through producer contributions. (the exception is in Quebec  whereby all benefits are considered taxable). As with all of our benefits, the Health Spending Benefit is regulated through the Income Tax Act, however there are available some additional benefit claim options that are covered through this benefit that are not covered in our regular benefit package.   

Examples of eligible expenses

Claiming The Expense

Health Spending Account Reductions

Allocation of Funds

Time Limitations

Examples of eligible expenses that can be paid are

a) Portions of claims not paid through Benefit 06 such as:

• The remaining % of eligible Health Care Benefit expenses and Basic Dental expenses you now pay

• Any or all of the % of Major Dental and % of eligible Orthodontic expenses you now pay

• Prescription or contact lenses, or frames expenses that exceed the dollar limit each 24 month period

• Licensed practitioner fees over $600 each year provided they would normally be covered

• Private hospital room expenses in excess of semi-private expenses

• Basic and Major dental expenses that exceed annual maximum per person or

• Orthodontic expenses that exceed the lifetime maximum for a dependent child

• Health Care Benefit expenses that exceed the maximum for members age 70 or over

• Drug dispensing fees are not eligible

b)        Alternate or “topping-up” of procedures such as crowns (where the dental benefit  may only reimburse for fillings), porcelain fillings, implants, orthodontic expenses for individuals age 19 and over and cosmetic dentistry.

c)        Some alternative medicine expenses for prescribed medications such as over the counter drugs, herbs, & homeopathic substances if prescribed by a licensed physician, dentist or medical practitioner and dispensed by a pharmacist; and for medical devices, aids and equipment not reimbursed under your Benefit Level. 

d) Laser eye surgery provided it is performed by a licensed physician.

Eligible expenses will not be paid automatically from the Health Spending Account.

• Claims for expenses in excess of the your current Benefit Level maximums to be paid from the Health Spending Benefit, must be submitted to Manulife. You can indicate on your dental, medical (health care) form if you wish to have any outstanding balance paid from your Health Spending Benefit.

• For other expenses not previously submitted, complete a claim form and submit to Manulife with original receipts.

Allocation of Funds

Any amount transferred to a Health Spending Benefit must be used for expenses incurred in the twelve (12) months immediately following the April 1 allocation of the funds to the account (Year 1). Unused funds will be carried forward for an additional twelve (12) months only (i.e., into Year 2) to be used for expenses incurred during Year 2.

Any funds that are carried forward, but not used within the time limits noted below, will be automatically and irrevocably forfeited by the Member and the funds will be allocated to the Health and Welfare Fund Reserves.

This is in accordance with the policies of the Canada Customs and Revenue Agency (formerly, Revenue Canada).

Time Limitations

Members have up to twelve (12) months immediately following the end of Year 1 in which to submit receipts for expenses incurred during Year 1 but which were not submitted during Year 1. Any claims for Year 1 expenses not submitted by the end of this twelve (12) month period will not be paid.

Any claims for Year 2 expenses which are to be paid with funds that were carried forward from Year 1, must be submitted for payment within 30 days after the end of Year 2.

Under the Income Tax Act, your Health Spending Benefit must be used within 2 years.  For example, if you qualify for this benefit April 1, 2007 , it must be used by March 31, 2009 .  Any amounts not used, or if you do not remain a member in good standing of I.A.T.S.E. Local 667 or 669, will be transferred back into the reserve fund.