In efforts to address the province’s $11.7 billion dollar deficit, the Ontario Ministry of Health and Long-Term Care (MOHLTC) has proposed an amendment to Regulation 552 of the Health Insurance Act. The proposal plans to depart from the Out of Country Travelers Program under the Ontario Health Insurance Program (OHIP), and changes could take effect as early as October 1, 2019.
Currently, the program covers emergency inpatient medical expenses to a maximum of $400 per day, and $50 per day for outpatient and doctor services. However, this offering is restrictive and reimbursement rates are quite modest – totalling only 5% of costs on average. Additionally, there has been no increase to rates in over 20 years! It’s no wonder OHIP data suggests that over 90% of Ontarians still purchase private travel health insurance when leaving the country.
With companies sending their workers abroad, or those travelling for much-needed R&R, employers will want to make the necessary adjustments when providing employee health benefits. If not, personnel who receive out of country emergency medical care can be left with sky-high bills to pay for. Employees want to feel empowered and financially secure with their compensation package. Respectively, it is important that they are diligent and check the coverage available through their work benefits before travelling.
Employers may be wondering how the impending change will land in their laps. Consultations with the travel insurance industry in April 2019 suggest that businesses may experience a one-time transitional cost associated with the elimination of the program, and a small increase in premiums. The Canadian Life and Health Insurance Association will be working in coordination with the MOHLTC to ensure a smooth transition and avoid disruption to current private and group benefit plans.
So, how did we even get here and why? Considering the program’s high administrative costs and very low reimbursement levels, this amendment actually adds up. The good news is that the removal of the program will minimally impact Ontarians who already have private healthcare… And for those employers who don’t have this in place, now is the time to start shopping.
1. Proposed OHIP change for travel benefits could raise costs for plan sponsors: CLHIA. Benefits Canada. Retrieved on May 14, 2019 from https://www.benefitscanada.com/news/proposed-ohip-change-for-travel-benefits-could-raise-costs-for-plan-sponsors-clhia-129597
2. Ontario moved forward with plans to scrap OHIP program for travelers abroad. Global news. Retrieved on May 14, 2019 from https://globalnews.ca/news/5226830/ontario-scrap-ohip-travel-insurance-abroad/
3. OHIP out of country services. Ministry of health and long-term care. Retrieved on May 14, 2019 from http://www.health.gov.on.ca/en/public/programs/ohip/outofcountry/travellers.aspx
4. Proposed amendment to Ontario regulation 552 under the health insurance act. Ontario’s regulatory registry. Retrieved on May 14, 2019 from https://www.ontariocanada.com/registry/view.do?postingId=29390&language=en
5. Ontario considers cutting OHIP travel coverage. CTV news. Retrieved on May 14, 2019 from https://www.ctvnews.ca/health/ontario-considers-cutting-ohip-travel-coverage-1.4393179
6. Ontario considers cutting OHIP travel coverage, cites high administration costs. Toronto star. Retrieved on May 14, 2019 from https://www.thestar.com/news/canada/2019/04/24/ontario-considers-cutting-ohip-travel-coverage-cites-high-administration-costs.html