B - Morneau Shepell Flashcards
MORNEAU - MEDICAL INSURANCE PLAN
Health Care :
Role of Provincial
Role of Federal through Canada Health Act
Funding?
Provincial
-Administration and Delivery of health care
Federal
-Ensure that reasonable access to essential health care without financial barriers are provided by province. Impose financial penalties if not.
-Federal transfers funds (less than half of the healthcare bill) to the provincial via the Canada Health and Social Transfer (CHST), but has no saying on how the money is being spend.
MORNEAU - MEDICAL INSURANCE PLAN
5 conditions a provincial health care program must meet to be eligible for unreduced federal funding
1) PUBLIC ADMINISTRATION : non-for-profit, accountable to Provincial
2) PORTABLE : from one province to another
3) ACCESSIBLE : provided uniformly for all residents
4) UNIVERSAL : all eligible residents must be covered
5) COMPREHENSIVE : must cover all necessary medical services.
MORNEAU - WC
Worker’s compensation program
What it covers
It is a form a NO-FAULT INSURANCE:
1) paying benefits to employees injured at work
2) protecting employers from being sued for NEGLIGENCE
WC covers :
med expenses, salary replacement, rehab, survivor benefits.
MORNEAU - WC
How WC program is financed
By contribution of employers only (contribution of employees not allowed)
1) vary based on the risk of each industry
2) can be adjusted based on individual employer’s experience
MORNEAU - WC
Briefly discuss the eligibility of the Worker’s compensation coverage
WC coverage is MANDATORY for all employees in INDUSTRIAL OCCUPATIONS
MORNEAU - WC
Contrast
Individual Liability vs Collective Liability
as assessment basis for a WC program
INDIVIDUAL LIABILITY:
-each employer is self-insured, or individually liable for costs as they occur
-used by govts, public agencies
COLLECTIVE LIABILITY:
-employers are divided into classes or similar activity having similar risk
-Assessment rates (% of payroll) are determined based on the cost experience of the group
-used by majority of industries in Canada
MORNEAU - WC
Contrast the 2 common types of experience rating :
RETROSPECTIVE vs PROSPECTIVE RATING
RETROSPECTIVE: At the end of the year, refunds or surcharges based on actual experience for the year
PROSPECTIVE: Apply discount or surcharge on current year’s rate, based on prior experience.
MORNEAU - WC
5 Broad Categories of WC Benefits
1) HEALTH CARE
2) SHORT-TERM DISABILITY : payable until employee has recovered and can return to work
3) LONG-TERM DISABILITY
a) Permanent Partial Disability
b) Permanent Total Disability
4) REHAB: med and vocational rehab
5) SURVIVOR : if employee dies, benefits + burial expenses covered
MORNEAU - EMPLOYMENT INSURANCE
Employment Insurance - EI
2 objectives
Jurisdiction responsible for EI Program
Provides replacement of income when work is interrupted
- 55% of averaged weekly earnings.
AND Provides assistance for re-employment
- for LOSS OF WORK : employment benefit
- for SICKNESS : sickness benefit - 15 weeks
- for MATERNITY LEAVE : maternity benefit - 15 weeks when pregnant
- for PARENTAL LEAVE, ADOPTION LEAVE : PARENTAL BENEFIT - 35 weeks, by one parent or shared
- for LEAVE TO ASSIST DYING FAMILY MEMBER - compassionate care benefit - 6 weeks
FEDERAL is exclusively responsible.
MORNEAU - EMPLOYMENT INSURANCE
eligibility criteria to receive EI due to loss of work
- must be willing to and capable of working each day, and must be actively looking for work
- if leaving job voluntarily or losing jobs due to misconduct : do not qualify
MORNEAU - EMPLOYMENT INSURANCE
Calculate the Benefit Amount of EI.
David worked 12 weeks in the last 26 weeks and earned a total of 15000$. He lived in a region where the unemployment rate was 10.5% (therefore the divisor is 17).
maximum ( nb weeks worked in last 26 weeks, divisor number)
= max(12,17) = 17
Calculate the weekly earning = 15000 / 17 = 882.35$
Calculate the weekly benefit = 882.35 x 55% = 485$
MORNEAU - EMPLOYMENT INSURANCE
describe what is the Family Supplement
Provide additional benefit to low income families with children.
MORNEAU - EMPLOYMENT INSURANCE
How is the EI Program financed
- From employee and employer contribution
- with certain programs funded by federal government
MORNEAU - EMPLOYMENT INSURANCE
Is EI the 1st or 2nd payer of disability benefits?
- Employers Plan is the 1st payer
- Employment Insurance is the 2nd payer
MORNEAU - EMPLOYMENT INSURANCE
4 minimum requirements for an employee benefit plan to qualify to EI premium reduction
1) disability benefit at least equal to EI sickness benefit
2) payment starting before 15th day of disability
3) for weekly indemnity payment, payment for at least 15 weeks for each occurrence
4) eligibility to claim benefits within 3 months of continuous employment
5) 24-hour coverage
6) designation of the plan as the 1st payer
