Here are the fee guides that have been issued to date:
- Québec: increase of 4.2% overall (compared to 2.6% in 2020)
- Ontario: increase of 4.6% overall (compared to 1.27% in 2020)
- Alberta: no change (compared to 4.4% in 2020)
To help plan members continue to have access to the dental care they need, we’ll update our system with the 2021 fee guides. We’ll continue to reimburse plan members based on the fee guide indicated in their plan.
We won’t change a plan sponsor’s premium rates on January 1, 2021 to recognize these higher increases. These fee guide changes will impact experience that will be taken into account at their next renewal. We’ll also update the inflation factor in our renewals that are due on February 1, 2021.
We understand that cost control is important to some of your Clients. If their plan reimburses dental claims based on the current year fee guide, they might want to have options to limit the cost increase in 2021 (for ASO) or at their next renewal (for insured). Here are some options available to them.
Options for plan sponsors
Option 1 – Plan sponsors can choose the status quo. In that case, we’ll continue to pay dental claims in alignment with the fee guide in their contract. No communication to plan members will be required. The full increase in cost will show in the plan’s experience and will impact the next renewal or their first ASO bill of 2021. This is our default and no action is required from your Clients.
Option 2 – If you have plan sponsors that prefer to ensure that the increases to their costs are more limited, they can initiate a fee guide change. This option will impact plan members who will pay more out of pocket as applicable. To initiate a fee guide change, you need to contact your Account Executive. They can make this request immediately, or upon renewal. The process is the same for all funding arrangements and all market segments. Here are some examples of fee guide changes available to plan sponsors:
- Fee guide of previous year – for example, if the contract currently covers the current year fee guide, this would mean that the plan would stay at the 2020 fee guide in 2021. If a plan sponsor chooses this option, the full increase in the 2021 fee guide passes on to the plan member.
- Fee guide of current year minus X% - for example, a plan sponsor could choose to cover the 2021 fee guide minus 2%. This way, the plan takes on part of the increase and 2% passes on to the plan member.
If your Client chooses one of the approaches in Option 2, we advise them to send a communication explaining any changes to their plan members.
Communications to plan sponsors
We’ll follow our standard practice and communicate with plan sponsors in Q1 2021 once all provincial fee guides have been published.
Questions? We’re here to help.
Please contact your Sun Life Group Benefits representative.
