Terms and Conditions of Your Health Plan

Last modified: January 16, 2024

Our Services


  1. Services Provided: Coastal HSA provides an application for businesses and organizations to manage their employee’s health benefits. Coastal HSA shall provide the Client with administration of Health Spending Accounts, including claims adjudication and reimbursement payment services, in accordance with the terms and conditions of this Agreement.
  2. Coastal HSA as the Administrator: The Company appoints Coastal HSA as the administrator of the plan sponsor’s Health Spending Account (HSA). Coastal HSA agrees to act as the administrator in accordance with the provided terms and conditions to perform the plan services, including administrative and claims services.
  3. Use of Coastal HSA Technology: Coastal HSA provides the Company with access to the HSA platform and client services portal through its web application. The Company will be granted access solely for the purpose of receiving services during the term of this contract.
  4. Establishment of the Plan: Pursuant to section 248(1) of the Canadian Income Tax Act, Coastal HSA will oversee the creation of a PHSP (commonly known as a health care spending account or private health services plan. Coastal HSA commits to compensate the covered member(s) of the plan holder for all eligible medical expenses covered under the plan. Coastal HSA agrees to remit and record GST paid on your behalf. Client accounts must remit to Coastal HSA the total claimed amount, along with all taxes and admin fees payable.
  5. Eligibility: Corporations and un-incorporated businesses with at least one arms-length employee are eligible. These plans cannot be exclusively for shareholder/owners unless they also function as employees earning T4 income. All employees added to a health spending account must be actively engaged in business activities on a regular and ongoing basis, except for those on temporary leave.
  6. Claimable Expenses: Coastal HSA plans encompass all eligible medical expenses as defined in subsections 118.2(2) and 248(1) of the Canadian Income Tax Act.
  7. Currency: All payments under this agreement will be in Canadian dollars
  8. Plan Members: Coastal HSA plans include all covered employees added by the Company.
  9. Plan Limits: Each member of the Company may be offered varying limits under the plan based on metrics decided by the business owner and/or the signing officer. The benefit limit should be reasonable, considering the employee’s income and position within the company, typically ranging from 10% to 18% of the employee’s income.
  10. Plan Structure: The Company establishes a start date upon the acknowledgment of legal terms and checkbox agreement, which concludes no later than 12 months following the start date, renewing annually.
  11. Employee Shareholders: Individuals serving as both employees and shareholder/owners can receive benefits under an HSA. Benefits conferred to shareholders must be comparable in nature, amount, and cost-sharing ratio to coverage given to non-shareholder employees performing similar services and responsibilities. Participation must be open to all employees, including those who are not shareholders and/or not at arms length.
  12. Claim Adjudication and Reporting: Coastal HSA will adjudicate all claims, remit necessary taxes based on the client’s province, and issue reimbursement payments for the total cost of eligible expenses to the claimants.
  13. Accuracy of Submitted Records: Coastal HSA requests electronic receipts for submitted claims and will use professional judgment to ensure supporting documents reconcile and match the claim submitted. Coastal HSA will not be held responsible for claims resulting from the submission of doctored or fraudulent documents.
  14. Standard of Care: Coastal HSA commits to exercising its responsibilities as the plan administrator carefully and diligently, employing qualified personnel, and providing necessary administration and support to its employees.
  15. Confidential Information: Coastal HSA treats all employee and medical information as sensitive and confidential personal information. Services are provided in accordance with its privacy policy, and applicable laws and industry standards are followed.
  16. Information to be Provided by the Plan Sponsor: The Company will provide Coastal HSA with the information necessary to perform its obligations under this contract, including the allocation of plan credits for each employee.
  17. Legal and Financial Liability: Coastal HSA does not insure or underwrite the plan. The Company retains legal and financial liability for paying benefits under the plan. The Company will indemnify Coastal HSA against any damage, liability, fines, penalties, interest, and expenses resulting from claims or disputes unless arising from negligence or willful misconduct by Coastal HSA.
  18. Amendments to the HSA: The Company is responsible for making changes to the plan, including adding/removing employees and adjusting/altering plan limits.
  19. Service Fees and Expenses: The Company will pay Coastal HSA service fees and expenses for performing the services under this contract.
  20. Term: This contract is effective from the date the HSA is implemented and will renew annually unless terminated by either party.
  21. Termination: The contract may be terminated by the Company with written notice, and by Coastal HSA if the Company fails to satisfy Coastal HSA’s terms and conditions. If a law prohibits the continuation of the contract, termination will occur automatically in that jurisdiction.
  22. Residual Effects of Termination: Provisions of this contract will survive until the final payment is made. Coastal HSA will not assess or pay any claims received after the effective date of termination.
  23. Notices: Notices will be deemed fully given if delivered personally or sent by post office, mail, email, or courier to the addresses provided.
  24. Records and Files: With appropriate authorization, Coastal HSA will make available personal information to the Company related to the HSA on reasonable notice.
  25. User Accounts: To use the Services, you must create a user account with Coastal HSA. You are responsible for maintaining the confidentiality and security of your account information and passwords. You are also responsible for all activities that occur under your account. Coastal HSA reserves the right to suspend or terminate your account at any time if we have reason to believe that you have violated this Agreement or any applicable laws.
  26. User Data: You acknowledge and agree that Coastal HSA may collect and use data related to your use of the Services. We will only collect the minimum amount of business and personal information necessary to fulfill our obligations under the Canada Revenue Agency’s rules and guidelines and to effectively process claims. Coastal HSA will use this data to provide you with the Services.
  27. Intellectual Property: Coastal HSA retains all right, title, and interest in and to the Services, including all intellectual property rights. You may not use the Services or any of Coastal HSA’s intellectual property for any purpose other than as expressly authorized in this Agreement.
  28. Confidentiality: The Service Provider shall maintain the confidentiality of all information provided by the Client in connection with this Agreement, and shall not disclose such information to any third party without the Client’s prior written consent, except as required by law or as necessary to provide the services contemplated by this Agreement. You acknowledge and agree that any information provided to you by Coastal HSA is confidential and proprietary, and you agree to maintain the confidentiality of such information and not disclose it to any third party.
  29. Representations and Warranties: The Service Provider represents and warrants that it has the necessary skills, experience, and qualifications to perform the services contemplated by this Agreement, and that it shall perform such services in a professional manner. Our Application is provided “as is” and without warranties of any kind, either express or implied. Coastal HSA does not warrant that our application will be error-free or uninterrupted.
  30. Indemnification: You agree to indemnify and hold Coastal HSA harmless from any claims, damages, or expenses arising out of your use of the Services or any violation of this Agreement.
  31. Governing Law: This Agreement shall be governed by and construed in accordance with the laws of British Columbia Canada, without giving effect to any choice or conflict of law provision or rule.
  32. Entire Agreement: This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof, and supersedes all prior or contemporaneous agreements or understandings, whether oral or written.
  33. Amendments: This Agreement may not be amended or modified except in writing signed by both parties.
  34. Acceptance of Terms and Conditions. By using the Services, you agree to be bound by this Agreement. If you do not agree to these terms, please do not use the Services.

By using the Services, you acknowledge that you have read and understand this Agreement, and you agree to be bound by its terms and condition