Quebec group insurance pooling update 2013 - What's changing?

#372

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Every year the Quebec Drug Insurance Pooling Corporation (also referred to as the Société de Compensation en Assurance Médicaments du Québec) revises the Quebec group insurance pooling parameters. We have started applying new pooling levels and fees to all 2013 renewal calculations that involve Quebec plan members.

Who does it affect?

All group insurers in Quebec contribute to a pooling plan that protects private sector plan sponsors against the financial impact of large claims for drug costs. Based on pooling results for previous years, the Quebec Drug Insurance Pooling Corporation submitted a report to Quebec’s Health and Social Services minister. The report details 2013 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 similar, new pooling levels and fees apply for 2013:

2013 pooling parameters

Group size Pooling level Annual single fee Annual family fee Eligible groups
Fewer than 25

$5,100

$137.00

$377.00

Insured and ASO
25–49

$13,500

$65.00

$181.00

Insured and ASO
50–124

$25,000

$29.00

$81.00

Insured and ASO
125–249

$39,000

$16.00

$45.00

Insured and ASO
250 -499

$60,000

$10.00

$27.00

Insured and ASO*
500-999

$80,000

$7.40

$20.40

Insured and ASO*
1000-1,499

$100,000

$5.75

$15.75

Insured and ASO*
1,500-2,999

$100,000

$5.75

$15.75

Insured and ASO*
3,000 and over  Free market – Groups not subject to Quebec Industry Pooling

* Pooling of RAMQ drugs only.

Questions?

Please contact your Sun Life Financial group benefits representative.