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O. Reg. 146/17: GENERAL
filed May 23, 2017 under Health Insurance Act, R.S.O. 1990, c. H.6
Skip to contentontario regulation 146/17
made under the
Health Insurance Act
Made: May 18, 2017
Filed: May 23, 2017
Published on e-Laws: May 23, 2017
Printed in The Ontario Gazette: June 10, 2017
Amending Reg. 552 of R.R.O. 1990
(GENERAL)
1. (1) Subsection 10 (6) of Regulation 552 of the Revised Regulations of Ontario, 1990 is revoked and the following substituted:
(6) Subject to subsections (6.1) to (9), the maximum amount of the co-payment is,
(a) for each day, other than a day that is part of a month referred to in clause (b), that services are received by a person in a category set out in Column 1 of the Table to this section, the amount prescribed opposite in Column 2; and
(b) for each calendar month that services are received on every day of the month by a person in a category set out in Column 1 of the Table to this section, the amount prescribed opposite in Column 3.
(6.1) If the maximum amount of the co-payment determined under subsection (6) is a negative number, the maximum amount of the co-payment is deemed to be zero.
(2) Subsection 10 (6) of the Regulation, as enacted by subsection (1) is amended by,
(a) striking out “Column 2” at the end of clause (a) and substituting “Column 3”; and
(b) striking out “Column 3” at the end of clause (b) and substituting “Column 4”.
(3) Subsection 10 (11) of the Regulation is amended by striking out “and in Table 2” in the portion before the definitions and substituting “and in the Table to this section”.
(4) Subsection 10 (11) of the Regulation, as amended by subsection (3), is amended by adding the following definition:
“threshold income amount” means, in respect of an Item in the Table to this section, the threshold income amount determined under Column 2 of the Item.
(5) Section 10 of the Regulation is amended by adding the following subsections:
(13) Beginning on July 1, 2018, and on every July 1 thereafter, the maximum daily co-payment amount set out in Column 3 of Item 1 of the Table to this section and the threshold income amounts set out in Column 2 of the Table to this section shall be adjusted in accordance with the following rules:
1. Subject to paragraphs 2 and 3, the amounts that applied immediately before the applicable July 1 date shall be adjusted by the percentage change between,
i. the Consumer Price Index for the previous calendar year, and
ii. the Consumer Price Index for the calendar year immediately preceding the previous calendar year.
2. If the percentage change described in paragraph 1 is greater than 2.5 per cent, the amounts shall instead be adjusted by 2.5 per cent.
3. If the percentage change described in paragraph 1 is negative, the amounts shall instead not be adjusted.
(14) For the purposes of subsection (13), the Consumer Price Index for a calendar year is the Consumer Price Index for Canada (All-items) for the calendar year, as reported by Statistics Canada under the authority of the Statistics Act (Canada).
(15) The Minister may publish the adjusted amounts on a government website.
(6) Section 10 of the Regulation is amended by adding the following Table:
Table
Maximum Co-Payment Amounts on or after July 1, 2017 but before July 1, 2018
|
Item |
Column 1 Persons Receiving Chronic Care Services |
Column 2 Maximum Daily Co-payment |
Column 3 Maximum Monthly Co-Payment |
|
1. |
Person not referred to elsewhere in this Table |
$59.82 |
$1,819.53 |
|
2. |
Person with no dependants – maximum estimated income equal to $1,819.53 plus the amount set out in paragraph 1 of subsection 32 (1) of Ontario Regulation 222/98 (General) made under the Ontario Disability Support Program Act, 1997 |
Take the estimated income and subtract the amount set out in paragraph 1 of subsection 32 (1) of Ontario Regulation 222/98 (General) made under the Ontario Disability Support Program Act, 1997, then divide the result by 30.4167 and round it to the nearest cent |
Take the estimated income and subtract the amount set out in paragraph 1 of subsection 32 (1) of Ontario Regulation 222/98 (General) made under the Ontario Disability Support Program Act, 1997, then round it to the nearest cent |
|
3. |
Person with one dependant – maximum aggregate estimated incomes $9,483.00 |
Take the aggregate estimated incomes and subtract $4,023.00, then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract $4,023.00, then divide the result by 3 and round it to the nearest cent |
|
4. |
Person with two dependants – maximum aggregate estimated incomes $10,056.00 |
Take the aggregate estimated incomes and subtract $4,596.00, then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract $4,596.00, then divide the result by 3 and round it to the nearest cent |
|
5. |
Person with three dependants – maximum aggregate estimated incomes $10,582.00 |
Take the aggregate estimated incomes and subtract $5,122.00, then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract $5,122.00, then divide the result by 3 and round it to the nearest cent |
|
6. |
Person with four or more dependants – maximum aggregate estimated incomes $11,049.00 |
Take the aggregate estimated incomes and subtract $5,589.00, then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract $5,589.00, then divide the result by 3 and round it to the nearest cent |
(7) The Table to section 10 of the Regulation, as enacted by subsection (6), is revoked and the following substituted:
Table
Maximum Co-Payment Amounts on or after July 1, 2018
|
Item |
Column 1 Persons Receiving Chronic Care Services |
Column 2 Threshold Income Amount |
Column 3 Maximum Daily Co-payment |
Column 4 Maximum Monthly Co-Payment |
|
1. |
Person not referred to elsewhere in this Table |
Not applicable |
$59.82, subject to the annual adjustment set out in subsection (13) and rounded to the nearest cent |
Take the daily co-payment determined under Column 3 and multiply it by 30.4167, then round it to the nearest cent |
|
2. |
Person with no dependants – maximum estimated income equal to the maximum monthly co-payment (Column 4, Item 1) plus the amount set out in paragraph 1 of subsection 32 (1) of Ontario Regulation 222/98 (General) made under the Ontario Disability Support Program Act, 1997, rounded to the nearest cent |
Not applicable |
Take the estimated income and subtract the amount set out in paragraph 1 of subsection 32 (1) of Ontario Regulation 222/98 (General) made under the Ontario Disability Support Program Act, 1997, then divide the result by 30.4167 and round it to the nearest cent |
Take the estimated income and subtract the amount set out in paragraph 1 of subsection 32 (1) of Ontario Regulation 222/98 (General) made under the Ontario Disability Support Program Act, 1997, then round it to the nearest cent |
|
3. |
Person with one dependant – maximum aggregate estimated incomes equal to the sum of one dollar, the threshold income amount (Column 2 of this Item) and three times the maximum monthly co-payment (Column 4, Item 1), rounded to the nearest dollar |
$4,023.00, subject to the annual adjustment set out in subsection (13) and rounded to the nearest dollar |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 3 and round it to the nearest cent |
|
4. |
Person with two dependants – maximum aggregate estimated incomes equal to the sum of one dollar, the threshold income amount (Column 2 of this Item) and three times the maximum monthly co-payment (Column 4, Item 1), rounded to the nearest dollar |
$4,596.00, subject to the annual adjustment set out in subsection (13) and rounded to the nearest dollar |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 3 and round it to the nearest cent |
|
5. |
Person with three dependants – maximum aggregate estimated incomes equal to the sum of one dollar, the threshold income amount (Column 2 of this Item) and three times the maximum monthly co-payment (Column 4, Item 1), rounded to the nearest dollar |
$5,122.00, subject to the annual adjustment set out in subsection (13) and rounded to the nearest dollar |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 3 and round it to the nearest cent |
|
6. |
Person with four or more dependants – maximum aggregate estimated incomes equal to the sum of one dollar, the threshold income amount (Column 2 of this Item) and three times the maximum monthly co-payment (Column 4, Item 1), rounded to the nearest dollar |
$5,589.00, subject to the annual adjustment set out in subsection (13) and rounded to the nearest dollar |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 91.2 and round it to the nearest cent |
Take the aggregate estimated incomes and subtract the threshold income amount (Column 2 of this Item), then divide the result by 3 and round it to the nearest cent |
2. Table 2 of the Regulation is revoked.
Commencement
3. (1) Subject to subsection (2), this Regulation comes into force on July 1, 2017.
(2) Subsections 1 (2), (4), (5) and (7) come into force on July 1, 2018.