Quebec group insurance pooling update 2008

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What's changing?
Each year the Société de compensation en assurance médicaments du Québec revises the Quebec group insurance pooling parameters. Sun Life Financial will apply new pooling levels and fees to all 2008 renewal calculations that involve Quebec plan members.

Who does it affect?
All group insurers in Quebec contribute to a pooling plan. It protects private sector plan sponsors against the financial impact of large claims for drug costs. Based on pooling results for previous years, the Société de compensation en assurance médicaments du Québec submitted a report to Quebec’s Health and Social Services minister. The report details 2008 pooling parameters and has been approved by all industry members.

How does it affect our clients?
Pooling levels and fees are designed to cover predicted costs for claims and operating expenses associated with prescription drugs. While the overall pooling structure remains the same, there are new pooling levels and fees for 2008:

2008 pooling parameters

Group size

Pooling level Annual single fee

Annual family fee

Eligible groups

Less than 10

$2,400

$154

$425

Insured and ASO

10–24

$3,800

$111

$308

Insured and ASO

25–49

$9,800

$51

$142

Insured and ASO

50–124

$19,000

$21

$58

Insured and ASO

125–249

$32,000

$8

$23

Insured only

250 and over

Free market *

* Except for catastrophic pooling at $60,000 of RAMQ drugs for insured groups only.

Questions?
Please contact your Sun Life Financial group representative.