Private Health Services Plan Client Forms

To enroll in the Private Health Services Plan (PHSP) with Cost Efficient Benefit Plan, fill out and submit the enrollment form.

Use this form to enroll in the Private Health Services Plan (PHSP). The included Terms form explains the agreement between your company and Cost Efficient Benefit Plan.

The enrollment fee of $100 plus GST/HST can be paid over the telephone (VISA or MasterCard only).

Once we have received your enrollment form and the enrollment fee you may proceed to submit your claim.

To submit a claim to Cost Efficient Benefit Plan, fill out the Remittance form with the description of the expenses incurred.

If you would like to submit your claim electronically, please follow the directions listed under 'Simplify your claims'. Please feel free to contact us if you have any questions about the process, or to obtain your account number for online banking.

If you would like to submit your claim by mail or in person, please print the Remittance form and mail or bring it to us with all original receipts and your company payment. You may email an advance copy of the form by clicking the next and submit buttons on the form.

We will process your claim quickly.

Simplify Your Claims
Submit Your Claims Electronically

Submit your claims conveniently by choosing the ‘Remittance Form’ option. Just answer a few questions regarding your claim, attach an electronic copy* of your receipt and submit. Enjoy the convenience of electronic claim submission and avoid the burden of filling out paper claim forms and mailing in your claims. This means CEBP receives your claims sooner so you can get your money faster! *Scanned images of receipts must be clear, and legible. Files may contain multiple pages, but must be less than 3MB in total size. A maximum of 5 files may be submitted at any one time. Acceptable file types are gif, jpg, png, pdf, and tif. Be sure any transaction slip (debit/credit card receipt) does not cover pertinent information (e.g. name(s), date(s) of service, etc.) on your provider receipt when scanned. CEBP has the right to ask for original receipts at any time, so please retain your original receipts.

Pay Your Claim Online

Your claim may be paid online at most major financial institutions. Look for Cost Efficient Benefit Plan on your financial institution’s list of Payee’s. Contact us to obtain your account number for Online Banking.

Fast Electronic Reimbursement

Direct Deposit is available to reimburse you without waiting on the mail. Please provide a void cheque with your banking information and we will set up direct deposit on your file. Your funds will be deposited directly into your bank and a Statement emailed to you conserving time, paper, and postage.

We retain all receipts submitted to Cost Efficient Benefit Plan for 7 years, then shred them.