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CLHIA welcomes interim report of Advisory Council on the Implementation of National Pharmacare

Published on 06/03/2019

Prescription Drug Costs > Drug pricing Generic drug pricing Provincial & territorial drug program information Pharmacare

Following six months of consultations with stakeholders, including our industry, the federal panel studying national pharmacare issued its interim report on March 6. The report identified six core principles that it believes should underpin a future program, as well as three initial “building blocks” that it recommends be acted upon immediately.

Flanked by the federal ministers of finance and health, advisory council chair and former Ontario Health and Long-Term Care Minister Dr. Eric Hoskins said the future program must improve access to prescription drugs for all Canadians, ensure portable access across Canada, provide for a comprehensive formulary, be designed with input from patients, be a partnership of all orders of government, including indigenous peoples, and include a “a robust pharmaceutical management system.”

The report called for immediate action on a national drug agency, a comprehensive, evidence-based national formulary and improved drug data and information technology systems.

Not missed by observers including CLHIA, is the report’s silence on the important question of how a national pharmacare would be delivered. On that, CLHIA’s response emphasized that a future program must ensure that all Canadians can access affordable prescription medicines no matter where they live and work in Canada. A balanced solution will ensure that the system is sustainable into the future and protects the health benefit plans that Canadians value.

The advisory council’s final report is slated for release in June, four months before the federal election.

Benefits fraud is a real crime with real consequences

Published on 04/03/2019

Compliance > Fraud risk management

March is national Fraud Prevention Month and CLHIA is using the month to educate consumers of the signs, risks and real consequences of benefits fraud.

Our efforts have continued to promote the Fraud = Fraud website and campaign launched late last year to raise awareness of benefits fraud and how to recognize, refuse and report it. As part of this, CLHIA issued a national news release, and have promoted Fraud = Fraud assets in our social media channels. To help member companies, we also prepared updated banners and a Fraud Prevention Month toolkit located on our Member Centre that includes social media content and messaging.

Fraud Prevention Month is an annual campaign supported by the federal government and industry that seeks to help Canadians to recognize, reject and report fraud.

Sponsored by CLHIA with the support of our member companies, the Fraud = Fraud website has attracted 99,000 unique visitors, generated national media attention and has close to 400,000 views of the video and 7,000 social media hits.

CLHIA Comments on the Ontario Auto Insurance Consultation

Published on 15/02/2019

Disability Group Insurance Insurance > Long term disability Paramedical benefits Employee benefit plans Provincial & Territorial Legislation

Comments on 2019-20 FSRA Priorities and Budget

Published on 08/02/2019

Compliance Insurance > Fair treatment of customers (FTC) Conduct of business (Commercial practices) Provincial & Territorial Legislation

Earlier this month, the CLHIA made a submission to the FSRA’s public consultation on its 2019-20 priorities and budget. Our submission emphasized our support for FSRA’s proposed core priorities in the areas of reducing regulatory burden and improving regulatory effectiveness. The CLHIA recommended that the new agency find opportunities for policy review with the aim of eliminating overlap and duplication, consider establishing a dedicated life and health insurance industry advisory committee, and harmonize the fair treatment of consumers guidance with existing CCIR-CISRO Guidance.

The CLHIA looks forward to continuing to collaborate with Ontario’s new financial sector regulator in the months ahead.

Proposed Amendments to Ontario Regulation 201/96 made under the Ontario Drug Benefit Act

Published on 31/01/2019

Prescription Drug Costs > Provincial & territorial drug program information

On January 31, the CLHIA responded to draft regulations on proposed changes to OHIP+ that were issued on January 2. The CLHIA recommended moving forward with Trillium Drug Program (TDP) automation as well as regulatory changes to ensure that employers do not eliminate drug coverage for youth under 25.

The Fall Economic Statement noted that the planned changes to OHIP+ would occur in March 2019. Any child/youth with coverage through a private insurance plan must submit prescription drug claims to their existing private coverage. Children/youth without coverage through a private insurance plan will be eligible to submit any excess out-of-pocket costs to the TDP. TDP is available to all Ontarians and is means-tested so that the deductible required to be paid out-of-pocket increases with household income.

Globe and Mail supplement: Fraud Prevention Month, March 2018

Published on 08/03/2018

Group Insurance > Employee benefit plans

Understanding Claims for Treatment of Obstructive Sleep Apnea with Positive Airway Pressure (PAP) Devices

Published on 03/01/2018

Group Insurance > CLHIA Group Insurance guidelines and reference documents Paramedical benefits Employee benefit plans

This Reference Document is meant for informational purposes only. All claims for PAP devices will be adjudicated in accordance with the terms of the group benefit plan under which they are being claimed. In the event of a discrepancy between this Reference Document and the group benefit plan, the provisions of the group benefit plan will apply.

Improving drug access and affordability : Can public and private payers do more, together?

Published on 01/12/2017

Prescription Drug Costs > Drug pricing Pharmacare

Karen Voin, CLHIA's Vice President, Group Benefits and Anti-Fraud, presents the association's efforts on bridging the public-private divide.

CLHIA Views on the Ontario Private Member’s Bill 162

Published on 18/10/2017

Insurance > Provincial & Territorial Legislation

Bill 162, an Act to amend the Insurance Act to Authorize Life Settlements, seeks to amend section 115 of the Ontario Insurance Act to provide for an exception to the current rule which prohibits any person, other than an insurer or its duly authorized agent, from trafficking or trading in life insurance policies. The Bill seeks to provide an exception to this prohibition for a life insurance policy if the purchase is from the original policyholder and the policy has been held for at least 36 months. The Bill also provides for a 10-day cooling-off period, during which time the agreement for the sale of a life insurance policy may be cancelled.

Empowering employees to make healthy choices - Workplace wellness programs

Published on 12/09/2017

Group Insurance > Employee benefit plans

Published in the National Post's "Health Literacy" supplement

CLHIA Standardized Advisor Practice Review for Use in the MGA channel

Published on 21/08/2017

Distribution > CLHIA Distribution guidelines and reference documents

Serving Clients Through Needs-Based Sales Practices - Training Module

Published on 06/06/2017

Insurance > CLHIA Insurance guidelines and reference documents

Reference Document

Advisor Disclosure Best Practices - Training Material

Published on 06/06/2017

Insurance > CLHIA Insurance guidelines and reference documents

Reference Document


Published on 16/05/2017

International > International Trade CLHIA International Trade Policy Paper

This position paper briefly describes the benefit of trade in financial services to Canada, the participation of our insurance companies in foreign markets, and the policy directions the Canadian government should take to promote and facilitate trade, particularly for financial services.

Health care dollars lost to fraud are everyone's concern

Published on 16/03/2017

Group Insurance > Employee benefit plans

The Globe and Mail's Fraud Prevention Report

When it comes to buying life insurance, there's no time like now when you're young and healthy >

Published on 21/03/2017

Information Updates

When it comes to buying life insurance, there’s no time like now when you're young and healthy

IVIC Suitability Needs-Based Sales Practices

Published on 31/10/2016

Distribution > CLHIA Distribution guidelines and reference documents

Canadian Life and Health Insurance Facts, 2016 Edition

Published on 15/09/2016

Capital and Assets Distribution Group Insurance Insurance Pensions and Retirement > Long-term investments Minimum Continuing Capital and Surplus Requirements Coordination of benefits Employee benefit plans Travel insurance Segregated Funds (IVICs) Annuities Public pensions (OAS/CPP/QPP/GIS) Pooled registered pension plans/PRPPs (and provincial variations) Employer pension plans Registered Products (RRSP, LIRA, RRIF)

Big changes afoot for life agents?

Published on 22/04/2016

Distribution > Market conduct Sales practices

Investment Executive May 2016

Time for creativity to finance Canada’s infrastructure, Frank Swedlove, President and CEO, CLHIA

Published on 25/02/2016

Capital and Assets > Long-term investments

Canada’s insurers are very able and more willing than ever to play a larger role in making sure Canada builds the infrastructure the country needs in a timely and affordable fashion.

Replacement Disclosure

Published on 05/09/2014

Distribution > CLHIA Distribution guidelines and reference documents

Understanding Claims for Footwear and Orthotics

Published on 01/03/2018

Group Insurance > CLHIA Group Insurance guidelines and reference documents Paramedical benefits Employee benefit plans

Guaranteed Withdrawal Benefit (GWB) Illustrations

Published on 22/03/2011

Distribution Insurance > CLHIA Distribution guidelines and reference documents Product disclosure CLHIA Insurance guidelines and reference documents Segregated Funds (IVICs)

The purpose of this Guideline is to describe the information that should be included in illustrations of IVICs offering guaranteed withdrawal benefits. In particular, the Guideline identifies features that could be misunderstood by consumers or which are affected by consumer decisions and recommends practices to assist in explaining these.