Update: New Brunswick Pharmacare Changes

Effective: April 1, 2015

This update is a two-fold message: 1. To assure you that our IT experts have been

actively working toward system enhancements to ensure compliance with New Brunswick changes to become effective April 1, 2015.

2. If you have members located in the Province

of New Brunswick, we would ask that you immediately start populating the Province of Residence code on your eligibility files sent to ClaimSecure. This way, once April 1, 2015 rolls around, your files will be compliant.

In December, 2013, we issued an eNews communication (Below), alerting you to the highlights of some of the proposed changes to the New Brunswick government formulary to be implemented April, 2015. Since then, there have been some further developments and we thought this would be a good time to pass them along:

Groups/plans have the flexibility of choosing options to meet the minimum requirements (a) maximum $30.00 per prescription or (b) an annual out of pocket maximum per patient up to $2000.00;

Retiree plans are not required to meet any of the minimum requirements;

If an employer offers a Flex Plan, only one option needs to meet the minimum requirement, with the stipulation that the employees can change options at least once per year or after a life-changing event;

Qualifying plan must have documentation to prove that the plan meets the minimum requirements;

A New Brunswick resident working in another province with comparable private group drug coverage which does not meet the minimum requirements, may apply for an exemption under Sub-section 18(6) of the Act.

We will continue to provide updates to the New Brunswick formulary as they become available. In the meantime, if you have any questions, please feel free to contact your Client Service Associate at 1-888-479-7587.

October 28, 2014

NEW BRUNSWICK GOVERNMENT UNVEILS THEIR DRUG PLAN EFFECTIVE APRIL 1, 2015

Just a heads-up to let you know that the New Brunswick government has unveiled their Drug Plan with the intent of ensuring all New Brunswick residents are guaranteed prescription drug coverage.

Below are a few of the highlights of the program to be introduced in 2015. As expected, they are following the Quebec RAMQ model to some extent. It is important to note that this may impact your plan design and the ability for private payers to co-ordinate with provincial drug program. We are currently seeking additional details from various stakeholders.

Some of the proposed highlights:

Beginning April 1, 2015, all New Brunswickers will be required to have prescription drug insurance. Those not insured by a private plan will join the New Brunswick Drug Plan.

Effective April 1, 2015, minimum coverage standards will come into effect, which means that all private group drug plans must be at least as comprehensive as the New Brunswick Drug Plan. This means:

• All private group drug plans will cover every drug covered under the New Brunswick Prescription Drug formulary;

• Private group plans will not be allowed to have annual or lifetime caps on coverage; and

• Costs at the pharmacy must be managed in one of two ways depending on plan design:

• Co-payments paid at the pharmacy may not exceed $30 per prescription; or

• Co-payments and/or deductibles paid at the pharmacy for each plan member may not exceed $2,000 per year.

After April 1, 2015, those who have group drug coverage available to them will not be eligible for the New Brunswick Drug Plan.

We will be keeping you apprised as this program unfolds. We wanted to make you aware that a change is coming. If you wish to view the New Brunswick Government’s program in more detail, we have provided the link below.

http://www2.gnb.ca

If you have any questions, please do not hesitate to contact your Client Service Associate at:1-888-479-7587.

December 2013