Search
Close this search box.

How the Plan Works

Your DGC Benefits Plan provides you and your family with valuable, affordable mental and physical health coverage and financial protection if you experience an illness, injury or disability. In this section, we explain how the plan works and what’s covered under each level.

Healthcare Spending Account (HSA)

A key part of the DGC Benefits Plan is the HSA. It’s like a tax-effective bank account. You decide how much money to put in from your dollar bank, and then you spend it to help pay for healthcare expenses not otherwise covered by the DGC Benefits Plan.

How It Works

During each annual re-enrolment period, you can choose to transfer money from your dollar bank to your HSA. How much you transfer each year, if anything, is up to you — as long as you have the money available in your dollar bank to transfer. Keep in mind, however, that:

  • You can only transfer money to your HSA during the annual re-enrolment period, or when you have an eligible life status change.
  • Money in your HSA must be used to pay for eligible health and dental expenses — it cannot be withdrawn as cash.
  • Use it or lose it. When you transfer money into your HSA, you must use it within two years (a Canada Revenue Agency rule). Any unused amounts are forfeited back to the DGC Benefits Plan.

You can spend HSA money as you see fit. The only requirement is that you spend it on medical, prescription drug and dental-related expenses that are not covered under the plan (or any other private or government healthcare plan), but that are allowed under the Income Tax Act.

 

For example, if you buy a $500 pair of prescription glasses and the plan covers $300, you’d be able to claim the remaining $200 from your HSA — provided, of course, you have allocated that much to your HSA.

When deciding how much money to move to your HSA, keep in mind:
  • Your HSA can be used to offset the cost of a wide range of medical, drug and dental expenses not covered (or not fully covered) under your coverage level.
  • It may be more cost-effective to use your HSA to pay for uncovered expenses than it is to upgrade to a higher coverage level, depending on your benefit needs.
  • You can use your HSA to cover eligible expenses for you and your dependants — even if you do not have family coverage. Even better, when it comes to your HSA, the definition of eligible dependants is expanded.
  • Any money you deposit in your HSA in one plan year must be used by the end of the following plan year — otherwise it will be forfeited. For example, if you move money from your dollar bank into your HSA for the 2025 plan year, you must spend that money by December 31, 2026.
  • You cannot carry forward an expense from one plan year to the next. In other words, if you incur an expense in one year, you cannot use money deposited in your HSA for the next year to cover that expense.

For example, if you incurred an expense in October 2024, but don’t have enough money left in your HSA from your 2024 deposit to cover that expense, you cannot use money deposited in your HSA for the 2025 plan year to pay for it.

DEADLINES FOR USING MONEY IN YOUR HSA
ANY MONEY DEPOSITED IN YOUR HSA FOR THE PLAN YEAR…
MUST BE USED BY…
2024
December 31, 2025
2025
December 31, 2026
2026
December 31, 2027
2027
December 31, 2028

Any funds not used by the deadline will be removed from your HSA and used to offset plan costs. This use-it-or-lose-it rule is a Canada Revenue Agency requirement.

Eligible Dependants

When it comes to your HSA, the definition of eligible dependants is expanded. It includes your spouse and dependant children, as well as anyone who is recognized as your dependant by the Canada Revenue Agency. For example, a grandchild, parent, grandparent, brother, sister, aunt, uncle, niece or nephew of you or your spouse will qualify, provided they:

  • Are dependent on you for support, and
  • Normally live with you in Canada (unless away at school).
Eligible Expenses

The HSA covers a long list of eligible expenses as defined under the Income Tax Act. There are literally hundreds of eligible expenses, such as:

  • Dental work — everything from root canals to braces;
  • Hearing aids — including repairs;
  • Paramedical services — including the services of a massage therapist, chiropractor, acupuncturist, and physiotherapist;
  • Vision care — such as contact lenses, laser eye surgery, and even prescription sunglasses; and
  • Deductibles and co-payments under your health and dental coverage.

Keep in mind, however, that to qualify as an eligible expense, the service, procedure or supply in question must be provided or prescribed by a medical practitioner who is licensed according to the laws of the province in which he or she is practicing.

For a complete list of covered expenses, refer to subsection 118.2(2) of the Income Tax Act. Additional information on many of these expenses can be found in the Income Tax Folio S1-F1-C1: Medical Expense Tax Credit.

 

If you can claim an expense under another plan (such as the DGC Benefits Plan, your spouse’s benefits plan or a government drug plan), you may want to do that first before submitting your claim under the HSA.

HSA Claims

Eligible HSA expenses must be received by Canada Life within 180 days following the end of the plan year in which the expense was incurred. If your DGC Membership and health coverage ends because you resigned or were terminated, after your coverage end date, you have 90 days to submit your HSA expenses for reimbursement.

 

For example, if you incurred an eligible expense in October 2024, you must submit your claim by June 30, 2025. Only money deposited in your HSA for the 2023 and/or 2024 plan year can be used to pay that claim — money deposited for the 2025 plan year cannot be used.

 

Keep in mind that the deadlines for HSA claims are different (and shorter) than the claim deadlines for the DGC Benefits Plan’s health and dental coverage.

YEAR EXPENSE INCURRED
THIS EXPENSE CAN BE PAID USING MONEY DEPOSITED IN YOUR HSA IN…
THE DEADLINE FOR SUBMITTING THE EXPENSE TO CANADA LIFE IS…
2024
2023 & 2024
June 30, 2025
2025
2024 & 2025
June 30, 2026
2026
2025 & 2026
June 30, 2027
Tax Advantages

In addition to reducing your out-of-pocket expenses, using the HSA can help reduce your tax hit (see example below).

 

This is because you don’t pay income tax on the money when it is deposited or when it’s claimed from your HSA. That can make a huge difference in how much money you have available to spend on health and dental-related expenses.

 

For those of you who live in Quebec, the tax rules are a bit different. Any amounts claimed from your HSA will be considered a taxable benefit. You’ll sidestep the federal tax hit, but provincial income tax will apply.

 

The bottom line is that the HSA offers you a clear tax advantage regardless of where you live in Canada.

Example: The HSA tax advantage

 

Let’s say the dentist tells you that you have two cavities that will cost $500 to fill. If you have Level I coverage, the cost of filling those cavities won’t be covered under the plan. That means you have two options:

 

  1. You can pay the cost using $500 in pre-tax money from your HSA.
  2. You can pay the cost out of your own pocket. If you pay out of pocket, you’ll be using after-tax dollars. Assuming a 22% marginal tax rate, you would have to earn $640 to have enough after-tax dollars to pay the $500 dentist bill.
TIPS FOR YOUR HSA
  • Target specific expenses when deciding how much to move to your HSA during re-enrolment each year.
  • When you submit other claims, select the box to cover any uncovered amount through your HSA.
  • Always check your unused amount before allocating more next year, then use it before it expires.
  • Be sure to take advantage of coordination of benefits before using your HSA.
Search
Close this search box.