Health and dental
Summary of group benefits legislation
Jurisdiction
Genetic testing – A law to prohibit and prevent genetic discrimination
An Act to Prohibit and Prevent Genetic Discrimination (formerly Bill S-201), came into force on May 4, 2017. This new law restricts life insurance companies from requiring an individual to undergo a genetic test or to disclose their results to the insurer for the purposes of purchasing insurance or when submitting a claim. The law requires an insurer to obtain an individual’s written consent to collect, use or disclose genetic test results.
British Columbia government releases details of new Employer Health Tax
Earlier in March, we told you that as part of British Columbia’s 2018 budget, the Minister of Finance announced they would eliminate Medical Services Plan (MSP) premiums by January 2020. To fund the change, they would introduce an employer health tax in January 2019.
On July 4, 2018 the Ministry of Finance released an Employer Health Tax Notice (Notice 2018-001) providing information about the proposed tax. The tax will be based on payroll, so employers are responsible for reviewing and determining if they have any taxable liability.
The Notice is intended for guidance at this point. The BC government expects to pass legislation in the fall.
Expansion of PharmaCare Coverage for Insulin Pumps
As of July 3, there will no longer be an age restriction for insulin pump coverage in British Columbia Pharmacare website.
Alberta announces changes to insured out of country expenses and diagnostic imaging referred by some practitioners.
Effective 1 April 2020, Albertans travelling in another country will no longer be covered for elective non-urgent health services and routine laboratory tests. Only the cost of insured emergency physician and services received in a general or auxiliary hospital outside Canada will be eligible for reimbursement under the Alberta Health Care Insurance Plan (AHCIP).
Alberta announced a change in its policy relating to payment for diagnostic imaging referred by chiropractors, physiotherapists and audiologists. Effective 31 March 2020, claims for diagnostic imaging services referred by one of these practitioners are de-insured and no longer covered by the Alberta Health Care Insurance Plan (AHCIP). This change does not affect these practitioners' scopes of practice, or their ability to order diagnostic imaging services.
New 2018 Alberta Dental Fee Guide
The Alberta Dental Association and College (ADA&C) has a new Fee Guide for 2018. This took effect January 1st. The ADA&C last published a suggested Fee Guide for Dentists in Alberta in 1997.
Manitoba repeals universal health care for international students
Effective September 1, 2018, the Manitoba government will no longer provide universal health care coverage to international students. The regulation amends the Health Services Insurances Act by repealing a privilege granted in 2012 that gave college and university students from abroad access to universal health care.
International post-secondary students with a study permit in Manitoba will have to buy private health insurance. They will no longer be eligible to receive a Manitoba Health Card.
International students with a work permit valid for at least 12 months in Manitoba are eligible for health coverage as of the date the work permit was issued.
For employers in Manitoba with international students as employees, Manulife’s Provincial Plan Replacement (PPR) product is a great solution.
Contact your Manulife representative to get more information.
Assistive Devices Program (ADP) in Ontario reduces approved Prices for Positive Airway Pressure (PAP) Systems and walkers.
UPDATE: As of June 24th, the start date of the changes below has been postponed to January 1st, 2021.
Starting January 1st, 2021, the Ontario Ministry of Health will implement lower approved prices for ADP registered vendors for Positive Airway Pressure (PAP) systems and wheeled walkers. In order to make PAP systems more affordable for Ontarians, the government is implementing a price change for these devices, which will result in lower co-payment costs for patients, starting January 1st, 2021.
The ADP has also removed the additional medical eligibility criteria for patients auto-titrating positive airway pressure (APAP) systems. As of January 1st, 2021, to receive funding for an APAP system, the applicant must only demonstrate a diagnosis of Obstructive Sleep Apnea Syndrome and the presence of significant symptoms or medical risks without treatment, and the absence of symptoms or risks with treatment.
Amendment to Ontario Regulation
The Ontario Ministry of Health and Long-Term Care will amend Regulation under the Health Insurance Act (HIA). The amendment ends the Out-of-Country Travellers Program (OOC Travellers Program) for emergency medical services (arising while outside the country) for Ontarians travelling outside of Canada. This program provides reimbursement for services required to treat conditions that are acute, unexpected, while traveling outside Canada that require immediate treatment. The rates OHIP pays have been in place for 20 years.
This change will happen January 1, 2020.
- The ministry will reimburse eligible claims incurred up to and including December 31, 2019. Claims for emergency services incurred up to December 31, 2019 must be submitted no later than December 31, 2020.
- Any OOC emergency services that are incurred on or after January 1, 2020 will not be eligible for reimbursement.
If you have any questions, please contact your Manulife Representative.
Proposed Amendment to Ontario Regulation
The Ontario Ministry of Health and Long-Term Care has proposed amending Regulation 552 under the Health Insurance Act (HIA).
- End the Out-of-Country Travellers Program (OOC Travellers Program) for emergency medical services (arising while outside the country) for Ontarians travelling outside of Canada. This program provides reimbursement for services required to treat conditions that are acute, unexpected, while traveling outside Canada that require immediate treatment. The rates OHIP pays have been in place for 20 years.
The proposed amendment does not affect publicly funded health care coverage for Ontarians travelling in other parts of Canada.
The public had until April 30th to provide comments to the ministry on their proposed change. The Canadian Life Health Insurance Association (CLHIA), on behalf on the insurance industry, along with Manulife have submitted feedback for their consideration.
The following change is also included in the proposed amendment:
- End OHIP coverage for osteopath services provided out-of-province. While the services are no longer eligible in Ontario, OHIP has been paying for osteopathy services performed in other provinces to Ontario residents. The amendment will eliminate inconsistency in coverage for osteopathy services provided out of province versus in province.
If approved, these changes would take effect on October 1st, 2019. We will monitor the progress of these proposed changes and keep you posted.
If you have questions, contact your Manulife representative.
P.E.I. government announces changes to its social assistance program
Effective July 1, 2018 Prince Edward Island residents leaving social assistance for a job on P.E.I. can extend their social assistance medical, dental, and optical benefits for the first 24-months. The government will consider an extension beyond 24 months if losing the benefits becomes a barrier to keeping a job. In addition, higher income exemptions will allow residents to earn more money each month without their benefits being reduced.
Residents of P.E.I. that qualify for ongoing social assistance will be able to waive their employer health and dental benefits when they’re asked to sign up for benefits through their employer. Once their coverage through social assistance is no longer available, we will consider it a life event. The member then has 31 days to apply for health and dental benefits through their employer.