GREAT NEWS – Dental Fee guide Increase LOWER than Expected.

Each year the Ontario Dental Association (ODA) sets their dental fee guide for the coming year.  This guide is used by many dentists to set their prices (though they can charge above or below this). Insurers tend to use these numbers as the “reasonable & customary” limitation for claims.

Last year the Ontario increase was 4.19% on average, which was the highest we’d seen in well over a decade.  The average over that time period was about 2.2%/ year.  The 1.27% increase for 2020 is a bit of a nice break and much lower than we’d been led to expect.

What this means to employers is that if your employees all submitted the exact same claims this year, as they did last year, then the cost charged would be 1.27% higher.  In reality, there are also trend and utilization numbers that are added to this (because we don’t do the same thing every year), but that said, this means a bit of relief in the rate creep we had been dreading.  (Other insurers will be similar to the levels shown below)

Interested in attending an benefits focussed educational event?

If you’re a current client of Mainstay Insurance Brokerage (or are considering being one), then know that you are always welcome to CGIB events at my expense.

CGIB is an association that holds several educational events each year.  The seminars are intended for a benefit advisor audience, to help them to educate their clients.  If you attend, you’ll be getting the message direct from the horses mouth.

Our next event is March 4th in Vaughan and all the details are here… http://www.cvent.com/d/ghqrt4

Just drop me a note if you’d like to attend and we’ll book you a spot.

Tax Tip – If your employees share the health and dental premium

As employers prepare T4’s, they can make like a bit easier for staff.  By reporting the employees contributions to the health and dental premium in Box 85, you are helping staff make sure they get the medical Expense Tax Credit (METC) where available.

This avoids employees being audited for proof of contributions (and you having to write out letters for them).  You can find more on the CRA site below or ask your accountant.

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Why Bother With All These Forms For My Employees?

An interesting article, by a law firm, on the importance of getting staff to complete insurer forms.  We deal with this several times a year for different reasons, usually concerning staff not completing forms for excess Life and LTD coverage.  it is imperative that staff complete and submit these in a timely manner in order to get the coverage the employer offers.


Throughout an employee’s time with an employer, there are many occasions where the employer will be required to have the employee complete forms or other documents for third parties, or where the employer must complete forms themselves for third parties. We have encountered employers who either delay or completely disregard these requirements. Failing to meet these requirements are risky and potentially costly oversights! Below we will identify the consequences for the employer if these documents are not completed, completed inaccurately, or are not completed in a timely manner.

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How to avoid a massive holiday health care bill when OHIP out-of-country coverage ends

We’ve had several calls by clients about the OHIP removal of out of country coverage and if it posed a problem.  In actuality, the cut has made it easier to have claims paid with the group coverage by almost every carrier (no waiting for the province to pay first).  This article provides some context around it and also great questions to ask if people are not covered by group plans and plan on buying coverage.


If you are an Ontario resident planning to travel outside of Canada over the holidays and will be out of the country after Jan. 1, make sure you have adequate travel health insurance coverage or risk dealing with a crippling medical bill should a medical emergency arise.

READ MORE https://www.ctvnews.ca/canada/how-to-avoid-a-massive-holiday-health-care-bill-when-ohip-out-of-country-coverage-ends-1.4721528

Workplace Policies That All Businesses Need

A very short list of the policies that you MUST have (and those that you SHOULD have) in Ontario.


Ontario employers are required by law to have certain workplace policies in place at work. The policies that employers must have include the following:

  1. Workplace Health and Safety Policy;
  2. Workplace Violence and Harassment Policy;
  3. an Accessibility Policy; and
  4. Pay Equity Plan (employers with 10 or more employees).

Failure to have these policies in place is a violation of Ontario law and may result in the imposition of statutory fines and penalties.

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Maternity leave returners no longer facing reset of LTD pre-existing clause

I’m so pleased to finally get this initiative resolved after almost 3 years of effort.

If you’re reading this, and a Mainstay client, then you know how adamant I am about NOT allowing women to opt-out of coverage during maternity leave. If you’re not a client, or are not sure why this is so important, just give me a call.


Major Canadian insurers are no longer resetting the long-term disability pre-existing condition clause for women whose benefits coverage lapsed during their maternity leave when they return to work.

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Elimination of B.C. medical services plan premiums good news for employers

Many of our clients that employee BC employees have paid for the BC MSP premium (much as we did in Ontario with OHIP premiums many decades ago).  This obligation has now been removed.  On the other hand, an employer health tax similar to Ontario was introduced last year so employers are not 100% off the hook, but are avoiding the duplication.


British Columbians are ringing in the new year by joining all Canadians in not paying monthly rates for health care.

Premiums under the province’s medical services plan will be eliminated on Jan. 1, saving individuals up to $900 a year while families will pocket up to $1,800. The change comes two years after premiums were halved and a year after B.C. introduced an employer health tax of 1.95 per cent for businesses with a payroll above $1.5 million. Companies with a payroll under $500,000 were exempt from the tax, while those in between have paid a reduced rate.

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Ontario to Increase Claims Limit for Small Claims Court

You’re likely asking yourself…has Dave lost it?  What does Small Claims Court have to do with benefits, or  how does this help the great clients he works with?  It’s all about protecting you.

We are starting to see employees use Small Claims Courts for resolving reasonable notice periods at termination (suing for the severance they think they deserve).  Read the article below for more…


Effective January 1, 2020, the monetary claims limit for Small Claims Court in Ontario will increase from $25,000.00 to $35,000.00 (excluding interest and legal costs). Of note, the previous limit has been in place since 2010 when the limit was increased from $10,000.00.

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