Of Benefit to You BENEFITS INFORMATION NEWSLETTER – WEST REGION – November 2013* INSIDE THIS ISSUE I. PROVINCIAL DRUG UPDATES V. ALBERTA: GENERIC DRUG PRICE ................................. 2 BRITISH COLUMBIA: GENERIC DRUG PRICE ................. 2 MANITOBA: 2013 CHANGES TO PROVINCIAL VI. PHARMACARE ............................................................ 2 II. CHANGES IN PROVINCIAL HEALTH CARE INSURED SERVICES/PREMIUMS ALBERTA: INCREASE IN PRIVATE AND SEMI-PRIVATE HOSPITAL ROOM RATES ............................................. 3 NEW BILLS (ROYAL ASSENT NOTIFICATIONS) UPDATE: BILL ON BILL C-38, JOBS, GROWTH AND LONG-TERM PROSPERITY ACT EFFECTIVE JULY 2014. . 5 INDUSTRY REPORTS/STATISTICS IS CANADA IN A RETIREMENT CRISIS? ........................ 5 BREAKING THE STIGMA: STUDY DISCOVERS AGING IS NOT THE OVERWHELMING DRIVER OF HIGHER HEALTHCARE SPENDING ............................................ 6 BRITISH COLUMBIA: MORE VACCINES AVAILABLE THROUGH PHARMACISTS ........................................... 3 BRITISH COLUMBIA & MANITOBA: INCREASE TO ALLOWABLE OUT-OF-PROVINCE MAXIMUM PERIOD.. 3 III. HEALTH & WELLNESS INITIATIVES ARE POOR PRESCRIPTION CHOICES INCREASING HEALTH CARE COSTS?................................................. 3 IV. LEGISLATIVE / BUDGET CHANGES ALBERTA: PHARMACARE PLAN DELAYED .................... 4 MANITOBA: PROVINCIAL SALES TAX RATE INCREASE . 4 Edmonton 11120 – 178th Street Edmonton, AB T5S 1P2 Phone: 780.483.0408 Fax: 780.420.6082 Calgary 300, 736 – 8th Avenue Calgary, AB T2P 1H4 Phone: 403.298.0488 Langley 201, 9440- 202 Street Langley, BC V1M 4A6 Phone: 604.881.8820 Fax: 604.881.8828 ® Johnson Inc. · www.johnson.ca · November 2013 I. PROVINCIAL DRUG UPDATES ALBERTA: GENERIC DRUG PRICE The Government of Alberta has been gradually reducing the cost of generic drugs as part of its 2013 health budget commitment. Effective May 1, 2013, the price of generic drugs in Alberta reduced from 35 percent of the brand name equivalent to 18 i percent . It is estimated that this reduction in price will save taxpayers $90 million in 2013-2014, as well as additional savings for those who pay out-of-pocket ii for their medications .For more information on the new generic pricing rules, please see the recently updated Alberta Drug Benefit List Price Policy. BRITISH COLUMBIA: GENERIC DRUG PRICE The Government of British Columbia has been gradually reducing the cost of generic drugs through its Pharmaceutical Services Act (Bill 35). In April the B.C. government reduced the price of generic drugs from 35 percent to 25 percent of the brand name equivalent, with the goal of further decreasing this iii amount to 20 per cent of the equivalent by 2014 . The Canadian Broadcasting Corporation provided the following example of the impact of decreasing generic drug costs through a breakdown of the iv cholesterol-lowering drug Lipitor : Current cost of a 30-day prescription (not including pharmacy fees) is $55. The generic equivalent at 25 per cent of the brand name is approximately $14. Effective April 1 2014, generic drugs will be reduced to 20 per cent of the brand equivalent, Edmonton 11120 – 178th Street Edmonton, AB T5S 1P2 Phone: 780.483.0408 Fax: 780.420.6082 decreasing the generic cost to approximately $11. Venlafaxine - treats depression and other mental-health conditions; MANITOBA: 2013 CHANGES TO PROVINCIAL PHARMACARE Amlodipine - treats high blood pressure and angina; and Four changes have been announced in 2013 regarding Manitoba’s Pharmacare plan. Omeprazole and Rabeprazole – both treat a variety of gastrointestinal conditions. Firstly, effective January 21, 2013, Health Minister Theresa Oswald added 153 new drugs to the provincial pharmacare formulary, offering more choice and significant savings to families dealing with a broad range of serious medical conditions such as diabetes, hypertension, heart disease, colitis v and Crohn’s disease . The additions include many generic versions of prescription drugs, which will save money for Manitoba families and reduce provincial drug costs by $2.9 million. Manitoba is one of the few provinces that has not yet legislated maximum pricing on generics. The third change was the announcement in July 2013, of the province negotiating lower drug prices and adding 92 more prescription drugs to the pharmacare formulary. The lower prices announced are expected to save the pharmacare program $4 million per year and Manitoba families an expected vii $8.6 million per year . It was noted that the savings from listing more generic drug alternatives is being viii reinvested to cover new brand name drugs . The second change announced in March indicated a movement towards lower prices, creating further savings for reinvestment in drug programs. Effective April 1, 2013, Manitobans gained access to lower prices for six generic drugs with an estimated annual savings of $6 million for Manitobans, and $3.2 vi million for drug programs such as pharmacare . These drugs were negotiated to approximately onefifth the price of the equivalent brand, which was the lowest generic prices achieved so far by provincial and territorial drug plans. The drugs include: Atorvastatin - treats high cholesterol; Ramipril - treats blood pressure and other cardiovascular conditions; Calgary 300, 736 – 8th Avenue Calgary, AB T2P 1H4 Phone: 403.298.0488 The fourth change was announced October 28, 2013 with the Government adding 93 new medications to Manitoba’s formulary. These lower prices are estimated to save the pharmacare program $3.9 million per year and Manitoba families $5 million per year. These newly listed drugs include medications ix to treat: : Rheumatoid arthritis; Stroke and systemic embolism; Chronic obstructive pulmonary disease; and Advanced non-small cell lung cancer. Manitoba continues to work together to negotiate better drug prices for all jurisdictions. According to the Canadian Generic Pharmaceutical Association, Manitoba has the highest use of generics in Canada, accounting for 65.1 percent of prescriptions in x Manitoba . Langley 201, 9440- 202 Street Langley, BC V1M 4A6 Phone: 604.881.8820 Fax: 604.881.8828 2 ® Johnson Inc. · www.johnson.ca · November 2013 II. CHANGES IN PROVINCIAL HEALTH CARE INSURED SERVICES/PREMIUMS ALBERTA: INCREASE IN PRIVATE AND SEMI-PRIVATE HOSPITAL ROOM RATES Alberta Health has announced increases to hospital accommodation. The first increase went into effect September 1, 2013, with rates scheduled to rise at specified dates until March 31, 2016. Below is a xi schedule of the hospital rate increases : PRIVATE SEMI-PRIVATE PRIOR TO SEPTEMBER 2013 $40 $24 SEPT. 1, 2013 – MARCH 31, 2014 $80 $48 APRIL 1, 2014 – MARCH 31, 2015 $120 $96 APRIL 1, 2015 – MARCH 31, 2016 $180 $144 BRITISH COLUMBIA: MORE VACCINES AVAILABLE THROUGH PHARMACISTS Effective April 2013, British Columbia residents gained access to an extensive assortment of publicly funded vaccines from their local pharmacist. The expansion of covered vaccines gives eligible patients increased inoculation access and choice for them xii and their families. The additional vaccines include : Measles, mumps and rubella (MMR); Hepatitis A and B; Tetanus/Diphtheria; Varicella (chicken pox) and Hepatitis B; HPV; Pneumococcal polysaccharide; Meningococcal C Conjugate vaccine; and Pertussis vaccine. Edmonton 11120 – 178th Street Edmonton, AB T5S 1P2 Phone: 780.483.0408 Fax: 780.420.6082 Not all pharmacists are qualified to distribute vaccines. Pharmacists are required to partake in additional training to achieve vaccine authorization status. Currently there are over 2,000 pharmacists qualified to offer vaccines, with the number xiii continuously rising . BRITISH COLUMBIA & MANITOBA: INCREASE TO ALLOWABLE OUT-OF-PROVINCE MAXIMUM PERIOD. Updates to both British Columbia’s and Manitoba’s out-of-province allowance have occurred. This allowance is a provincially regulated set of rules that requires residents to be physically present in their province of residence for an identified period of time in order to qualify for provincial health care benefits. Effective earlier this year, both British Columbia and Manitoba increased this allowance from six (6) months, to seven (7) months. Meaning residents are allowed to travel outside the province for up to 7 months (212 days) within a 12-month period and continue to be eligible for provincial health care coverage. These days do not have to be consecutive. Below is a table outlining the out-of-province allowance guidelines for all Canadian provinces: PROVINCE RESIDENCY REQUIREMENT OUT OF PROVINCE ALLOWANCE BC, MB, ON 153 Days 212 Days NL 122 Days 243 Days AB, SK, QC, PE, NB, NS, NT, NU, YT 183 Days 182 Days Note: Quebec does not count trips of less than 21 days against the 183-day residency requirement. This extension grants you one additional month to travel throughout Canada or abroad. It is important to note, that if you frequent the United States, this Calgary 300, 736 – 8th Avenue Calgary, AB T2P 1H4 Phone: 403.298.0488 extension does not increase the length of time permissible in the US. United States immigration dictates these rules which permit Canadians to visit the US for up to six months (182) days per calendar year. It should also be noted that every time you cross the US border (even for only an hour), one day xiv of the allotted 182 is used . III. HEALTH & WELLNESS INITIATIVES ARE POOR PRESCRIPTION CHOICES INCREASING HEALTH CARE COSTS? On October 8, 2013 the Globe and Mail devoted an eight-page special to “the future of prescription drugs” that covered a variety of topics, including methods of reducing costs and improving health outcomes. The article provided some insight into the stigma that an aging population, the pervasiveness of chronic disease, and the high cost of speciality mediations are making health care xv unaffordable . On the contrary, research conducted by Express Scripts Canada in their 2012 Drug Trend Report divulged that increased prescription costs are predominately due to poor patient decisions, such as when “a patient uses pharmacy services that are more expensive, or a medication that costs more but offers no clinical advantage”, causing waste to flow xvi through employer-sponsored health plans . The article identifies a variety of triggers adding to the wastage of healthcare spending such as: Where / when / how patients fill their prescriptions; Choosing brand-name drugs versus generics with no additional health benefits; and Langley 201, 9440- 202 Street Langley, BC V1M 4A6 Phone: 604.881.8820 Fax: 604.881.8828 3 ® Johnson Inc. · www.johnson.ca · November 2013 Disobedience to prescription instruction, causing further health deterioration and additional costs to plan sponsors. Express Scripts Canada estimates that poor purchasing decisions create up to $5.1 billion in annual drug spending waste – one of every three xvii dollars wasted within a typical drug benefit plan . There are plan design methods and cost-sharing approaches that can be used to help combat this overspending. If your organization is concerned about your employer-sponsored benefit plan’s current model, and would like assistance in redesigning your group benefit plan to help reduce wastage, please contact your local Johnson Inc. Plan Benefits Consultant. IV. LEGISLATIVE / BUDGET CHANGES ALBERTA: PHARMACARE PLAN DELAYED In March of 2013, Alberta Health released its budget statement of health funding allocations for 2013 – 2014. The statement provided a breakdown of funding the health system which included mention of the introduction of a income-based pharmacare xviii system for Alberta . The report mentioned that approximately $56 million is estimated to be saved from “the reduction in generic pricing and savings from the implementation of the pharmacare xix program” . This pharmacare program was said to be introduced January 1, 2014. The purpose of the pharmacare plan is to provide complete drug and supplementary health benefit coverage for all Albertans. It is estimated that 20 percent of Albertans do not have coverage or cannot afford crucial drug therapies, health services or Edmonton 11120 – 178th Street Edmonton, AB T5S 1P2 Phone: 780.483.0408 Fax: 780.420.6082 xx support . This program will be income-based and provide coverage to all Albertans, regardless of age. and plan sponsors are provided with adequate xxii information to implement plan changes . The announcement of the proposed plan in Alberta triggered a lot of speculation within the insurance industry. Stephen Frank, Vice President, Policy Development and Health at the Canadian Life and Health Insurance Association Inc. (CLHIA) transcribed and publically posted a letter to Michele Evans, Executive Director, Pharmaceutical Funding and Guidance at Alberta Health identifying some key questions regarding the proposed pharmacare program. Frank’s letter unveiled some key points that Alberta Health may have overlooked in their pharmacare announcement and planned program launch date. Points raised include that the new program may require: Details of the plan design and implementation schedule of Alberta’s proposed pharmacare program are still underway. However, Alberta Health Minister Fred Horne released a statement in October verifying that the proposed pharmacare launch will be delayed, due to the drastic alterations necessary by affected parties, such as: supplemental health plan sponsors, insurance companies, seniors’ groups xxiii and pharmacists . Review of private supplemental health plans potentially resulting in redesigning plans to align/coordinate with the new program (both individual and employer supplemental health xxi plans) . Review and possibly revisions to existing contracts, Communicating and training brokers and agents, Communicating with plan sponsors and transitioning them into the new plan design offers; and, Implementing new administrative practices, claims and changes to administration systems. The CLHIA’s letter also referenced that the above mentioned changes would significantly impact the insurance industry and require between 12 to 18 months of implementation time, provided insurers Calgary 300, 736 – 8th Avenue Calgary, AB T2P 1H4 Phone: 403.298.0488 MANITOBA: PROVINCIAL SALES TAX RATE INCREASE Effective July 1, 2013, Manitoba’s retail sales tax (RST) increased from 7 percent to 8 percent. Manitoba’s RST is applicable on group insurance premiums for plan members residing in Manitoba xxiv for the subsequent coverages : Life Accidental death & dismemberment Disability (short-term and long-term) Critical illness All creditor insurance Please note that extended health care and dental coverage continue to be exempt from Manitoba’s xxv RST . The same is true for administration services only (ASO) arrangements. V. NEW BILLS (ROYAL ASSENT NOTIFICATIONS) UPDATE: BILL C-377 ON UNION TRANSPARENCY – REFRUTED. Langley 201, 9440- 202 Street Langley, BC V1M 4A6 Phone: 604.881.8820 Fax: 604.881.8828 4 ® Johnson Inc. · www.johnson.ca · November 2013 On June 26, 2013, Canada’s Senate refuted the passing of Bill C-377, forcing the Bill back to the House of Commons for amendments. Note that the Bill has not been altogether blocked, however the Senate’s recommended amendments have delayed Bill C-377’s passing until at least the fall xxvi . Amendments that Tory Senator Hugh Segal and 15 xxvii of his colleagues supported include : Raising the mandate of declared expenses from $5,000 to $150,000; Implementing the legislation to apply only to unions with more than 50,000 members and not to locals or branches; Altering the requirement to divulge salaries of employees who make $100,000 per year to $444,661, or more. The purpose of Bill C-377 is to legislate union transparency through the release of financial documents to the public. Supporters of Bill C-377 have defended the Bill stating: “it is about informing xxviii taxpayers – you and me ”. The Bill would require unions to publicize forms, receipts and expenses paid throughout the year on a Canada Revenue xxix Agency (CRA) website . It would also dictate that the percentage of time dedicated to political xxx activities be recorded and made public . Any person or body (including their lawyers) that conducts business with a union in the amount of $5,000 or more, would potentially have their names and transactions posted on-line for the public to xxxi examine . Edmonton 11120 – 178th Street Edmonton, AB T5S 1P2 Phone: 780.483.0408 Fax: 780.420.6082 UPDATE: BILL ON BILL C-38, JOBS, GROWTH AND LONGTERM PROSPERITY ACT EFFECTIVE JULY 2014. In 2012, Bill C-38 was passed which was set to alter the Canada Labour Code and implement new longterm disability (LTD) insurance requirements for the federally-regulated private sector. It has been announced that the new provisions will come into xxxii effect on July 1, 2014 . This Bill impacts federally regulated private sector employers in that they will no longer be allowed to provide LTD plans to employees on an Administrative Services Only (ASO) basis. This means that federal employers are obligated to attain insurance for any LTD plans offered to their staff, therefore providing financial protection for employees on disability, if the employer were ever xxxiii to become insolvent . This does not apply to provincially regulated employers at this time. Alberta and B.C. are the only provinces which require plan sponsors that provide employee benefit plans for income replacement to disclose to the plan participants, prior to or at the time benefits are offered, that the benefits are not underwritten by an insurer and are supported solely by the financial xxxiv resources of the company . VI. INDUSTRY REPORTS/STATISTICS IS CANADA IN A RETIREMENT CRISIS? Morneau Shepell, a large human resources consulting and outsourcing services company conducted a survey in June 2013 with their pension plan sponsor clients about their perceptions of whether Canada is undergoing a retirement crisis. Of the 165 respondents, 29 percent did not consider Calgary 300, 736 – 8th Avenue Calgary, AB T2P 1H4 Phone: 403.298.0488 Canada to currently be in a retirement crisis and xxxv were broken down as : 21 percent foresee that Canada is heading towards a crisis in the future; eight percent having faith that the retirement systems just needs a little fine-tuning. Of the remaining respondents, 71 percent believe that Canada is currently experiencing a retirement crisis, although the consensus of what could be done xxxvi to resolve the predicament is divided . Slightly more than half believe the government needs to take decisive action soon. The less than half believe that it is the responsibility of individuals and employers to rectify the problem. The respondent preference to the type of government intervention necessary to combat the issue is broken down in order of popularity xxxvii below : 37 percent recommend the embracing of a national pension strategy instead of the current individual provincial strategies; 29 percent recommend better risk-sharing options in occupational pension plans (e.g. target benefit plans); The remaining respondents believe that either introducing pooled registered pension plans (PRPPs) can assist, or expanding the Canada Pension Plan (CPP)/ Quebec Pension Plan (QPP) will be effective. Langley 201, 9440- 202 Street Langley, BC V1M 4A6 Phone: 604.881.8820 Fax: 604.881.8828 5 ® Johnson Inc. · www.johnson.ca · November 2013 BREAKING THE STIGMA: STUDY DISCOVERS AGING IS NOT THE OVERWHELMING DRIVER OF HIGHER HEALTHCARE SPENDING Chronic conditions in the young (under age 30) take a higher relative toll on that population then they do for the older population. A U.S. study sponsored by the Society of Actuaries has proven wrong the assumption that an aging population has been the overwhelming driver of higher healthcare costs. The study was conducted using data from the Health Care Cost Institute (HCCI) and Medicare fee-for-service to examine differences in health care costs by age against the overall health xxxviii . care cost change Female costs accelerate during the child-bearing ages and plateau in the 40’s before increasing again. The study is not implying that an aging population has no effect on increased healthcare spending; however, it does identify that the percentage of healthcare costs for the older population is marginally less than presumed. The report notes that “changing demographics of age and gender have contributed from 7 percent to 10 percent of the real growth in per capita health care costs (less xxxix than 0.5 percent per year)” . The data also identifies there is an increase in out-ofpocket spending when individuals retire before age 65. Early retirees at age 55 that are estimated to live until age 85 will spend 154.4% more on health care than a person retiring at age 65 ($372,400 in total health care costs for early retirees versus $146,400 xl for those retiring at age 65) . Male costs are generally less than that of females and are fairly flat in the 20s and begin to increase after age 30. By the early 60s, male per capita spending begins to exceed that of females, and by around age 90 per person costs begin to decline. Although the healthcare systems in Canada and the U.S. are different, many similarities in aging can be shown. *The articles contained in this Newsletter are provided for the general information of Johnson Inc. clients. Reasonable care is taken to ensure that the information contained in this Newsletter is as up-to-date and as accurate as possible on the date of issue, but no responsibility can be taken by Johnson Inc. for any errors or omissions contained herein. The data included claims information from HCCI 2002 through 2010, and Medicare data from 2006 through 2010. The figures identified the following facts: Health care costs increase by age with the exception of very high costs in the first year or two of birth. Edmonton 11120 – 178th Street Edmonton, AB T5S 1P2 Phone: 780.483.0408 Fax: 780.420.6082 Calgary 300, 736 – 8th Avenue Calgary, AB T2P 1H4 Phone: 403.298.0488 For more information on the subjects in this newsletter, or for advice on how these issues may impact your benefit programs and plans, please contact: John Crouse, B.Sc (HONS.), MA, FSA, FCIA National Director, Benefits/Consulting 780.413.6605 jcrouse@johnson.ca Shannon Patershuk, MBA, FSA, FCIA, CERA Regional Manager, Retiree Program Relations (West) 780.413.6616 spatershuk@johnson.ca Shelley Malanchuk, B.Com., CEBS Regional Manager, Plan Benefits (West) 403.298.0488 smalanchuk@johnson.ca Kurt Wilchuck, M.B.A., CEBS Consultant, Plan Benefits (West) 780.732.2313 kwilchuck@johnson.ca REFERENCES i Sun Life Financial: Focus Update (March 7, 2013). Highlights of the federal, provincial and territorial budgets for 2013. ii Alberta Health (accessed: October 23, 2013). Drug coverage and services: Prescription generic drugs and health benefits. www.health.alberta.ca/services/drug-coverage-services.html iii Pacific Blue Cross (March 25, 2013). BC Government announces drug price regulations. www.pac.bluecross.ca/corp/company/media/?articleid=6348970 81855781250 iv ibid v Manitoba Health: News Media Services (January 18, 2013). Province providing more prescription drug coverage for Manitoba families. vi Manitoba Health: News Media Services (March 18, 2013). Provincial Government works with other provinces to secure lower drug prices for Manitobans. vii Manitoba Health: News Media Services (July 15, 2013). Manitobans to save on prescription drugs thanks to lower prices negotiated by the Manitoba Government: Oswald. viii Ibid. Langley 201, 9440- 202 Street Langley, BC V1M 4A6 Phone: 604.881.8820 Fax: 604.881.8828 6 ® Johnson Inc. · www.johnson.ca · November 2013 ix Manitoba News Release (October 20 , 2013). Government Adds 93 new medications to medicare formulary to help Manitobans suffering from lung cancer, arthritis and stroke. x Ibid. xi Alberta Blue Cross (received: August 23, 2013). Increase in Alberta private and semi-private hospital room rates. xii British Columbia Ministry of Health (April 12, 2013). More publicly funded vaccines available through pharmacists. xiii ibid xiv Travel Insurance File (July 9, 2013). How long can Canadians stay out of the country? travelinsurancefile.com/headlines/how-longcan-canadians-stay-out-of-the-country/ xv Globe and Mail (October 8, 2013). The future of prescription drugs: Patient-centred health care – strategic approach critical to reducing costs, improving health outcomes. xvi Ibid. xvii Ibid. xviii Alberta Health (March 7, 2013). Health funding allocations for 2013 – 2014. www.health.alberta.ca/about/health-funding.html xix ibid xx Alberta Health(accessed: October 23, 2013). Drug coverage and services: Drug and supplementary health benefits program. www.health.alberta.ca/services/drug-coverage-services.html xxi Canadian Life and Health Insurance Association Inc.: Frank, Stephen (March 22, 2013). Life and health insurers’ key questions regarding proposed pharmacare program in Alberta. xxii ibid xxiii Edmonton Journal: Gerein, Keith (October 24, 2013). Alberta Health to delay major change to drug coverage system. www.edmontonjournal.com/story_print.html?id=9080203&spons or= xxiv Sun Life Financial: Focus Updated (June 13, 2013). Manitoba provincial retail sales tax rate increase announced. xxv Government of Manitoba: Information Bulletin (July 15, 2013). The Retail Sales Tax Act. www.gov.mb.ca/finance/taxation/bulletins/061.pdf xxvi UFCW Canada (June 28, 2013). UFCW campaign wins senate support against Harper's Bill C-377. www.ufcw.ca/index.php?option=com_content&view=article&id= 3534%3Aufcw-campaign-wins-senate-support-against-harpersbill-c-377&catid=6%3Adirections-newsletter&Itemid=6&lang=en xxvii The Daily Commercial News (July 5, 2013). Tensions inside Tory caucus flare over Senate snub on Bill C-377. http://dcnonl.com/cgibin/dcnhome.pl?rm=print_story&story_id=56044&source=article xxviii Law of Work (accessed: July 10, 2013). Bill C-377: The Conservatives’ private members Bill on union transparency. http://lawofwork.ca/?p=5739 Edmonton 11120 – 178th Street Edmonton, AB T5S 1P2 Phone: 780.483.0408 Fax: 780.420.6082 xxix Parliament of Canada (60-61 Elizabeth II, 2011-2012, 1st Session, 41st Parliament). House of Commons of Canada: Bill C-377. http://parl.gc.ca/HousePublications/Publication.aspx?Language=E &Mode=1&DocId=5942377&File=24 xxx ibid xxxi Law of Work (accessed: July 10, 2013). Bill C-377: The Conservatives’ private members Bill on union transparency. http://lawofwork.ca/?p=5739 xxxii Government of Canada: Canada Gazette (May 8, 2013). Jobs, Growth and Long-Term Prosperity Act. www.gazette.gc.ca/rppr/p2/2013/2013-05-08/html/si-tr49-eng.html xxxiii Osler, Hoskin & Harcourt LLP (May 31, 2013). Canada: New requirements Re Insurance for LTD plans of federally-regulated employers coming into force In 2014. www.mondaq.com/canada/x/240720/Employee+Benefits+Comp ensation/New+Requirements+Re+Insurance+For+LTD+Plans+Of+F ederallyRegulated+Employers+Coming+Into+Force+In+2014 xxxiv Canadian Life and Health Insurance Association Inc. (September 2010). Protecting Canadians’ long term disability benefits. xxxv ibid xxxvi Morneau Shepell: News Release (June 11, 2013). Morneau Shepell survey indicates most pension plan sponsors believe Canada is in a retirement crisis. xxxvii Canadian HR Reporter (June 12, 2013). Majority of pension plan sponsors believe Canada in retirement crisis: Survey. www.hrreporter.com/articleprint.aspx?articleid=18199 xxxviii Society of Actuaries (June 18, 2013). Health Care Costs – From birth to death. www.healthcostinstitute.org/SOA-1-2013. Accessed: July 4, 2013. xxxix ibid xl HealthCare Finance News (May 16, 2013). Aging not the overwhelming driver of higher healthcare spending as thought. www.healthcarefinancenews.com/print/67666. Accessed: July 4, 2013. Calgary 300, 736 – 8th Avenue Calgary, AB T2P 1H4 Phone: 403.298.0488 Langley 201, 9440- 202 Street Langley, BC V1M 4A6 Phone: 604.881.8820 Fax: 604.881.8828 7 ® Johnson Inc. · www.johnson.ca · November 2013