The pooling system safeguards the viability of private plans from the risk of catastrophic claims. It also protects covered individuals from unaffordable premium increases.
Why is there a pooling system?
Under the Prescription Drug Insurance Actall insurers and administrators of employee benefit plans offering guarantees for the cost of pharmaceutical products and services in Quebec must pool the risks they assume through their participation in the Basic Plan. Therefore they pool the amounts claimed above a certain threshold. This is done in accordance with the Terms and Conditions of Poolingagreed upon by the participants.