Cost Plus
Service & Administration Agreement
Carefully read this agreement, complete the form, and press "Send." A Cost Plus representative from our "Administrator" Benefits by Design (BBD Inc.) will contact you.
What is the Administrator's Fee?
10% of all Claims Paid "Fee". The minimum administrator's fee is $25.00. The maximum administrator's fee is $300.00.
Are there any other taxes?
Where applicable, Good's and Services Tax (GST) and/or, Harmonized Sales Tax (HST) and/or Provincial Sales Tax will be added to the Administrator's Fee.
What is the start date of the plan?
The Administrator and the Policyholder agree to establish and administer the Private Health Services Plan ("Plan") on the term's specified.
What are the terms of agreement?
The agreement will commence on the effective date and will continue for a one-year period. This agreement shall be automatically renewed. (Enter your desired 'effective date' in the form below.)
1. COVERAGE:
The Plan covers all hospital, medical and dental expenses of the Insured ("Claims") that qualify as such expenses under The Income Tax Act of Canada ("ITA") and are not prohibited by law. *Coverage is only offered to registered companies. Sole Proprietorships are not eligible.
2. CLAIM APPROVAL AND SUBMISSION:
The Administrator, on receipt of a claim from an employee of the Policyholder, shall determine whether the claim is for an expense covered by the Plan. In order to be eligible for payment, expenses must be incurred during the current or preceding calendar year. Claim Deadline: March 31st of the second year. (i.e. expenses for 2006 must be submitted before March 31, 2008)
3. CLAIMS AND FEE PAYMENT:
Upon receipt of an eligible claim, the Administrator shall issue payment for the Claim by cheque directly to the individual Insured and shall provide notification of such payment to the Policyholder. The Administrator may deduct the Fee from the Contributions at the time the cheque for the Claim is issued.
4. TERMINATION PRIOR TO THE TERM DATE:
The Administrator or the Policyholder may terminate this Agreement on 30 calendar days written notice to the other at the address indicated.
5. TAX TREATMENT:
The characterization of the Contributions and the Claims paid under the ITA is a matter to be assessed solely by the Policyholder. The Policyholder should consult an accountant about tax treatment and CRA guidelines. The Administrator is not legally responsibility for any and all claims that are not accepted by CRA.
6. GENERAL:
If any provision of this Agreement is found by a court of competent jurisdiction to be unenforceable then such provision shall be severed and the remaining terms and covenants shall be unaffected and enforced to the greatest extent permitted by law. No amendment of the Agreement shall be valid unless in writing and signed by the Policyholder and the Administrator.
The Summary forms part of this Agreement.
List Eligible Employees: _______________________________________________________________________________________
(e.g. "Management" or "All Employees")
Names of Eligible Employees Occupation
