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Response to the New Brunswick Association of Optometrists


Release Date: 10/01/2015
Staff Reference: Stephen Frank

October 1, 2015

Dr. Amy Robinson, Chairperson
Unregulated Dispensing Working Group of New Brunswick
New Brunswick Association of Optometrists
490 Gibson Street, Unit 1
Fredericton, NB E3A 4E9

Dear Dr. Robinson,

Thank you for your letter dated September 21, 2015 to Donald Guloien. As President and CEO of the CLHIA, I am pleased to respond to your letter.

To provide you with some background on vision care coverage offered by private health plans, it is important to note that coverage will vary depending on the plan design that is chosen by the plan sponsor (the employer). Each plan sponsor will design their plan with the goal of providing attractive benefits in order to attract and retain talent, while also ensuring the sustainability of their benefit plans from a financial perspective. Increasingly, given the costs of eyewear, we are seeing a trend towards plan sponsors introducing maximums and co-payments on this benefit. As a result, individuals are seeing increasing out-of-pockets costs when purchasing eyewear. This may result in plan members seeking lower cost options in the market, such as purchasing eyewear over the internet. As well, the convenience and growing ease with shopping on-line may also be a driver.

Most benefit plans will leave the choice of provider to the plan member and will not specifically exclude certain providers such as those selling over the internet. It is our understanding that regulations in the province of New Brunswick are intended to regulate practitioners within the province and do not regulate the actions of the consumer. Eye wear purchased through the internet appear to be governed by regulations pertinent to the jurisdiction where the eye wear is fabricated and shipped. As such there do not appear to be any legal restrictions prohibiting a New Brunswicker from purchasing eye wear over the internet or outside the province. In our view our current approach to managing this benefit respects the consumer's choice and meets the needs of both plan members and plan sponsors.

You have raised the issue of fraudulent claims arising from eye wear sales over the internet. Our members routinely audit claims and have processes in place to mitigate the risk that you raise.

I hope that this explains the position of the industry with respect to regulation, provider and consumer choice in the area of eye wear.

Sincerely,

Original signed by

Frank Swedlove