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Submission to Health Canada Re: Draft Guidance (Accelerated Review of Human Drug Submissions)

Published on 22/07/2019

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

On July 27, the CLHIA responded to Health Canada’s accelerated drug review pathway draft guidance, suggesting revisions in the areas of substantial evidence and promising evidence, as well as transparency in bridging indications from an established indication to a new indication. The CLHIA also suggested that there be more clarity and coordination among the national organizations assessing rare drugs, including Health Canada, pCPA, CADTH and INESSS. The draft guidance is meant to provide assistance to industry regarding the criteria to access an accelerated review, what a Notice of Compliance with conditions (NOCc) means to the manufacturer, the collection of real world evidence for rare diseases as well as other information important to manufacturers and insurers.

Consultation on Comprehensive Review of Yukon Health & Social Services

Published on 28/06/2019

Prescription Drug Costs > Catastrophic drug coverage Drug pricing Pharmacare

On June 28, the CLHIA responded to a recently established independent expert panel in Yukon that is reviewing six key areas within the delivery of healthcare and social services. The CLHIA provided comments into two areas of focus. Under Coordination of Care, within and out of territory, we cited areas of private healthcare funding for treatment/services that are being delivered remotely, including cognitive behavioral therapy and some elements of physical therapy programs. A second area of review was Pharmacare and Pharmaceutical Benefits. We agreed with the expert panel’s position that drug prices are too high and must be lowered for all Yukoners, including those with private benefit plans. The CLHIA also agreed on the need to identify those Yukoners lacking coverage or with limited coverage who could benefit from an established list of common medicines and to a coordinated private-public approach to rare diseases.

Submission to Saskatchewan re The Massage Therapists Act

Published on 25/06/2019

Group Insurance > Regulated professions

The province of Saskatchewan recently signaled its intention to regulate the practice of massage therapy by issuing the draft Massage Therapists Act for comment by stakeholders. In a submission to the Ministry of Health, the CLHIA expressed its support of regulation of massage therapy in Saskatchewan and other unregulated provinces. Regulation puts in place standards of practice, a formal complaints and disciplinary process and enhances the protection of the public in general. In addition, Saskatchewan residents would benefit from the Canadian Revenue Agency’s (CRA) tax-free treatment of services delivered by regulated healthcare providers, as this may increase access to care. Lastly, the CLHIA encouraged protection of titles such as 'Registered Massage Therapist' that are consistent across Canada.

Alka Gautam Elected CLHIA Chair

Published on 25/06/2019

CLHIA Governance > Board of Directors

BC Submission re: Cayton Report PIPA and Privacy

Published on 14/06/2019

Insurance Trade & Commerce Group Insurance > Provincial & Territorial Legislation Privacy Dental insurance

CLHIA responds to final report of the Advisory Council on the Implementation of National Pharmacare

Published on 05/06/2019

Prescription Drug Costs > Drug pricing Pharmacare

On June 12, the Advisory Council on the Implementation of National Pharmacare released its final report. So far the Federal Government response has been muted. The Minister of Health thanked the Council for their report but has not made any commitments with respect to next steps and the Minister of Finance has not made any public statement. The CLHIA news release can be found here.

The highlights of the report include recommendations that:

· Canada should adopt a universal, single-payer public pharmacare program. The program should be phased in over eight years
· The federal government should establish a national standard formulary, and would require that out-of-pocket amounts for individuals be capped at $5 per prescription, with a co-pay of $2 per medicine up to an annual maximum of $100 per household
· The federal government should finance the incremental costs to the provinces of moving to this model via a new dedicated federal transfer to the provinces
· Provinces could opt-in to the program subject to agreeing to the requirements outlined above.

Submission to Health Canada Re: Proposed Generic Drug Regulations

Published on 07/06/2019

Prescription Drug Costs > Generic drug pricing

On June 7, the CLHIA wrote to Health Canada expressing support for its recent proposal to amend the definition of 'equivalence' when evaluating a new generic drug in comparison to the originator. The amended definition would allow a route to market for new generics that are not pharmaceutically equivalent to the reference product, but contain the same identical therapeutically active component, thereby improving choice and potentially resulting in lower costs for plan sponsors and members.

CLHIA announces withdrawal of Guideline G19

Published on 31/05/2019

Distribution > Product disclosure Market conduct

Proposed Changes to OHIP Out of Country coverage October 2019

Published on 30/04/2019

Group Insurance > Coordination of benefits Travel insurance

On April 30, the CLHIA responded to an Ontario government proposal that would see the elimination of emergency health claim reimbursements incurred outside of Canada. The CLHIA’s submission asked for a clear communication plan for Ontarians regarding these changes. The CLHIA also requested the government’s assistance in ensuring that beds are available to Ontarians incurring medical emergencies at destination, and who are ready to return to an Ontario hospital for follow-up care.

CLHIA supports budget proposal to improve retirement options for Canadians

Published on 20/03/2019

Pensions and Retirement > Annuities Retirement Income System Reviews Wealth & Retirement

Budget measures offer sensible steps to achieve pharmacare for all who need it

Published on 19/03/2019

Prescription Drug Costs > Drug pricing Pharmacare

CLHIA welcomes Saskatchewan court ruling in Ituna, Mosten and Atwater litigation

Published on 18/03/2019

Insurance > Provincial & Territorial Legislation

On March 15, in separate sets of reasons, Justice Brian Scherman of the Saskatchewan Court of Queen’s Bench ruled in favour of the three member insurers (Industrial Alliance, Manulife, and BMO Life), dismissing applications brought by three limited partnership policyholders (Ituna, Mosten, and Atwater). The applications were brought seeking a declaration that the policyholders were entitled to deposit unlimited sums of money into the side accounts of universal life policies they had acquired that were issued in the late 1990’s to early 2000’s when interest rates were much higher than today. The CLHIA intervened in the applications because the position taken by the policyholders was contrary to the nature and intended purpose of the product, fundamental insurance law concepts and Canada’s regulatory system. Justice Scherman ruled that the proper interpretation of the contracts was that deposits were limited to those amounts that could be used for the cost of insurance, premium taxes and policy administration fees during the expected life of the insured, as well as amounts used for investment or savings within the policy, up to the accrual tax-exempt limits set in the Income Tax Act. This finding is consistent with the insurers’ licensing, the nature of the product and the absence of any evidence of any other intent by the original purchaser. It provides a harmonious interpretation of premium to the whole policy and would be consistent with an ordinary insured's understanding. The Court found no ambiguity in the policy wording. The CLHIA's press release on the decisions can be found here. The complaints have filed appeals for all three decisions to the Saskatchewan Court of Appeal.

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 Opening Remarks to the House of Commons Standing Committee on Health - Appearance on Pharmacare

Published on 19/10/2017

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

Canada’s life and health insurers believe all Canadians should be able to access affordable prescription drugs. Today, prescription drugs costs are too high and we know there are gaps in coverage. However, meaningful reductions in prices and improving access for all Canadians can be achieved today working within our current system. Canada’s insurers are keen to help and believe we have much to offer.

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

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

Updated needs-based selling resources for insurers and advisors now available

Published on 27/01/2017

Updated needs-based selling resources for insurers and advisors now available

CLHIA recently updated the following three Reference Documents, which describe best practices, including examples, for needs-based selling.

Why would Ottawa even consider a tax that won’t increase revenue, but hurt middle-class Canadians?

Published on 03/01/2017

Group Insurance > Dental insurance Employee benefit plans

Op-ed submitted to National Post on Taxation of Benefit Plans

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)

Retiring Soon?

Published on 02/09/2016

Retiring Soon?
Use this guide to get ready.

Comment préserver les acquis

Published on 29/07/2016


La Presse

Retirement Income: Coalition appeals to finance ministers

Published on 27/06/2016

Pensions and Retirement > Public pensions (OAS/CPP/QPP/GIS) Retirement Income System Reviews

The Insurance & Investment Journal

CLHIA concerned about benefit plan impact of proposed change to chiropractor services

Published on 28/06/2016

Group Insurance > Paramedical benefits Regulated professions

Benefits Canada

Who will cover the cost of drugs for doctor-assisted death?

Published on 12/06/2016

Prescription Drug Costs > Provincial & territorial drug program information Pharmacare

Toronto Star/The Canadian Press

The financial downside of living too long

Published on 11/06/2016

Pensions and Retirement > Registered Products (RRSP, LIRA, RRIF) Wealth & Retirement

Winnipeg Free Press

CLHIA-Quebec opposed to selling insurance policies to third parties

Published on 02/06/2016

Insurance > Provincial & Territorial Legislation

Interview with CLHIA Quebec president Lyne Duhaime

Good-bye travel incentives!

Published on 26/04/2016

Distribution > Sales practices

The Insurance and Investment Journal

Big changes afoot for life agents?

Published on 22/04/2016

Distribution > Market conduct Sales practices

Investment Executive May 2016

Group benefits providers report: Insurers get a boost in the battle against fraud

Published on 15/04/2016

Trade & Commerce > Privacy Federal Legislation

Benefits Canada

Most Canadians think government programs will cover LTC

Published on 14/04/2016

Long-term Care

Investment Executive

Rest in peace: Weigh your needs when considering to buy life insurance

Published on 14/04/2016

Consumers > Financial Literacy Initiatives

Canadian Press

Insurance company drops 'discriminatory' policy on suicide attempts

Published on 30/03/2016

Group Insurance > Employee benefit plans

CBC News

CLHIA says sales practices could be improved

Published on 30/03/2016

Distribution > Sales practices

The Insurance & Investment Journal

Insurance companies reconsider 'dated' policies for suicide attempts, Frank Zinatelli on The National

Published on 29/02/2016

Compliance Group Insurance > Fair treatment of customers (FTC) Employee benefit plans

The National

The keys to protecting your business against fraud

Published on 16/02/2016

Compliance > Fraud risk management

Businesses and consumers urged to be more vigilant about fraud

What's New - Insurance Distribution in Canada: Promoting a customer-focused system

Published on 13/05/2016

What's New - Insurance Distribution in Canada: Promoting a customer-focused system

Average Alberta dental rates jump 56% over 10-year period

Published on 08/02/2016

Group Insurance > Dental insurance Regulated professions

The profession says higher salaries for dental hygenists are part of the problem

How should Alberta deal with rising dental fees?

Published on 24/02/2016

Group Insurance > Dental insurance Regulated professions

Global News

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.

CLHIA calls for one-year delay to ORPP

Published on 11/02/2016

Pensions and Retirement > Pooled registered pension plans/PRPPs (and provincial variations)

Benefits Canada

Life insurance price increases come under fire

Published on 05/02/2016

Distribution > Product disclosure

Life Health Professional

Should you buy long-term care insurance?

Published on 03/02/2016

Health Care Policy > Long-term Care

Special to The Globe and Mail

Ryerson dance student paralyzed after swimming accident in Cuba

Published on 18/01/2016

Group Insurance > Travel insurance

CTV Toronto

Mourir dans la dignité… et l’assurance

Published on 17/01/2016

Insurance > Provincial & Territorial Legislation

La Presse

Apparence de contradiction à l'AMF

Published on 15/01/2016

Distribution > Alternate distribution

Private insurers want in on national bulk-buying deal for drugs

Published on 20/01/2016

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

Benefits Canada

Globe and Mail supplement April 2016

Published on 27/04/2016

Information Updates

Globe and Mail supplement April 2016

Opposing views on the ORPP

Published on 27/02/2015

Pensions and Retirement > Pooled registered pension plans/PRPPs (and provincial variations)

Investment Executive

Replacement Disclosure

Published on 05/09/2014

Distribution > CLHIA Distribution guidelines and reference documents

CLHIA releases its 2017 Factbook

Published on 27/10/2017

CLHIA releases its 2017 Factbook

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.