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Summary of provincial changes affecting
group benefit plans
Each year, provincial governments make changes that Quebec Parental Insurance Plan (QPIP) introduced
affect coverage under both public and private benefit The province of Quebec implemented the Quebec plans. Outlined below are the changes Great-West Life Parental Insurance Plan to provide maternity, paternity believes wil be of greatest interest to plan sponsors. and parental benefits to its residents. The program This is not intended to be a complete listing of all replaces the maternity, paternity and parental benefits changes for 2006, but rather a summary that highlights previously provided to Quebec residents through the key developments. Plan sponsors may have learned of federal employment insurance program. It provides some of these changes through previous GroupLines.
benefits to employees who take time off work for the birth or adoption of a child.
Quebec
RAMQ drug coverage
amended – RAMQ adjusted
the Basic Prescription Drug Insurance Plan. Changes Mandatory retirement ends – As of December 12,
that became effective July 1, 2006, included the 2006, Ontario law protects employees aged 65 and older from age discrimination. Provincially regulated employers can no longer force employees to retire • The minimum coverage of RAMQ formulary drugs solely because they have reached age 65.
that plan sponsors must offer plan members who are residents of Quebec decreased to 71 per cent Province of Ontario reforms drug system – Ontario’s
Bil 102 (Transparent Drug System for Patients Act, 2006) passed in the province’s legislature in June. The • The annual out-of-pocket maximum for RAMQ reforms are intended to improve patients’ access to formulary drugs increased to $881 from $857.
drugs under the public program, promote appropriate • The monthly deductible increased to $12.10 use of drugs and bolster the governance and operation of the public drug system. Among the changes were increased access to lower-cost generic drugs, a more • The annual premium that Quebec residents rapid provincial review process for some drugs and must pay for RAMQ coverage increased to $538 greater ease in obtaining approval for drugs that are not part of the Ontario Drug Benefit general formulary.
Quebec may ease private healthcare restrictions
The Quebec government introduced Bill 33 (an Act
to amend the Act respecting health services and Out-of-province and out-of-country chiropractic,
social services and other legislative provisions). The optometric, dental and podiatric services – Effective
government is currently holding hearings about the July 1, 2006, Alberta no longer covers chiropractic, bill. If enacted, Bill 33 will amend several pieces of optometric, dental and podiatric services received Quebec legislation relating to healthcare access, and out-of-province or out-of-country. These services, open the door to private healthcare in Quebec in a when provided outside Alberta for an Alberta resident, limited way. Its main focus is to create greater access wil be covered under Great-West insured plans and to health care and reduce treatment delays that occur administrative services only plans according to the terms of a plan sponsor’s current benefit plan.
Pharmacists to prescribe some drugs – The
Newfoundland and Labrador
Alberta government has passed legislation that allows Children’s dental health – The Newfoundland
pharmacists to prescribe some drug treatments, and Labrador government announced changes to continue prescriptions made by other health its children’s dental health program, which provides practitioners and administer injection drug treatments, coverage of basic dental services to children 12 and such as vaccines. These changes take effect in younger, subject to a co-payment. Effective September April 2007. The intent of the Alberta government 1, 2006, the government plan is the payer of last is to provide patients with better access to drug resort for families with private insurance.
treatments, particularly basic drugs, in situations where prescriptions need to be extended. Pharmacists will Prescription drug program – The provincial
be able to prescribe drugs when they have had extra government announced it is considering an expansion training, subject to specific limits established by the of the Newfoundland and Labrador Prescription Drug Program to include additional low-income residents. The program provides assistance in the purchase of Manitoba
pharmaceuticals and some related medical supplies. PPI status changed – Manitoba Pharmacare changed
Details of the expansion are limited; the government is the status of Proton Pump Inhibitors (PPIs) from Part expected to propose legislation to take effect in 2007. 2 to Part 3. Effective March 13, 2006, Manitoba At the same time, the legislation would make the Pharmacare requires that patients starting PPI therapy for the first time meet Exception Drug Status (EDS) Bill 25 – Bill 25 became law on May 26, 2006. Under
criteria in order to be eligible for Pharmacare coverage. the new law, family status was added as a prohibited Those who commenced PPI therapy prior to March 13, ground of discrimination. The law also prohibits 2006, will continue to have Pharmacare coverage for mandatory retirement effective May 26, 2007.
eligible PPIs until January 15, 2007. After this date, Manitoba Pharmacare will require that all patients Nova Scotia
meet EDS criteria in order to have continued coverage Pharmacare for low-income children – The Nova
of eligible PPIs. The drugs affected by this change are Scotia Low-Income Pharmacare for Children program Apo-Omeprazole, Losec, Pariet, Pantoloc and Prevacid.
became effective October 1, 2006. It will potentially New Manitoba Pharmacare deductible rates – The
help up to 35,000 children under the age of 18 whose provincial government increased Pharmacare family families receive the Nova Scotia Child Benefit.
deductible rates for the 2006-2007 benefit year. The rates, which took effect April 1, 2006, are as follows: For more information
Please contact your benefits advisor or Great-West
Manitoba Pharmacare Deductible
Adjusted Total
as a Percentage of Adjusted Total
Family Income
Family Income
This GroupLine is for general use and informational purposes 2005-2006
2006-2007
only. It is not intended to be legal or tax advice. You should Pharmacare
Pharmacare
Plan Year
Plan Year
consult your professional advisors about your particular circumstances. to $15,000Greater than $15,000 and less than or equal to $40,000Greater than $40,000 and less than or equal

Source: http://www.buffetttaylor.com/client_resources/industy_news/PDF/Summary_Provincial_Changes_Affecting_Group_Benefits_Plans.pdf

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