OmbudService for Life & Health Insurance reports on record numbers

 Canada’s OmbudService for Life & Health Insurance (OLHI) held its annual general meeting and released its annual report for 2016/17, reporting on a year of record numbers and renewed priorities.

Highlights:

  • Complaint volumes increase by 23.2% across Canada, marking a historic high
  • Increase in complaints from Quebec (+36.2%), Prairie provinces (+25.6%) and British Columbia (+ 24.4%)
  • Public contacts exceed 87,000
  • Edmonton office established as a part of western expansion strategy

“We discovered many things about ourselves this past year: we are small yet influential; we are experts in our field; we are strategic; and we are ready to redefine our future,” said Chair Dr. Janice MacKinnon at the meeting on September 14, 2017. “The launch of OLHI’s new case management and reporting system (CMRS) and website provides us with an opportunity to take a fresh look at how we do business today and moving forward.”

Among OLHI’s business plans for the future is increasing visibility outside Central Canada. This past year, complaint volumes rose in ManitobaSaskatchewanAlberta and British Columbia. To build on this momentum, OLHI established a physical presence in Edmonton in Q4 with a new office.

For fiscal 2016/17, OLHI received 2,632 complaints, with 57.5% of these relating to denied claims. Disability, life and employee healthcare & dental, together, made up 83.9% of all product complaints. Web visits rose by 19.1% over last year, reaching nearly 85,000.

“OLHI is successful because of stakeholder support and the respect we receive as an independent, impartial organization,” said Brigitte Kent, Acting Executive Director. “This allows us to meet our benchmark of closing 80% of all complaints within 120 days.”

Looking ahead, OLHI will continue to measure effectiveness and efficiency, identifying best ways to utilize the CMRS and accelerate service without sacrificing quality. OLHI will also complete its third Independent Review and begin work on ensuing recommendations.

For more detail on OLHI’s operations, including case studies and statistics, the full 2016/2017 Annual Report is available at http://olhi.ca/news-publications/annual-report/.

About the OmbudService for Life & Health Insurance
The OmbudService for Life & Health Insurance (OLHI) is Canada’s only independent complaint resolution service for consumers of Canadian life and health insurance. Canadians trust OLHI to review their insurance complaints about life, disability, employee health benefits, travel, and insurance investment products such as annuities and segregated funds. OLHI’s free bilingual services are available to any consumer whose insurance company is an OLHI member – and, currently, 99% of Canadian life and health insurers are. OLHI also offers general information online about life and health insurance. To ensure impartiality, OLHI’s operations are overseen by the Canadian Council of Insurance Regulators (CCIR). For more information, visit www.olhi.ca.

SOURCE OmbudService for Life & Health Insurance

Desjardins Insurance announces changes to its leadership team

Press Release:

Gregory Chrispin, Senior Executive Vice-President of Wealth Management and Life and Health Insurance, is pleased to announce the following appointments.

André Langlois has been named Senior Executive Vice-President, Life and Health Insurance.

André will head up operations for Desjardins Insurance and all of its business lines, including: individual insurance, group and business insurance, group retirement savings and creditor and direct insurance. He will be responsible for managing the group savings firm Desjardins Financial Security Investments (DFSI) and the SFL and Desjardins Financial Security Independent Network (DFSIN) distribution networks. André has extensive knowledge of the life and health insurance sector, acquired over nearly 30 years with Desjardins Group.

Michael Rogers has been named Vice-President, Sales and Distribution.

In this national role, Michael will be responsible for individual insurance business development. He will also manage the SFL and DFSIN distribution networks and the group savings firm Desjardins Financial Security Investments, which has more than $14 billion in assets. Michael will be rolling out a renewed service offer for our distribution partners to contribute to their performance and strengthen their presence across the country. Relying on the expertise of 4,800 people and more than 10,000 distribution partners, Desjardins Insurance provides peace of mind to more than 5 million Canadians. With assets of $100.3 billion, the company is the fifth largest life and health insurance company in Canada.

Source:

John Bordignon
Media Relations – State Farm Canada

www.statefarm.ca

Top GOP senator seeks action now to steady insurance markets

A leading Republican senator is calling for immediate action to stabilize shaky health insurance markets around the country, amid concerns that the GOP will get blamed if constituents’ lives are disrupted.

Sen. Lamar Alexander of Tennessee called on the Trump administration Thursday, June 15, 2017 to guarantee payment of billions of dollars in disputed ” cost-sharing” subsidies at least through next year, and probably in 2019 as well.

The federal money allows insurers to reduce deductibles and copayments for people with modest incomes buying plans through HealthCare.gov and state-run markets. A GOP lawsuit cast a cloud over the payments.

Alexander, the health committee chairman, says guaranteeing the money would avoid the “real possibility” that millions of people will have no options for coverage next year.

He joins other Republican lawmakers calling for administration action.

 

Canada’s life and health insurers support progressive trade agenda

Canadian Life and Health Insurance Association (CLHIA)

As global leaders with significant international operations, Canada’s life and health insurers are strong supporters of the Canadian government’s international trade agenda.  Today, CLHIA released a position paper outlining key trade priorities for the industry.

“The life and health insurance industry supports the Government’s efforts to increase our international trade”, stated Frank Swedlove, President and CEO of the Canadian Life and Health Insurance Association (CLHIA). “We’d like to see the Government finalize free trade agreements in key markets with a strong emphasis on financial services.”

Key trade priorities for the life and health insurance industry include: ensuring that the interests of Canada’s financial sector are well-represented in all of Canada’s free trade agreements; and, that agreements include coverage of new and emerging trade issues such as the cross-border flow of information and rules governing the commercial operations of State Owned Enterprises.

Three of Canada’s insurers rank in the top 15 insurance companies in the world and operate in over 20 countries “Our international operations bring clear benefits to Canadians and we look forward to working with the Government to ensure we continue to bring value to the Canadian economy.”  added Mr. Swedlove.

About the CLHIA

Established in 1894, the CLHIA is a voluntary association whose member companies account for 99 percent of Canada’s life and health insurance business. The industry is very active internationally, with operations in over 20 countries. Canadian life and health insurers have over $800 billion worth of assets invested on behalf of foreign policyholders and payout almost $78 billion worth of benefits outside of Canada. 45 million individuals are protected by these foreign operations and 138,000 people are employed in support of Canadian operations abroad.

SOURCE Canadian Life and Health Insurance Association Inc.

For further information: Wendy Hope, Vice President, External Relations, (613) 691-6001/whope@clhia.ca

Republican administration weighs health insurance ‘stabilization’

Worried about the nearly 20 million people who buy their own health insurance policies, the Republican administration and congressional Republicans are weighing how to stabilize a wobbly market, government and industry officials say.

The goal is to soothe jittery insurance companies that may bolt next year, while reassuring consumers anxious about the future. That could also buy time for more ambitious GOP attempts to rework the health care law.

Some of the changes can be carried out single-handedly by the new administration, but others may require congressional action or co-operation.

The measures would affect not just those consumers on the subsidized marketplaces under “Obamacare,” but also people purchasing directly from an insurer or through an independent agent. The two groups have become intertwined. This year’s sharp premium increases in the health law markets also hit consumers buying individual policies on the outside, but they are not eligible for financial assistance from the government.

No final decisions appear to have been made. Trump administration officials would not comment ahead of an expected Senate vote on confirming Georgia Rep. Tom Price as the new health secretary.

But a Republican congressional aide familiar with the internal discussions said the regulatory changes that the administration is considering include:

_ Tightening rules for “special enrolment periods” that allow consumers to sign-up outside of the standard open enrolment window. Insurers have complained that some people take advantage of such opportunities to get coverage when they need care and later drop out, raising costs for everyone else.

_ Loosening a provision of the Affordable Care Act that prevents insurers from charging older customers more than three times the premium for young adults. It’s unclear how this would happen, since the limitation is specified in the law. But the GOP aide said the administration might be able to find wiggle room. Before the Obama health law, insurers routinely charged older customers five times or more what younger people paid. The ACA has made insurance more affordable for older adults, but critics say that’s pricing out the young and healthy. AARP is already mobilizing to try to head off any attempt to make older customers pay more.

_ Shortening the 90-day grace period to pay premiums for consumers who get subsidized coverage. Insurers complain this makes it easier for people to game the system.

_ Shortening the current health law sign-up season, which runs about 90 days.

_ Relaxing rules on how insurers structure their networks of hospitals and doctors. Republicans tend to think those should be set by states.

The GOP aide spoke on condition of anonymity to discuss internal deliberations. Another person familiar with the administration’s thinking said the points were on target. The regulatory changes mirror requests by insurers, who argue they would help check premiums.

A White House regulatory website lists a health insurance market stabilization rule as “pending review.”

Along with the administration, congressional Republicans would have a role to play in stabilizing the markets, by stepping back from several previous efforts to block “Obamacare” financing.

Chief among them is the fate of billions in subsidies that help low- and moderate-income people cover high insurance deductibles and co-payments. More than half of the consumers in the government marketplace get these subsidies, and insurers say they are essential. House Republicans have questioned their legality.

Other financing issues involve the health care law’s complicated internal system for stabilizing premiums. It has not worked as intended, partly because of GOP efforts to deny financing to the Obama administration.

After promising to quickly shred Obama’s law and replace it with a conservative approach, Republicans seem to be slowing down and thinking things over. Every lawmaker has thousands of constituents potentially affected.

At a hearing last week, House Energy and Commerce Committee Chairman Greg Walden, R-Ore., answered critics by saying it’s “beyond the pale” to suggest that Republicans just want to cut coverage.

He said the country isn’t going back to the days when “through no fault of your own (if) you have some disease that keeps coming at you … sorry, you’re on your own and you’re destitute.

“That’s not the choice here,” said Walden. “The choice is how we get it right.”

About 12 million people have signed up for coverage this year through the health law’s subsidized markets, according to federal and state figures.

Congressional experts estimate that another 8 million buy individual policies outside the government markets. Consumers in this group get no federal subsidies, but they have also seen their premiums shoot up. Many are self-employed business people or early retirees, constituencies considered receptive to Republicans.

 

A breakdown of pain management treatments

Pain management is a branch of medicine aimed at reducing patient suffering and boosting quality of life. While some experts distinguish between pharmacological and non-pharmacological approaches to treating pain, Dr. Fiona Campbell, a pediatric anesthetist based in Toronto and the incoming head of the Canadian Pain Society, breaks the strategies into three areas: pharmacological, physical and psychological. Marc White, a medical researcher and president of the Canadian Institute for the Relief of Pain and Disability says there is good evidence demonstrating the effectiveness of these alternative options for treating some subsets of the population.

Pharmacological: The drugs and medications available over the counter or through a doctor’s prescription. These methods tend to receive the most research funding and better coverage within Canada’s medical system, making them easier to access for people who don’t have private health insurance. Examples of the drugs include anti-inflammatory drugs, acetaminophen, narcotics.

Physical: These interventions range from behavioural modifications, such as exercise or physiotherapy, to more invasive procedures, such as surgery or steroid injections. Examples for the intervention include steroid injections, exercise, physiotherapy, massage, acupuncture, heat/cold application

Psychological: Mental techniques tend to focus on a person’s relationship with pain, engaging with the behaviours, feelings and thoughts that accompany physical suffering. Techniques include psychotherapy, cognitive behavioural therapy, mindfulness, meditation, hypnosis, relaxation techniques

Sources: American Psychological Association, American Chronic Pain Association

 

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