These changes affect plan sponsors who provide drug coverage to plan members residing in Quebec.
| Legislative changes | Drug claims for Quebec plan members |
|---|---|
| Increase in annual out-of-pocket maximum to $1,117 from $1,087 | Drug claims from plan members residing in Quebec for drugs listed on the RAMQ formulary will now be subject to the new annual out-of-pocket maximum of $1,117. |
| Decrease in co-insurance (amount RAMQ pays) to 63.0% from 65.1% | Drug claims from plan members residing in Quebec for drugs listed on the RAMQ formulary will now be subject to the new minimum co-insurance amount of 63.0%. |
We are in the process of updating our systems to reflect these changes. There will be no immediate rate adjustments due to the changes and we expect minimal impact on plan members and on claim experience.
Questions? We’re here to help.
For Clients with less than 50 employees, please contact your Client Service Administrator at 1-877-786-7227.
For Clients with more than 50 employees, please contact your Sun Life Group Benefits representative.
