GroupNews – April 2021

Benefit plan management

Manitoba pauses increase to pharmacare deductible

Flag of the province of Manitoba, Canada. Blue sky backgroundAccording to a March 31 news release, in an effort to help Manitobans deal with the financial uncertainties caused by COVID-19, the government of Manitoba will freeze the pharmacare deductible rate for the second consecutive year. The rate for 2021–2022 will remain at 2019–2020 levels. The annual deductible is determined by multiplying the adjusted total family income for 2019 by the applicable deductible rate. Pharmacare will pay 100% of eligible expenses after the minimum deductible of $100 is met.

The following table provides a breakdown of the deductible rates:

Adjusted
Family Income

Deductible Rate:
2021-2022

$0 – $15,000 3.17%
$15,001 – $21,000 4.49%
$21,001 – $22,000 4.53%
$22,001 – $23,000 4.61%
$23,001 – $24,000 4.67%
$24,001 – $25,000 4.72%
$25,001 – $26,000 4.79%
$26,001 – $27,000 4.84%
$27,001 – $28,000 4.90%
$28,001 – $29,000 4.94%
$29,001 – $40,000 4.97%
$40,001 – $42,500 5.39%
$42,501 – $45,000 5.52%
$45,001 – $47,500 5.64%
$47,501 – $75,000 5.71%
$75,001 and greater 7.15%


Impact:
Private plans that cover the employee deductible for eligible members will not experience increased costs for the 2021–2022 benefit year.

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Benefit plan management

Update on biosimilars in British Columbia

As previously reported in GroupNews in 2019, British Columbia PharmaCare introduced a Biosimilars Initiative in 2019 to move patients from biologics to biosimilars for specific indications. Effective April 7, the government is expanding the initiative to cover individuals being treated with Humira to an adalimumabe biosimilar brand such as Amgevita, Hadlima, Hulio, Hyrimoz and Idacio.

The province will allow a six-month transition period to provide time for patients to start the switching process with their prescriber. During the transition period from April 7, 2021 to October 6, 2021, PharmaCare will cover Humira and biosimilar brands of adalimumab for all currently covered patients. At the end of the transition period, PharmaCare will only cover an approved biosimilar.

Impact: From December 1, 2019 to November 30, 2020, the British Columbia government spent approximately $94 million on coverage for Humira. As the biosimilars are at least 40% less expensive, this can produce significant savings for the PharmaCare program in the province. The impact for savings on private plans will depend on how the drug plan is integrated with the provincial pharmacare program.

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Legal and legislative news

Coronavirus contagions floating over the Canadian flag.Federal government extends COVID-19 leaves under Canada Labour Code

On March 31, 2021, the federal government published regulations amending the Canada Labour Standards Regulations made under the Canada Labour Code to increase the length of federal COVID-19 leaves from two to four weeks unpaid leave for employees who:

  • have or might have contracted COVID-19
  • have underlying conditions, are undergoing treatments or have other specified circumstances that makes them more susceptible to COVID-19, or
  • have been advised to isolate by a medical practitioner, public health authority or other specified authority for reasons related to COVID-19.

Job-protected leave to care for a child or a family member who required care is also increased to
38 weeks (previously 26 weeks).

These changes align the COVID-19 leaves with changes to the Canada Recovery Caregiving Benefit and the Canada Recovery Sickness Benefits.

Impact: Federally regulated employers will need to ensure they comply with benefits continuation requirements under the Canada Labour Code.

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Legal and legislative news

Canadian jurisdictions consider leaves for COVID-19 vaccinations

Saskatchewan
Saskatchewan has become the first jurisdiction in Canada to implement a paid leave to allow an employee to take time off work to be vaccinated for COVID-19. Effective March 18, 2021, The Occupational Health and Safety Regulations, 2020 have been amended to stipulate that workers:

  • are entitled to three consecutive hours leave during work hours to receive a COVID-19 vaccination;
  • are entitled to more than three consecutive hours if the employer determines the circumstances warrant a longer break from work; and
  • do not lose any pay or other benefits while receiving a COVID-19 vaccination.
British Columbia
The government of British Columbia has announced that, as part of the province’s COVID-19 immunization plan, it will introduce regulatory improvements under the Employment Standards Act to provide job-protected leave and paid leave for part-time and full-time workers to take time off to travel and receive the COVID-19 vaccine, or to take a dependent family member to be vaccinated.

The regulatory changes also expand job-protected leaves for reasons related to COVID-19 to ensure job protection for all eligible federal benefit programs such as the Canada Recovery Sickness Benefit and Canada Recovery Caregiving Benefit.

Impact: Plan sponsors will be interested to see if any other Canadian jurisdictions follow Saskatchewan and British Columbia’s lead in providing paid vaccination leave. The changes in Saskatchewan and British Columbia will require plan sponsors to review their current plans to ensure they are complying with benefits continuation requirements.

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Legal and legislative news

Budget updates: Focus on healthcare in Nova Scotia, Ontario, Quebec, Saskatchewan, Manitoba and federally

Federal
The 2021 Federal Budget, was tabled by Finance Minister Chrystia Freeland on April 19, 2021. Due to the COVID-19 pandemic, this is the first full budget from the government since 2019. Also see our Special Notice for further information on the 2021 Federal Budget.
Employment insurance sickness benefits

 

  • Extends the maximum payment period for sickness benefits from 15 to 26 weeks starting in summer 2022.
  • Proposes to make amendments to the Employment Insurance Act, as well as corresponding changes to the Canada Labour Code to ensure that workers in federally regulated industries have the job protection they need while receiving EI sickness benefits.
Pharmacare
  • The government committed to move forward with its announced plan to provide ongoing funding of $500 million toward initiatives aimed at high-cost drugs for rare diseases.
  • Committed to working with regulators in other countries to enhance Canada’s drug approval processes, while also proposing funding to launch a National Quantum Strategy that will help design life-saving drugs.

Canada Recovery Benefit

 

  • Budget 2021 proposes to provide up to 12 additional weeks of Canada Recovery Benefit to a maximum of 50 weeks.
  • Canada Recovery Caregiving Benefit will be extended an additional 4 weeks, to a maximum of 42 weeks
Employment Insurance Reform
  • Budget 2021 proposes, starting in 2021–22, to provide for legislative changes to make Employment Insurance more accessible and simpler for Canadians.
  • Budget 2021 also announced forthcoming consultations on future, long-term reforms to Employment Insurance

 

Nova Scotia
There are several items of interest, including:

Health system improvements

 

  • $12.8 million increase to help Nova Scotians access the medications they need, including funding for seniors and family pharmacare.
  • $2.8 million to accelerate the use of virtual tools and digital approaches to providing healthcare.
Mental health support
  • $336.5 million for mental health services.
  • $5.9 million for an e-Mental Health and Addictions action plan to develop a coordinated, integrated, and efficient service with Nova Scotia Health Authority and the IWK  pediatric hospital and trauma centre in Halifax.
Long-term care More than $1 billion for continuing care through improvements to long-term care and home care, a $119.6-million or 13 percent increase from last year includes:

  • $22.6-million increase, for a total of $27.8 million, to implement the findings of the Expert Panel on Long Term Care, including long-term care assistants, expanding access to allied health providers, and implementing primary care coverage in nursing homes.
  • $12.3 million to extend Regional Care Centres for long-term care patients with COVID-19.
  • $6-million increase to support the continuing care sector with COVID-19-related expenses.
  • $2.7-million increase to the Supportive Care program to support people with cognitive impairments.
  • $814,000 increase for Adult Day Programming to provide personal assistance, supervision, and health, social, and recreational activities for community-based seniors.

 

Ontario
The Ontario government tabled its 2021 Budget, “Ontario’s Action Plan: Protecting People’s Health and Our Economy” on March 24, 2021. The Budget focuses heavily on relief measures to combat the ongoing COVID-19 pandemic, with an emphasis on related investments in healthcare. Items that may be of interest include:

COVID relief

 

  • The government is investing an additional $5.1 billion to support hospitals during the ongoing pandemic to create more than 3,100 additional hospital beds. This includes
    $1.8 billion in 2021–22 to continue providing care for COVID‑19 patients, address surgical backlogs and keep pace with patient needs.
Long-term care
  • Additional $933 million investment over four years, for a total of $2.6 billion, to support building 30,000 new long-term care beds, and $246 million over the next four years to improve living conditions in existing homes.
  • To protect long-term care residences from COVID‑19, the province is investing an additional $650 million in 2021–22, to bring the total resources invested since the beginning of the pandemic to over $2 billion to protect the most vulnerable.
  • $4.9 billion investment over four years to increase the average direct daily care to four hours a day in long-term care and hiring more than 27,000 new positions, including personal support workers (PSWs) and nurses.

Mental health and addictions

 

  • Additional funding of $175 million in 2021–22 as part of an investment of $3.8 billion over 10 years for mental health and addictions services.
  • Creation of four new mobile mental health clinics to provide a full suite of mental health and addictions services to individuals living in remote, rural and underserved communities.
  • The province is also ensuring that postsecondary students have the supports they need during COVID‑19 with an additional $7 million invested in 2020–21 to increase access to on‑campus and virtual mental health and addiction services. This builds on the investment of $19.25 million announced in October 2020.
Quebec
The 2021–2022 Quebec Budget, “Quebec is resilient and confident” was delivered March 25, 2021. The Budget focuses heavily on relief measures to combat the ongoing COVID-19 pandemic, with an emphasis on related investments in healthcare. Items that may be of interest include:

Reviewing the QPP disability pension

 

  • The government intends to review certain terms and conditions of the Québec Pension Plan’s disability pension to identify legislative changes required to better reflect the reality of workers aged 60 and over who end up disabled. This work will increase the protection to workers on disability and improve their situation when they retire.
COVID relief and healthcare initiatives $15.2 billion between now and 2025-2026 that includes:

  • $526.5 million over the next five years to improving access to frontline medical services.
  • $11.9 billion to combat the COVID-19 pandemic over a two-year period that began in March 2020.
  • $795 million in funding for services for youth in difficulty and vulnerable persons, and for mental health services.

Taxation

 

  • The province will allow for a further extension of the tax credit in respect of employer contributions to the Health Services Fund for employees on paid leave until
    June 5, 2021.

 

Saskatchewan

The Saskatchewan government released their 2021 Budget on April 6, 2021. The Budget contains a record $6.5 billion in healthcare funding and COVID-19 relief. The 2021─22 Ministry of Health budget of $6.12 billion, is an increase of $261 million or 4.5 percent from 2020─21. Items that may be of interest include:

Mental health
  • $458 million toward mental health and addictions programs and services, an increase of $23.4 million or 5.4% over last year.
  • Additional $7.2 million for targeted mental health and addictions services including specific youth-focused initiatives, more investments in suicide prevention, and significant expansion in harm reduction and addictions treatment.
  • The remaining $16.2 million increase is primarily for hospital-based mental health and addictions services, physician visits and prescription drug costs.
Autism spectrum disorder

 

  • Children between the ages of 6 and 11 with autism spectrum disorder will be eligible to receive individualized funding of $6,000 annually.
Insulin pump program and glucose monitoring
  • $5 million increase to expand eligibility under the Saskatchewan Insulin Pump Program, which means the cost of an insulin pump will now be covered for everyone in Saskatchewan.
  • Financial coverage will now include continuous and flash glucose monitoring systems for children and youth under 18 who are insulin dependent.
Ambulance fees
  • Ambulance fees for seniors reduced to $135 per trip, down from $275.

 

Manitoba
The Manitoba government released its 2021 Budget on April 7, 2021. The Budget focuses heavily on health care measures and the ongoing COVID-19 pandemic, with an emphasis on investments in preventative measures and treatments. Items that may be of interest include:
Reduced wait times 
  • $50 million to reduce wait times in the healthcare system, including $40 million to shorten wait times for priority procedures and services caused by the pandemic, and
    $10 million to further reduce wait times for hip, knee and cataract procedures.

Cancer treatment  

 

  • An additional $23 million for cancer treatments in the province.
Insulin pump program & glucose monitoring
  • Increasing the age limit of the province’s insulin pump program from age 18 to 25 for those with Type 1 diabetes.
  • Providing funding to establish a new program to pay for the cost of continuous glucose monitoring devices for eligible children and youth under the age of 25.
Mental health
  • Establishing a new department of Mental Health, Wellness and Recovery.
  • $1.7 million for the Mental Health and Addictions Strategy.
  • $1.8 million for 24/7 housing supports for individuals with diagnosed mental health conditions.
Smoking cessation In April 2021, the government is launching a new Social Impact Bond (SIB) dedicated to helping people quit smoking in partnership with Pharmacists Manitoba. Under this SIB, Shoppers Drug Mart will invest $2 million over three years to fund smoking cessation initiatives, including counselling and nicotine replacement therapies.

Impact: Governments across the country as well as the at the federal level have placed an emphasis on rebuilding healthcare systems that have been strained to their limits due to the ongoing COVID-19 pandemic. While most of the recent budget proposals do not directly immediately impact private plans, the focus on reducing wait times, increasing funding for mental health initiatives and improving access to frontline and virtual healthcare in the face of the pandemic will be welcome news for employees and residents across Canada. More is to come on the extension of EI sickness benefits.

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Research 

Data shows willingness to receive the COVID-19 vaccine in Canada

African American man in mask gesturing thumb up during coronavirus vaccination, approving of covid-19 immunizationWith most provinces in Canada in the midst of the third wave of the COVID-19 virus, data from
Statistics Canada shows the increasing willingness of Canadians to receive the vaccine as the pandemic continues.

According to the study, while more than 75% of Canadians reported a willingness to receive the vaccine in September 2020, 80% reported they were somewhat or very likely to get the vaccine during the period from November to mid-December. There was some variation across the provinces with Prince Edward Island, Nova Scotia and British Columbia each reporting above the 75% Canadian average.

Willingness to receive the vaccine also varied slightly with older Canadians age 65 and older being slightly more willing at 82% to get vaccinated compared with  75% of those 12 to 64 years of age. Willingness to get the COVID-19 vaccine also varied markedly for diverse groups of Canadians. Among groups designated as visible minorities, willingness to get the COVID-19 vaccine ranged from  56% among the Black population to  82% among the South Asian population.

Impact: The willingness of Canadians across the country to receive the vaccine might be a predictor of our ability to eliminate or diminish the threat of COVID-19. Vaccinating the majority of Canadians is likely to contribute to recovery for the embattled healthcare system and allow for return to addressing other medical issues in a timelier manner.

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Actuaries’ corner

Amendments to Section 3462 Employee Future Benefits: Implications for Plan Sponsors

In November 2020, Canada’s Accounting Standards Board (AcSB) announced final amendments to Section 3462 -Employee Future Benefits of Part II of the CPA Canada Handbook (CPA 3462). Along with clarifying the measurement of the Defined Benefit Obligation (DBO) for retirement and post-employment benefit plans that are required to prepare a funding valuation, the amendments also remove the previously permitted use of a funding valuation method and assumptions for defined benefit (DB) plans without a funding valuation requirement (unfunded plans). The amendments are effective for annual financial statements beginning on or after January 1, 2022, however, the AcSB is encouraging early adoption.

In some jurisdictions, pension benefits legislation now requires an explicit Provision for Adverse Deviation (PfAD) to be included in determining the minimum funding requirements of a DB pension plan. These amendments to CPA 3462 clarify that measurement of a plan’s DBO would include all components of a funding valuation including, for example, any applicable explicit PfAD. While this clarification will be of interest to plan sponsors reporting an obligation for a funded DB plan, a potential greater impact to a plan sponsor’s financial statements may be for plan sponsors who have to report an obligation for an unfunded DB plan (e.g. non-pension post-employment/retirement plans) who currently report these financial results using a funding basis consistent with their other funded plans.

The removal of the ability to measure the DBO of an unfunded plan, like a typical non-pension post-employment/retirement plan, using the funding valuation basis of a funded plan, could result in a substantial increase in the DBO of the unfunded plan. Typical discount rates used in a funding valuation (based on the expected return of plan assets) may be higher than the current discount rates used to prepare an accounting valuation of an unfunded plan (based on high-quality corporate bond yields). In fact, they may be considerably higher. For example, as at December 31, 2020, common discount rates used for funded plans were 5.75% per annum whereas common accounting discount rates for unfunded plans were 2.75% per annum. This would cause the DBO measured using a lower accounting discount rate to increase substantially.  For example, for each 1.0% decrease in the discount rate assumption, the DBO might increase by 15%–25%, depending on the duration of the plan. While there may be a tempering of the DBO impact due to the removal of the PfAD requirement, the discount rate change is anticipated to still result in an overall increase in the DBO and accounting expense.

Impact: Plan sponsors reporting under CPA S3462 or CPA S3463 should consult with their actuaries to estimate the impact of these amendments on their plans, assess the options they have for their plan and its reporting and ensure they comply no later than fiscal years beginning on or after January 1, 2022.

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This publication has been prepared by the GroupNews editorial board for general information and does not constitute professional advice. The information contained herein is based on currently available sources and analysis. The data used may be from third-party sources that Eckler has not independently verified, validated, or audited. They make no representations or warranties with respect to the accuracy of the information, nor whether it is suitable for the purposes to which it is put by users. The information is not intended to be taken as advice with respect to any individual situation and cannot be relied upon as such.

Current editorial board members are: Andrew Tsoi-A-Sue, Ellen Whelan, Charlene Milton, Philippe Laplante, and Nick Gubbay.