Drug insurance in Quebec – Terms and conditions of pooling for 2019
The pooling system for drug-related risks has been in force since 1997 following the introduction of the Quebec Basic Prescription Drug Insurance Plan (BPDIP). The Canadian Drug Insurance Pooling Corporation (the “Corporation”) coordinates the pooling process among various life and health insurance companies. The primary objective of pooling is to allow group insurance policyholders to protect themselves against the financial impact of significant drug claim costs.
Current features only apply to Quebec certificates
- Groups with fewer than 4,000 plan members are subject to the same standard formula that is applied across the industry, whether the group is insured or not.
- All insurers and administrators of administrative services only (ASO) plans must participate in the pooling system.
- Pooling will apply to the private plan formulary for all groups regardless of their size.
- Pooled amounts will be the amounts actually reimbursed that exceed the threshold.
Pooling parameters for 2019
iA Financial Group (Industrial Alliance Insurance and Financial Services Inc.) will continue to apply the threshold and costs for groups of 50 to 124 certificates to insured groups of 125 or more certificates in compliance with the pooling parameters set by the Corporation. iA Financial Group also offers several pooling parameters for groups that are funded on a retention or ASO basis.
These new parameters will be used for 2019 renewals.
For more information about pooling, please contact your advisor or your iA Financial Group Account Executive.