User guide · Employers, benefits administrators and employees approaching a plan-year or coverage change.
Manage unused allowances and claim deadlines
Under Pay-As-You-Use, an unused allowance is not a paid claim or a claim-based administration fee. Keep that entitlement separate from deposited cash, then use your plan’s coverage dates, submission deadlines and carry-forward rules to close the year correctly.
Before you start
- Your accepted plan year, eligibility dates and claim-submission terms.
- The employee’s allowance, claims already reimbursed and any documented carry-forward.
- Your selected funding arrangement and current deposited-fund records.
At a glance
Three dates control the claim journey
Coverage period
Determines which expense dates can qualify.
Submission deadline
Determines the final date for sending the claim.
Carry-forward expiry
Applies only if the plan permits credits or eligible expenses to carry forward.
Separate the allowance from deposited funds
An allowance is the employee’s limit for eligible reimbursements. It is not automatically money transferred to the employee or an amount already spent by the business. A funding deposit is cash provided to support reimbursement and agreed charges; it is accounted for separately.
For example, assume an employee has a $2,000 allowance and receives $600 in eligible reimbursements. The remaining $1,400 is unused entitlement. Under Pay-As-You-Use, that unused entitlement is not itself a reimbursed claim or a 10% administration-fee trigger. Any cash already deposited remains subject to the funding agreement and outstanding obligations.
- Record allowance, reimbursements and deposited cash as separate figures.
- Do not promise a cash payout or refund solely because an allowance remains unused.
Write down the coverage and submission dates
Check the plan’s actual coverage period; it need not match the calendar year. Then record the final submission date, including any documented run-out period. A run-out permits later submission of qualifying earlier expenses; it does not automatically extend coverage for new expenses.
For a departing employee, confirm the coverage end date and the final submission deadline separately. A later claim deadline does not necessarily mean the employee remains covered until that date.
- Check expense dates against coverage and employee eligibility.
- Check submission dates against the applicable deadline.
Confirm the permitted carry-forward method
Read whether the plan permits unused-credit carry-forward, eligible-expense carry-forward or neither. These are different arrangements: one carries an available allocation; the other permits an otherwise eligible unpaid expense to be considered against a later allowance.
CRA’s archived interpretation bulletin IT-529, paragraph 16, describes carrying forward either unused allocations or eligible medical expenses, not both, for a maximum of 12 months without disqualifying a PHSP solely because of that provision. This is archived interpretive guidance, not legislation or a promise that every plan offers 12 months. Other PHSP requirements still apply.
- Use your plan’s actual method and expiry, which may be shorter or provide no carry-forward.
- Keep enough detail to distinguish current-year and carried amounts.
Send a clear employee reminder
Give employees the coverage period, final submission date and any carry-forward method and expiry in one message. Include the required receipt information and the instructed claim route. Resolve unclear dates with your administrator before communicating a deadline.
- State whether unused entitlement expires or may carry forward.
- Identify a contact for individual eligibility or employment changes.
Apply the dates to a claim
This hypothetical example uses a January-to-December plan, a March 31 submission deadline for the previous year’s expenses and no unused-credit carry-forward. These dates illustrate the distinction; they are not Wellbytes’ default rules.
| Situation | Treatment under this example |
|---|---|
| Dental care on December 15, submitted February 10 | May use the previous year’s remaining allowance if eligible and documented. |
| New care on January 15 | Belongs to the new coverage period; the old submission deadline does not make it a previous-year expense. |
| Unused entitlement after the plan’s expiry | Does not become an employee cash balance. Deposited funds are handled under the funding agreement. |
Reconcile the plan-year close
Match reviewed claims, reimbursements and available balances before closing the year. Preserve the employee reminder and documented decisions with the plan records. Cancellation of Wellbytes’ administration agreement has separate processing and settlement terms from an employee leaving; check those terms before promising further claim processing.
Before you finish
- Coverage and submission dates are recorded separately.
- Any carry-forward method and expiry match the accepted plan.
- Unused entitlement and deposited cash are reconciled separately.
- Employees have received the correct deadline reminder.
Resolve a problem
| What you see | What to check |
|---|---|
| A claim arrives after coverage ends. | Check when the expense occurred and whether the plan permits submission during a documented run-out period. |
| A balance appears available after year-end. | Confirm whether it represents current allowance, permitted carry-forward or deposited funds before using it. |
| The documents do not show an expiry. | Ask the administrator to confirm the accepted rule before representing the amount as available. |
