Services Insured by the Régie de l'assurance maladie du Québec

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A private health services plan provides coverage that may or may not be backed by an insurance contract.

Coverage backed by an insurance contract

If coverage under a private health services plan is backed by an insurance contract underwritten by an insurance corporation, exclude the portion of the premium paid for an individual that reasonably represents the cost that would be paid by the Régie de l'assurance maladie du Québec (RAMQ) for equivalent services insured under the Health Insurance Act.

Reduction of the premium paid for the individual

However, if, for a given period in the year, an individual is not subject to the Health Insurance Act (as in the case, for example, of an employee posted outside Canada), and if the private health services plan provides benefits and coverage that include at least all of the services for which the individual would be covered under the Act if he or she were subject to its provisions, subtract the prescribed amount from the premium paid for the individual for coverage during the period in question and reduce the related tax on insurance premiums accordingly.

The prescribed amount is obtained by multiplying $2.74 (for individual coverage) or $10.96 (in all other cases) by the number of days in the period concerned.

Coverage not backed by an insurance contract

If coverage under a private health services plan is not backed by an insurance contract underwritten by an insurance corporation, you must, in determining the value of the individual's coverage, exclude from variable A the amount of benefits that can be considered to relate to the cost that would be assumed by the RAMQ for services insured under the Health Insurance Act.

Reduction of benefits

However, if for a given period in the year an individual is not subject to the Health Insurance Act (as in the case, for example, of an employee posted outside Canada), and if the private health services plan provides benefits and coverage that include at least all of the services for which the individual would be covered under the Act if he or she were subject to its provisions, subtract the prescribed amount from the individual's total benefits (variable A) for the benefits and coverage in question and reduce the related tax accordingly.

The prescribed amount is equal to the total of the amounts obtained by multiplying, for each such individual, $2.74 (for individual coverage) or $10.96 (in all other cases) by the number of days the individual is in this situation and benefits from the specific type of benefits and coverage in question.

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