Insurance companies cut group health plan premiums as claims fall

By Tara Deschamps


TORONTO _ Canadian insurance companies are slashing premiums in a bid to help small- and medium-sized businesses grappling with COVID-19.

The declining use of dental benefits and some extended health care benefits have pushed the Winnipeg-based insurer Canada Life Assurance Co. to offer premium reduction adjustments for employer-sponsored group benefits plans.

Canada Life President Jeff Macoun said the reductions will be 50 per cent for dental and 20 per cent for vision and extended health care benefits, excluding prescription drugs.

“Unlike premium deferrals, these savings do not need to be repaid later, and reflect that some healthcare service providers have shifted to virtual treatment, while others are offering more limited services,” he said in a statement.

Canada Life said prescription drugs are not included as the services are essential and the number of claims have not dropped.

The company said the premium reductions will be retroactive to April 1 with credits applied to May invoices.

“Over 1 million Canadians were laid off in March alone, and financial insecurity is growing,” he said.

“These premium reductions will give more than 26,000 of our business customers some much-needed financial relief, both to their business and to maintaining valued coverage for their employees.”

Over at Sun Life Financial Inc., credits against dental and non-drug-related extended health care premiums will be offered in hopes of reducing invoices for Canadian businesses, who are already struggling with low cash flow.

The insurance company will offer 50 per cent credit per month against paid dental premiums because most routine dental visits have stopped during the pandemic.

For non-drug-related, extended health care premiums it will offer a 20 per cent credit on each of a client’s extended health care benefits.

“Prescription drug usage has not declined during the pandemic,” said Dave Jones, the senior vice-president of group benefits at Sun Life Canada, in a statement.

“Plan members are using an increased volume of virtual care across their paramedical providers, however usage has still reduced.”

April credit in both areas will be applied to June invoices and Sun Life will continue to assess the offerings on a monthly basis.

Meanwhile, Manulife Financial Corp.’s said in an email to The Canadian Press that all group benefit plan sponsors, including small, medium and large-scale businesses, who have a fully-insured, non-refund benefits plan will be given premium relief.

Manulife will reduce their dental premiums by 50 per cent and their extended health care premium, including prescription drugs, by 10 per cent in the month of May.

Manulife said coverage for plan members will not change and the premium reductions will be applied to regular pre-authorized debit draws for May.


Provinces urged to end newcomer waits for public health insurance amid pandemic

By Colin Perkel


TORONTO _ Hundreds of doctors, nurses and activists are calling on provincial governments to ensure immediate access to free health care for new arrivals in light of the COVID-19 pandemic.

In an open letter to Ontario Premier Doug Ford and Health Minister Christine Elliott this week, the group OHIP For All says urgent action is needed in light of a looming public health emergency in Canada.

“We are deeply concerned about these pre-existing barriers to health care for uninsured individuals in Canada, and the potential public health implications in the context of a pandemic,” the letter states.  “As a group of health-care providers and community members, we call on all levels of government, health institutions, and public health leaders to act now to ensure care for everyone.”

Typically, new arrivals in Canada have to wait at least three months to access provincial health coverage. The newcomers include Canadians returning from longer stretches abroad, recent immigrants, some temporary foreign workers and international students, and undocumented workers. In some cases, people who have lost identity documents may also have trouble getting coverage.

Definitive numbers are hard to come by, but estimates suggest a significant number of people in Canada are in a non-coverage situation, said Dr. Arnav Agarwal, an internal medicine resident with the University of Toronto and core member of OHIP For All.

“The estimates would say something between 200,000 and 500,000, with more estimates on the upper end,” Agarwal said in an interview.

Ontario Health Minister Christine Elliott said the government was moving to scrap the wait period only for returning Canadians, but anyone needing health care would get it.

As of Thursday, Canada has seen more than 700 cases of COVID-19. Ten people have died, most of them in British Columbia. Ontario has recorded upwards of 250 cases and two deaths. Experts say the highly contagious virus poses little risk to most people. However, the elderly, those with underlying health conditions, and the marginalized face a much higher risk.

OHIP For All’s main concern is that those in need of health services might stay away, be denied care, or be forced to pay out of pocket and end up with large debts.

“We must recognize that people experiencing symptoms associated with COVID-19 will seek care through community clinics and hospitals, and therefore these sites must also be free and accessible to all,” the group’s letter states.

Society as a whole is at risk if everyone, regardless of immigration or other status, has no ready access to the health-care system, Agarwal said.

“The health and well-being of our community as a whole relies on the well-being of every individual in it,” Agarwal said. “When you recognize that this is such a substantial portion of our community, it makes it all the more important to ensure that they have access to testing as well as to the right supportive care.”

About 1,000 people and organizations have signed the letter urging coverage for the uninsured.

The letter calls on governments to ensure COVID-19 assessment centres have an explicit policy to be free and accessible to all, regardless of immigration status. It also wants similar unrestricted access to community clinics and hospitals.

The public, the groups says, must also be informed that assessment and care is available to everyone for free.

Private clinics would harm ‘ordinary’ people using public system in B.C.: lawyer

By Camille Bains


VANCOUVER _ A legal challenge by the owner of a private clinic providing scheduled surgery for  “affluent” patients should be denied because it is based on a flawed constitutional argument, a lawyer for the B.C. government says.

Jonathan Penner said Tuesday that Dr. Brian Day’s bid to have the province strike down provisions of the Medicare Protection Act prohibiting double-billing amounts to an  “unlawful business model.”

Penner told B.C. Supreme Court Justice John Steeves that Day’s legal team has called the province’s position shocking, adding that’s based on a disregard for patients who can’t afford private care at clinics, such as the Cambie Surgery Centre, opened by Day in 1996.

“In my submission what truly is shocking is this complete and utter disregard for the situation of anyone who is not in a position to come up with the funds to pay them to provide rapid surgical services,” he said.

“They seek the privileged, those few privileged British Columbians who require scheduled surgery and have the resources to pay for private care,” Penner said, adding  “ordinary” people would have less access to care under a two-tier system Day has proposed.

The frail and elderly, patients with complex conditions, and those with severe mental illness and/or substance-use issues would be particularly disadvantaged because regulating a public-private system that could invite American-style insurers would come at a high cost and take money away from public health care, he said.

Waitlists for patients requiring palliative care as well as emergency and urgent services would also increase under such a system because doctors, anesthesiologists and nurses would be lured to clinics allowing them to earn money in both the public and private systems, he said.

Penner suggested physicians should no longer be enrolled in the Medical Services Plan if they choose to work in for-profit clinics.

Day, an orthopedic surgeon, has hinged his decade-long legal battle on arguments around patients having a right to pay for services if wait times in the public system are too long.

He has maintained that four plaintiff patients have been deprived of life, liberty and security under the Charter of Rights and Freedoms after suffering harms from waiting for surgery in the public system before they sought care at his clinic.

Penner called that argument “political theatre” and said Day’s legal team has failed to identify whether any harms the patients may have endured were related to wait times in the public system.

Hanna Davis, a lawyer for the federal government, said Day’s assertion that private health insurance could enable patients to access care at clinics like his would not apply to people who can’t afford premiums, especially if they have pre-existing conditions.

The same applies for employer-based insurance, which also would not be available to those who are retired, unemployed or not provided with such options at their workplace, she said.

Regardless, the underlying principle of the Canada Health Act is based on access to care based on need, not ability to pay, Davis said.

A two-tier scheme would weaken the public system, which would be left to deal with more complicated health-care cases while private clinics would take on easier surgeries as part of what is referred to as  “cream skimming,” she said.

The Canada Health Act does not explicitly require provinces to prohibit duplicative private insurance as a condition of federal health funding, she said.

“However, all Canadian provinces have either voluntarily prohibited or effectively restricted private health duplicative insurance as one of the main safeguards to protect the integrity of the public health-care system.”

Requiring people to have their own insurance would amount to discrimination against those who wouldn’t be eligible for it, Davis said.

When Day opened his clinic, he said surgeons who worked in hospitals were not getting enough operating-room time and profit was not his motive.

However, the facility has been operating since 2003 in violation of unproclaimed provisions of the provincial Medicare Protection Act.

Health Minister Adrian Dix announced in 2018 that the government would begin to fine doctors $10,000 for a first offence if they charged patients for publicly available services and that the “don’t ask, don’t tell” approach that allowed private-clinic surgeries and diagnostic tests to continue would no longer be permitted.

Day won an injunction at the B.C. Supreme Court that ordered the government not to enforce that section of the act until his constitutional challenge is dealt with.

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