Changes in Quebec impacting Eligible Costs

There are two areas where recent changes in Quebec legislation will impact group benefit plans for those organizations with employees resident in that province. Effective June 20, 2015, Bill 28 came into effect allowing pharmacists to perform 7 new pharmaceutical services. While the exact terms of this agreement have not been made public, RAMQ has confirmed 4 out of the 7 new acts will be considered billable and, therefore covered under the Act Respecting Prescription Drug Insurance and, as a result, also covered by private drug plans for Quebec residents.

These 4 services are:

• Extending prescriptions (RAMQ fee not yet posted)
• Adjusting prescriptions to achieve therapeutic targets (RAMQ is set at $15.50 or $18.50 for the initial consult, and then a monthly fee of $16.00 or an annual fee of $40.00/$50.00 for follow up consults)
• Prescribing drugs to treat minor conditions where the diagnosis and treatments are known (RAMQ fee is $16.00)
• Prescribing drugs to treat minor conditions where the diagnosis and treatments are known (RAMQ fee is $16.00)

These will be eligible expenses under a drug plan for all claims incurred after June 20. While the Act has not yet provided details on fees for the other services, those are :

• Performing therapeutic substitution in case of a shortage of product
• Ordering and interpreting laboratory results
• Administering a drug to demonstrate the proper usage

These will be eligible expenses under a drug plan for all claims incurred after June 20. While the Act has not yet provided details on fees for the other services, those are :

Changes to Quebec Public Drug Insurance Plan

The Regie de L’assurance Maladie du Quebec (RAMQ) introduced changes to the Public Prescription Drug Plan effective July 1, 2015. These changes will affect Quebec residents between ages 18 and 64 as well as residents over age 65 not receiving the Guaranteed Income Supplement or receiving the supplement at a lesser rate (between 1% and 93%).

The highlights are as follows:

• Maximum out of pocket for members increases from $1,006 to $1,029
• Monthly deductible increases from $16.65 to $18.00
• Co-pay increases from 32.5% to 34%
• Maximum monthly out of pocket increases from $83.83 to $85.75
• Premium increases from $611 to $640

The highlights are as follows:

1. The plan’s reimbursement level for drugs will move to 100% once a plan member reaches the out of pocket maximum, and
2. The plan’s co-pay must be equal to or better than the RAMQ co-pay.

Top 5 Considerations When Dismissing Employees

Dismissing an employee is never an easy exercise for an employer and all too often employers do so without appreciating the obligations and potential liabilities associated with this process. Key considerations include:

1. Pay according to Common Law reasonable notice. While there are no hard rules, common practice is to budget a month’s compensation for each year of service with adjustments up and down based on age, position held and the ability to obtain comparable employment.
2. Continue Benefits during Notice Period. Under common law, the reasonable notice period, as referenced above, will include continuation of group benefits, pension contributions, car allowances, bonuses and profit sharing
3. Be cautious when Consider Dismissal for Cause. This position can have dire consequences for the employee – including denial of EI benefits. Difficulty getting another job and financial challenges if they did not receive an appropriate severance package. Courts have been known to side with the employee in these circumstances so to avoid additional costs of a court awarded settlement and accompanying litigation expenses, the employer should consider these risks when taking a cause position for the dismissal.
4. Dismissing an Employee on Leave. This, too, can result in litigation and any court or tribunal will want to ensure the dismissal had nothing to do with the leave. Protected leaves include pregnancy/parental, compassionate leave, emergency leave or when an employee is off due to a disability or Workers Compensation injury.
5. Ensure the Employee Signs a Release. The employer who pays a severance package that exceeds statutory entitlements should always get a full and final release from the employee.