Twenty per cent of claimants drive nearly 80 per cent of drug plan costs

This is a good, short note on the cost of high cost drugs and the effect that the employees and families claims have on plans.  Amongst our Mainstay clients, we see about 15% of our customers have claims over $10,000 a year


Representing 20 per cent of claimants, members with high-cost chronic conditions drive almost 80 per cent of plan costs with an average annual drug spending that is 15 times that of other claimants, says the report.

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PHARMACARE AND PRIVATE PLANS: AN OPPORTUNITY TO SHARE THE RISK?

In December 2017, Benefits Canada invited a group of benefits plan advisors to the Canadian Leadership Council on Drug Plan Partnerships in Toronto to discuss the impact of national pharmacare on the private health benefit industry.  We didn’t have all the answers but did identify more of the issues our industry is facing…


Canada is one of three developed countries in the world with a universal health-care program that does not include prescription drugs and, as such, medication needs have been met with a patchwork of public and private drug coverage. Although the federal government’s current focus is to reduce the cost of prescription drugs, there seems to be renewed discussion on the development of a national pharmacare program. This is likely due to reports by the House of Commons standing committee on health and the parliamentary budget officer on national pharmacare.

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Exclusive Mainstay client benefit – Free Access to HR toolkit

Dear Mainstay Clients,

You often tell us that you need HR, that you don’t know where to start, who to call, what to do.  And too often, you do nothing.

You’ve been heard!  Mainstay has entered into a program with ConnectsUs HR ™ so you can take advantage of the proven HR package made for Canadian small business and compliant for Ontario, Alberta and BC.

The best part?  There’s no cost to you – we’ve picked up the tab! You won’t even have to provide a credit card. Simply enter your unique program code.  Either:

  1. Refer to the introductory email that will be sent to you in the coming days; or
  2. Email dave@mainstayinsurance.ca who will be happy to provide it to you.

Get started on your HR today!

You Are Invited to a Littler Toronto Webinar

This is a webinar hosted by Littler LLP which is one of the largest Employment Law firms in the world.  George is a great speaker and the topic covers many of the areas we discuss with clients to try and keep you out of trouble. If you’re interested, please book your spot as these fill quickly.

PLEASE NOTE THAT, WHEN YOU REGISTER, PLEASE CLICK THAT YOU ARE NOT DAVE PATRIARCHE. 

PLEASE DO NOT CLICK ON UNABLE TO ATTEND  


Managing Group Insured Benefit Risks: Employment Law Considerations

This webinar will examine various benefit issues that arise during the employment life cycle and the potential liability for employers that can lead to significant damages.

This will include an overview of employer obligations in relation to benefits and benefits administration in the context of constructive dismissal; LTD absences; frustration of the employment contract; statutory leaves; and common law notice. Practical advice will be offered up for avoiding trouble before it becomes a reality!

Please note, content is geared toward Canadian law.


Tuesday,
May 15, 2018

1:00 p.m. — 2:00 p.m. ET

CLE, CPD, SPHR/PHR, and SHRM certifications are pending approval.

CLE credit will not be provided in the following states: AL, DE, IN, KS, LA, ME, ND, OK, PA, SC.

          

Login information will be provided to participants the day before the webinar.

Questions?

Please contact Kellie Cromarty at KCromarty@littler.com or 973.848.4752.

Speakers:

littler.com Employment & Labour Law Solutions Worldwide
181 Bay Street, Suite 3210
Toronto, ON M5J 2T3 | Canada | 647.256.4500

Tips On The Right Way To Fire Employees In Ontario

An article that gives some good and pointed suggestions for handling terminations.

Don’t forget that all benefits must be extended during the legislated Pay In Lieu of Notice (PILON) period (unless “for cause” termination) and any extension beyond that (severance) MUST be pre-approved by the benefit provider.


Employment law refers to the rules that govern relations between employers and employees. The term “employment law” is usually juxtaposed with the term “labour law”, the latter being concerned with the process of negotiating and enforcing terms and conditions of employment under a collective agreement. So, for example, when a lawyer uses the term “employment law”, it’s a good bet that they are referring to the rules that govern relations between an individual employee and his or her employer and not the relationship between a union and an employer.

Long Term Disability Insurance: Common Employer Misconceptions

This is a great article around the employer responsibilities of Long-Term Disability cases.  It is one of the tricky areas that small employers often have little experience with, are not appropriately staffed (with HR people etc) to handle, and as a result find it difficult to deal with.  This article gives you a few of the biggest misconceptions one needs to consider in a short concise read.


Canada: Long Term Disability Insurance: Common Employer Misconceptions

Article by: Devan Marr

Once an employee is injured and in receipt of disability benefits, misconceptions regarding the parties’ respective roles can expose them to increased risk and liability.

  • Misconception #1: The employer is no longer involved in the disability process
  • Misconception #2: If the employee receives disability benefits for 2 years, their employment can be terminated
  • Misconception #3: If the employee no longer meets the policy definition of disability, they must return to work
  • Avoiding Exposure Through Collaboration

Long Term Disability Insurance: Common Employer Misconceptions

This is a great article around the employer responsibilities of Long-Term Disability cases.  It is one of the tricky areas that small employers often have little experience with, not appropriately staffed (with HR people etc) and as a result find it difficult to deal with.  This gives you a few of the biggest misconceptions one needs to consider in aa short concise read.


Employers often provide their employees with access to long-term disability benefits through a group benefit plan. These benefits are usually provided and administered by a third party insurer. The insurer’s role is to manage the disability claim and adjust the file according to the available medical evidence. The employer’s role is to hold the employee’s position and accommodate a return to work as necessary. Ideally, the management of an injured employees return to work should be a collaborative process between employer, long-term disability insurer, and employee. Unfortunately, once an employee is injured and in receipt of disability benefits, misconceptions regarding the parties’ respective roles can expose them to increased risk and liability.

Workplace Strategies: Risk of Impairment from Cannabis

This is a great reference document for employers that deals with workplace impairment.  it also contains a sample Workplace Policy Regarding Substance Dependence/Impairment you may wish to use and a sample  Incident Report that could come in handy.


Impairment in the workplace can have severe consequences. There are many sources of impairment such as fatigue, use of drugs (over the counter, prescription, illicit), consumption of alcohol, etc. This White Paper discusses the implications associated with the use of cannabis for both therapeutic and recreational purposes. The key steps to reducing the impact of impairment on the workplace are to have appropriate mechanisms in place, to provide clear guidance to all workplace parties, and to apply workplace policies and programs using a fair and consistent approach.

This White Paper presents information and recommendations for employers, employees, and others interested in workplace health and safety including how to:

• address the potential for impairment as part of a hazard assessment,

• establish a concise policy and program on the use of any substance that can cause impairment,

• determine the actions the workplace will take regarding impairment,

• implement accommodation practices where necessary (including for therapeutic needs, and substance dependence), and

• create a supportive healthy and safe workplace.

How Ontario’s underused public pharmacare program could save private drug plans

This is an article from last year about the Ontario Trillium Drug plan that was due to coordinate with private plans in the fall of 2017.  It was delayed due to the introduction of OHIP+ but is still on the agenda.  There is a slight chance of its introduction in 2018 depending on the outcome of the next provincial election. Regardless, we will keep pushing the ministry to update their systems to make insurers pay your employees claims properly and charge you appropriately.


As private drug-insurance plans buckle under the costs of new medications that can prolong lives but only at massive expense, the Ontario government is planning to step in, at a cost that could reach into the hundreds of millions of dollars.