Twenty Years, and More Relevant Than Ever!
The year 2017 marks the 20th anniversary of the Quebec Drug Insurance Pooling Corporation. Over the past two decades, the Corporation has worked tirelessly to ensure the smooth functioning of the risk pooling system set up by the life and health insurance industry.
Today, more than ever, the Corporation’s work makes it possible to sustain a system capable of protecting accessibility to private drug insurance coverage and the viability of drug insurance plans.
Its work. The ongoing development of drug therapies and the very high cost of some medications highlight the need to pool drug claims above certain thresholds. The Corporation ensures that the system is updated annually, in accordance with changes in the number and profile of groups involved in pooling, the health of the insured population, and new drug therapies. This tailor-made system allows private insurers and benefit managers offering coverage for drug costs to maintain affordable premiums despite the emergence of high claims.
Because of risk pooling, drug insurance coverage remains accessible in Quebec.
By achieving this, the system also protects the viability of private group insurance plans.
Its expertise. The Corporation has just launched the 20th compensation process and will publish the 22nd instalment of the terms and conditions of pooling this year. Between 1997 and 2017, over the 19 completed pooling process, pooled funds increased from $ 6.7 million to over $ 67 million.
The Corporation has acquired valuable expertise since its inception in 1997. Each annual revision of the terms and conditions of pooling is based on experience from the previous years and on many current actuarial assumptions. The Corporation has set up an ongoing monitoring system to anticipate the arrival of new medications on the market and the effects of their use on group plans.
In addition, the Corporation tests participants’ understanding of and compliance with pooling by conducting a certain number of audits each year. It has also redesigned its website, https://mutualisation.ca/en/, to provide the public with complete and up-to-date information on the pooling system, relevant news and current processes.
Its foundations. The Corporation’s activities are guided by a clear and respectful view of the requirement for pooling laid out in the Act respecting prescription drug insurance and by the values of transparency and fairness.
The Corporation carries out its mission within a rigorous framework of good governance. Its Board of Directors has nine members representing insurance companies, employers or administrators of benefit and trust plans; five directors must meet the usual independence criteria. Three Board committees have been created to oversee the Corporation’s operations, namely the Committee on the Process, Terms and Conditions of Pooling, the Corporate Governance and Human Resources Committee and the Audit Committee. Since its inception, the Corporation has maintained a sound balance sheet and kept its operating expenses under control.
The birth of the Corporation
It all began in 1996, when the Quebec Government chose to create a general drug insurance plan for all citizens, and adopted the Act respecting prescription drug insurance. This legislation requires insurers and benefit plan managers to share among themselves the financial risks arising from their participation in the general plan.
Established in 1997, the Corporation is the body recognized by government and the industry to ensure compliance with this requirement, and to ensure that the pooling system protects accessibility to drug insurance coverage in Québec from the impact caused by high claims.