PHSP’s

PHSPs (Private Health Services Plans)

Private Health Services Plans (PHSPs) offer an alternative method of providing medical and dental benefits for self-employed individuals, small business owners and larger sized businesses with several employees. PHSPs will cover virtually 100% of ALL medical and dental services performed or prescribed by a registered or licensed practitioner. You determine the extent of the coverage that you, your employees and their dependents require. Services that are ineligible through traditional insurance programs can now be included in your coverage such as vision and major dental that may have been very costly under another plan.

Medical and dental services are not “insured” products but are “fee for serviceproducts. This means that as a service is required or used by an individual, then the benefit is administered and paid for as opposed to paying for a service inside of a plan that may or may not be used. Health Risk Services Inc. (HRS) has the ability and the program design expertise to remove these benefits from traditional plans and create benefit programs that provide the following advantages:

  • Cost Savings: an estimated 25% – 40% savings can be realized over both the short and long term. A PHSPs administration fee is charged only when HRS processes a claim and this fee is significantly less than the cost to operate a traditional benefits plan
  • Complete Flexibility: the limitations and restrictions placed on claim eligibility by traditional plans is eliminated by a PHSPs design which allows for greater flexibility as to how employees can use the program
  • Complete Control of Expenditures: you determine how much and where you wish to allocate premium dollars in current and future years. Unused premium dollars at year end stay with you and your benefits account
  • Plan Design Incentives: attract and maintain quality employees with benefit program designs that meet specific needs and return claims and information quickly
  • Tax Free Benefits: all benefits received through a PHSP are tax free

An efficient, fully functional PHSP can be established in one of many ways. There are 4 main design structures to choose from:

1. Health Spending Accounts

2. Cost-Plus Expenditure

3. Traditional Plan Design

4. Combination – Integrates Components of any of the options above

Cost-Plus Design Example

Cost-Plus Design Example