OHIP+: Reduction in Coverage

As discussed in an earlier post, effective January 1, 2018, the Ontario liberal government introduced OHIP+. OHIP+ is a program that covers the cost of more than 4400 drug products under the Ontario Drug Program for children and youth under the age of 25 who have OHIP coverage. Shortly after its election in June 2018, the newly elected Ontario conservative government announced that it “was fixing OHIP+ by focusing benefits on those who need it most.”

The Ontario government recently announced that, effective April 1st, OHIP+ will be amended to provide prescription drug coverage only for children and youth 24 years of age and under who are OHIP-insured and who do not have a private plan. Children and youth 24 years of age and under who have a private plan will no longer be covered under OHIP+ and will be required to access prescription medications through their private plan. The requirement to access prescription medications through a private plan will apply regardless of whether the private plan covers the particular drug for which coverage is sought, the annual maximum has been met or a co-payment, deductible or premium payment is required.

Households with high out-of-pocket prescription drug expenses, that include children and youth who are covered under a private plan, can continue to apply to the Trillium Drug Program. The Trillium Drug Program is available only to OHIP-insured Ontarians who have high prescription drug costs relative to their household income and is, therefore, much narrower in its application than OHIP+.

Ontario employers who currently provide prescription drug coverage to children and youth 24 years of age and under can expect higher costs under their employee benefit plans as a result of the changes to OHIP+.

Employment Insurance: Parental Sharing Benefit

As discussed in an earlier post, in its 2018 Spring Budget, the Canadian federal government announced that it intended to introduce a new parental sharing benefit under the Employment Insurance Act (Canada)(“EI Act”). Parents with children born or placed for adoption on and after March 17, 2019 are now eligible for this new benefit.

The parental sharing benefit under the EI Act provides additional weeks of benefits to families when the parents of a newborn or newly adopted child share parental benefits. With the sharing benefit, parents who elect to take a parental leave of a standard duration (up to 35 weeks) can receive an additional 5 weeks of benefits if those additional weeks are taken by the second parent. Parents who elect to take a parental leave of an extended duration (up to 61 weeks) can receive an additional 8 weeks of benefits if those additional weeks are taken by the second parent.

The new parental sharing benefit is intended to promote greater gender equality by creating an incentive for all parents to take a leave when a child is born or adopted. According to the federal government, women currently make 85% of all parental leave claims.

Employers need to be aware of the new benefit in order to ensure that the rights of employees are respected and the potential impact on staffing decisions is considered.

For further information on these changes, please contact Kim Ozubko by email or phone (416-597-4338), or subscribe to our A.M. Pension Blog and webinar series to stay informed on the latest developments.