Revised Attendant Care Hourly Rate Guideline and Transportation Expense Guideline

 
Bulletin
No. A-14/16
Property & Casualty
– Auto 
 
To the attention of all insurance companies licensed
to transact automobile insurance and health care providers in Ontario
​​

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With this Bulletin the Financial Services Commission of Ontario (FSCO) is releasing the revised Attendant Care Hourly Rate Guideline and Transportation Expense Guideline. The two revised guidelines come into effect October 1, 2016.
 
The revised guidelines have been approved by the Superintendent for use in connection with the Statutory Accident Benefits Schedule – Effective September 1, 2010 (SABS). The revised guidelines replace the previously issued guidelines. 


Revised Attendant Care Hourly Rate Guideline 

The revised Attendant Care Hourly Rate Guideline increases the maximum hourly rates for the three levels of Attendant Care Costs.
 
The following table outlines the revised rates:
​Attendant Care Costs​Maximum Hourly Rate
effective October 1, 2015
​Maximum Hourly Rate
effective October 1, 2016
​Part 1: Hourly Rate A
 
Level 1 Attendant Care is for routine personal care.
​$13.19​$14.90
Part 2: Hourly Rate B
 
Level 2 Attendant Care is for basic supervisory functions.
​$11.25​$11.40

Part 3: Hourly Rate C

 

Level 3 Attendant Care is for complex health/care and hygiene functions.
​$19.35​$21.11

The Level 1 and Level 3 rates are increased to be consistent with the equivalent rates determined by the Workplace Safety & Insurance Board (WSIB). The Level 2 rate is increased to $11.40 per hour to reflect Ontario’s general minimum wage increases effective October 1, 2016.
 
Insurers and health care providers are also reminded that as of October 1, 2016, service providers may participate in the Form 1 Health Claims for Auto Insurance (HCAI) pilot project and begin submitting the completed Form 1 through the HCAI system. See Bulletin A-11/16 – Revised Assessment of Attendant Care Needs and Introduction of Form 1 for more details about the pilot project and the revised Form 1.
 

Revised Transportation Expense Guideline

Under the Transportation Expense Guideline, the insurer is liable to pay mileage when an insured person and his/her aide or attendant, travel to and from treatment sessions, counselling sessions, training sessions, assessments and examinations, using the insured person’s automobile, excluding the first 50 kilometres of each round-trip. 

The revised guideline increases the rate paid for travel using the insured person’s automobile on or after October 1, 2016, from $0.38/km to $0.40/km.


Authority

The revised guidelines are issued by FSCO under section 268.3 of the Insurance Act for the purposes of the SABS and are incorporated by reference in the SABS.


Implementing the Changes

Please inform your claims staff, and any other staff who may be affected, about these changes. Also ensure that you make any operational changes needed to implement these changes by the effective date.
 

Copies of the Guidelines

The revised guidelines are available on the FSCO website:
 
The guidelines will also be published in the October 1, 2016, issue of The Ontario Gazette [New Window].
 
Brian Mills
Chief Executive Officer and
Superintendent of Financial Services
 
September 23, 2016

 


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