A Formula for Disaster

Insurers design protection against catastrophic drug claims!

On April 3, 2012, The Canadian life and health insurance industry announced an industry-wide drug pooling agreement to help mitigate the impact of high drug costs on fully insured employer drug plans.

This is a positive step for the industry and great news for employers who have a fully insured plan as it allows them to sustain the group drug benefit program in the event that one or more employees has a recurring, very high cost prescription drug claim.

Under the program, insurers share the costs of the most expensive drug claims in order to minimize the impact of high-cost specialty drugs on private benefits plans. The pooling agreement applies to fully insured plans and will come into effect on Jan. 1, 2013.

According to CLHIA, since 2008, claims for high-cost drug treatments have been increasing by more than 20% a year in the group insurance sector. With the new pooling agreement, insurers will no longer include claims for high-cost drug treatments when setting an employer’s premium.

The participating insurers so far are Alberta Blue Cross, Assomption Vie, The Co-operators, Desjardins Financial Security, Empire Life, Equitable Life, GMS Group Medical Services, Great-West Life, Green Shield Canada, Industrial Alliance, La Capitale, La Survivance, Manitoba Blue Cross, Manulife Financial, Medavie Blue Cross, Pacific Blue Cross, RBC Insurance, Saskatchewan Blue Cross, SSQ Financial Group, Standard Life, Sun Life Financial, Union Vie and Wawanesa Life.

Find out more on how this new initiative can help sustain your plan at our breakfast seminar.