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Thursday, December 15, 2022 - 14:48

QDIPC 2023 group insurance pooling threshold updates


Quebec group insurance pooling update

The Quebec Drug Insurance Pooling Corporation (QDIPC) has published its 2023 update of Quebec group insurance pooling terms and conditions, and Empire Life has begun to apply the new pooling thresholds and fees. This will affect all 2023 renewal calculations and quotes that involve Quebec plan members.

What’s Changing?

Pooling thresholds

  • For groups with fewer than 25 certificates, the threshold is increasing from $8,000 to $10,000.
  • For groups with 25 to 49 certificates, the threshold is increasing from $16,500 to $18,000.

Pooling factors

Empire Life has also updated its pooling factors, to reflect QDIPC changes. The table below highlights the changes. 

High-cost drugs pose a significant risk to the financial health of group insurance plans. Without pooling, many plans would not be able to bear the cost of high dollar claims. QDIPC requires all insurers and private employee benefit plan administrators to pool drug claims for plan members in Québec. Pooling levels and fees are designed to cover the predicted claim costs and operating expenses associated with prescription drugs.