O. Reg. 156/05: GENERAL

 

ontario regulation 156/05

made under the

ontario drug benefit act

Made: March 23, 2005
Filed: March 29, 2005
Printed in The Ontario Gazette: April 16, 2005

Amending O. Reg. 201/96

(General)

1. (1) Paragraph 3 of subsection 3 (1) of Ontario Regulation 201/96 is revoked and the following substituted:

3. In order to become eligible, an application to become enrolled must be made to the Minister on behalf of the person’s household unit and the Minister must be satisfied that the members of the household unit have collectively spent the amount determined in accordance with sections 4, 4.1 and 4.2, or more, on allowable expenses in any quarter in a fiscal period.

(2) Subsection 3 (3) of the Regulation is revoked and the following substituted:

(3) Subject to subsection (3.1), an application under paragraph 3 of subsection (1) shall be made in the form provided by the Minister and must include,

(a) receipts for allowable expenses as required by the form;

(b) information evidencing annual net income as required by the form; and

(c) completion of the consents required by the form.

(3.1) Every application made under paragraph 3 of subsection (1) shall be deemed to be renewed every year, effective as of the first day of the fiscal period, unless,

(a) the Minister confirms that no claims for payment were submitted to the Health Network mentioned in section 23 on behalf of any member of the household unit for one fiscal period;

(b) the member of the household unit that made the application on behalf of the household unit notifies the Minister that all members of the household unit withdraw the general consent required by the application form; or

(c) the member of the household unit that made the application requests that the Minister terminate the enrolment of all members of the household unit.

(3.2) If a person’s application is not renewed for one of the reasons set out in subsection (3.1), the person may reapply to be enrolled by completing the application form required by paragraph 3 of subsection (1) in accordance with subsection (3).

(3.3) The member of the household unit that made the application shall notify the Minister in writing of any change in the unit’s circumstances or membership that results in a member of the household unit ceasing to be a member of the eligible class of persons, or of any other changes that may affect the calculation of the unit’s allowable expenses under section 4, 4.1 or 4.2.

2. (1) Subsection 4 (3) of the Regulation is revoked and the following substituted:

(3) For the purposes of this section, a member’s most recent taxation year is the member’s taxation year that ended before the beginning of the fiscal period in respect of which an application is made under paragraph 3 of subsection 3 (1) or renewed under subsection 3 (3.1).

(2) Subsections 4 (6) and (7) of the Regulation are revoked and the following substituted:

(6) In the case of an election under subsection (5), if the relevant taxation year of a member of a household unit is not complete on the day the application to be enrolled is made or the day upon which the Minister receives the member’s written notification of his or her election, whichever is later, the member’s annual net income for that taxation year shall be determined using the sum of,

(a) the member’s income from the beginning of the taxation year until the day of the application or the Minister’s receipt of the notification of election; and

(b) an estimate of the member’s income from the day of the application or the Minister’s receipt of the notification of election until the end of the taxation year.

(7) An estimate under clause (6) (b) shall be determined by multiplying the number of days remaining in the member’s taxation year by the member’s average daily income for the month immediately preceding the day of the application or receipt of notification.

3. Clause 4.1 (1) (b) of the Regulation is revoked and the following substituted:

(b) in the quarter immediately preceding the quarter in respect of which eligibility is being determined, the members of the person’s household unit spent less on allowable expenses than the amount determined under subsection 4 (1).

4. Subsection 4.2 (1) of the Regulation is revoked and the following substituted:

(1) If the application made under paragraph 3 of subsection 3 (1) in any given fiscal period requests that eligibility begin after the beginning of the period, the amount referred to in paragraphs 2 and 3 of subsection 3 (1) that must be spent on allowable expenses in each remaining quarter of the fiscal period shall be determined in accordance with subsection (2).

5. This Regulation comes into force on July 31, 2005.