Ontario Gazette Volume 143 Issue 35 | August 28, 2010

Government Notices Respecting Corporations

Notice of Default in Complying with the Corporations Tax Act

The Director has been notified by the Minister of Finance that the following corporations are in default in complying with the Corporations Tax Act.

Notice Is Hereby Given under subsection 241(1) of the Business Corporations Act, that unless the corporations listed hereunder comply with the requirements of the Corporations Tax Act within 90 days of this notice, orders will be made dissolving the defaulting corporations. All enquiries concerning this notice are to be directed to Ministry of Finance, Corporations Tax, 33 King Street West, Oshawa, Ontario L1H 8H6.

Katherine M. Murray
Director, Ministry of Government Services
(143-G439)

Cancellation of Certificate of Incorporation (Corporations Tax Act Defaulters)

Notice Is Hereby Given that, under subsection 241(4) of the Business Corporations Act, the Certificate of Incorporation of the corporations named hereunder have been cancelled by an Order for default in complying with the provisions of the Corporations Tax Act, and the said corporations have been dissolved on that date.

Katherine M. Murray
Director, Ministry of Government Services
(143-G440)

Certificate of Dissolution

Notice Is Hereby Given that a certificate of dissolution under the Business Corporations Act, has been endorsed. The effective date of dissolution precedes the corporation listings.

Katherine M. Murray
Director, Ministry of Government Services
(143-G441)

Notice of Default in Complying with the Corporations Information Act

Notice Is Hereby Given under subsection 241(3) of the Business Corporations Act that unless the corporations listed hereunder comply with the filing requirements under the Corporations Information Act within 90 days of this notice orders dissolving the corporation(s) will be issued. The effective date precedes the corporation listings.

Katherine M. Murray
Director
(143-G442)

Cancellation of Certificate of Incorporation (Business Corporations Act)

Notice Is Hereby Given that by orders under subsection 241(4) of the Business Corporation Act, the certificates of incorporation set out hereunder have been cancelled and corporation(s) have been dissolved. The effective date of cancellation precedes the corporation listing.

Katherine M. Murray
Director
(143-G443)

Cancellation for Cause (Business Corporations Act)

Notice Is Hereby Given that by orders under section 240 of the Business Corporation Act, the certificates set out hereunder have been cancelled for cause and in the case of certificates of incorporation the corporations have been dissolved. The effective date of cancellation precedes the corporation listing.

Katherine M. Murray
Director
(143-G444)

Notice of Default in Complying with a Filing Requirement under the Corporations Information Act

Notice Is Hereby Given under subsection 317(9) of the Corporations Act, that unless the corporations listed hereunder comply with the requirements of the Corporations Information Act within 90 days of this Notice, orders will be made dissolving the defaulting corporations. The effective date precedes the corporation listings.

Katherine M. Murray
Director
(143-G445)

Cancellation for Filing Default (Corporations Act)

Notice Is Hereby Given that orders under Section 317(9) of the Corporations Act have been made cancelling the Letters Patent of the following corporations and declaring them to be dissolved. The date of the order of dissolution precedes the name of the corporation.

Katherine M. Murray
Director
(143-G446)

Erratum Notice

Ontario Corporation Number 1182098

Vide Ontario Gazette, Vol. 143-27 dated July 3, 2010

Notice Is Hereby Given that the notice issued under section 317(9) of the Corporations Act set out in the July 3, 2010 issue of the Ontario Gazette with respect to The Canadian Manufacturing Agility Forum was issued in error and is null and void.

Katherine M. Murray
Director
(143-G447)

Ontario Corporation Number 1801983

Vide Ontario Gazette, Vol. 143-27 dated July 3, 2010

Notice Is Hereby Given that the notice issued under section 317(9) of the Corporations Act set out in the July 3, 2010 issue of the Ontario Gazette with respect to New Jerusalem International School and Church was issued in error and is null and void.

Katherine M. Murray
Director
(143-G448)

Marriage Act

Certificate Of Permanent Registration as a person authorized to solemnize marriage in Ontario have been issued to the following:

August 9 - August 13

Re-registrations

Certificates Of Temporary Registration as person authorized to solemnize marriage in Ontario have been issued to the following:

August 9 - August 13

Judith M. Hartman,
Deputy Registrar General
(143-G449)

Financial Services Commission of Ontario

Health Claims for Auto Insurance September 2010 Guideline

September 2010

Superintendent’s Guideline No. 07/10

Introduction

This Guideline replaces the Health Claims for Auto Insurance 2010 Rollout Guideline – Superintendent’s Guideline No. 01/10 (Rollout Guideline) issued in May 2010, and is issued pursuant to s. 268.3 (1) of the Insurance Act for the purposes of ss. 49 (1) and 64 (7) of the Statutory Accident Benefits Schedule – Effective September 1, 2010 (Sabs).

As noted in the Rollout Guideline, this Guideline is being issued to reflect the Sabs that is effective on September 1, 2010.

This Guideline applies to documents specified in this Guideline that are delivered on or after September 1, 2010, regardless of the date of the accident to which they relate.

A document to which this Guideline applies and that previously would have been sent directly to an insurer to whom this Guideline applies, is instead to be sent to a Central Processing Agency (Cpa) established by the insurance industry to receive such documents on behalf of insurers.

This Guideline describes:

• which insurers, health care facilities (facilities) and health care providers (providers) are subject to the Guideline and in what circumstances;
• what documents are to be delivered to the CPA and in what circumstances;
• how such documents may be delivered to the Cpa; and
• how insurers are to provide information to the Cpa.

Insurers and Providers That Are Subject To This Guideline

This Guideline applies only to transactions between a Participating Provider and a Participating Insurer, as defined below, in respect to any claim for Sabs benefits under a motor vehicle liability policy issued in Ontario.

Participating Providers

The Financial Services Commission of Ontario will continue to maintain and update from time to time a list of identified health care facilities/providers (or specified branch offices thereof) participating in the Health Claims for Auto Insurance (“Hcai”) system (the “Hcai Participating Provider List”) and the dates that their participation begins. Please see Appendix 1 for details of how to obtain copies of the Hcai Participating Provider List in effect at any particular time.

For the purposes of this Guideline, each specified branch office of an identified facility, and each provider operating in a specified branch office of an identified facility, is a Participating Provider.

Participating Insurers

This Guideline applies to all insurers licensed in Ontario in respect of all claims for Sabs benefits under any motor vehicle liability policy issued in Ontario. Each such insurer is a Participating Insurer for the purposes of this Guideline.

This Guideline does not apply to:

• any reinsurer in respect of claims under a contract of reinsurance,

• any insurer in respect of which a winding-up order has been made under the Winding-up and Restructuring Act (Canada), or
• the Motor Vehicle Accident Claims Fund.

Designation of Central Processing Agency – Sabs s. 64 (7)

Health Claims for Auto Insurance Processing is the Cpa for the purposes of this Guideline and s. 64 (7) of the Sabs. Health Claims for Auto Insurance Processing is a not-for-profit Ontario corporation established and funded by the insurance industry and operated by a board of directors that includes representatives of the insurance industry and health care communities.

The primary role of the Cpa is to act as the agent of insurers to receive specified documents on their behalf; to confirm that the documents are duly completed and contain all of the information required to be included in them; and to then make the documents available for access by the insurers to whom they are addressed. The Cpa also acts as an intermediary for the purpose of enabling insurers to communicate information such as claims approval and payment decisions electronically to those health care goods and services providers who wish to receive such communications electronically through the Cpa.

The CPA is also expected to be a primary source of the information that automobile insurers will be required (under s. 101.1 of the Insurance Act) to provide to the Superintendent of Financial Services, concerning claims for goods and services for which automobile insurers are liable under contracts of automobile insurance.

Invoices For Goods And Services That Are Subject To This Guideline –Sabs s. 49

Any invoice for goods or services specified in Appendix 2 of this Guideline for the purposes of s. 49 of the Sabs must be in the form (the Auto Insurance Standard Invoice) approved by the Superintendent of Financial Services in accordance with s. 66 of the Sabs.

This requirement applies only if:

• all of the goods or services referred to in the invoice are provided in Ontario by the Participating Provider,
• the invoice is not submitted by the claimant,
• the invoice is submitted by a Participating Provider and is payable to the Participating Provider, and
• payment of the invoice is claimed against a Participating Insurer with respect to a transaction with a Participating Provider.

Where this requirement applies, s. 49 (1) of the Sabs prohibits a Participating Insurer from paying any invoice that is not in the approved form, does not include all of the information required by the approved form, or is not sent to the CPA as required by this Guideline.

Participating Providers are to invoice Participating Insurers for goods or services specified in Appendix 2 separately from goods or services not specified in Appendix 2. Similarly, Participating Providers are to invoice Participating Insurers for goods or services provided in Ontario separately from goods and services not provided in Ontario.

Documents That Must Be Delivered To The CPA

The following documents are specified for the purpose of s. 64 (7) of the Sabs. Each of these documents must be delivered to the CPA (not directly to the insurer to whom it is addressed) in accordance with this Guideline, if it is delivered to a Participating Insurer by a Participating Provider:

OCF-18 Treatment and Assessment Plan – Sabs s. 38

OCF-21 Auto Insurance Standard Invoice – Sabs s. 49 – but only if this Guideline requires the use of this form for the particular goods or services being billed

OCF-23 Treatment Confirmation Form – Sabs s. 40

Please note that with one exception (see * below), a document that this Guideline does not require to be delivered to the Cpa, must be delivered directly to the insurer using one of the delivery methods provided for in s. 64 (2) of the Sabs.

* An OCF-21 submitted to invoice an insurer only for the completion of a Disability Certificate (OCF-3) may be delivered either to the CPA in accordance with this Guideline, or directly to the insurer, at the option of the Participating Provider.

Section 64 (7) of the Sabs provides that a document to which this Guideline applies is deemed not to have been delivered to an insurer unless it is delivered to the CPA as required by this Guideline. If such a document is delivered directly to an insurer instead of the CPA, despite the requirements of this Guideline, the insurer is under no obligation to respond to it, as the document will be deemed not to have been received by the insurer.

How To Deliver Documents To The Central Processing Agency

A document that is required by this Guideline to be delivered to the CPA shall be delivered in either of the following ways:

1. Electronic Submission, or
2. Paper Submission

(1) Electronic Submission

The document may be delivered to the CPA in electronic form in a manner that results in it being capable of being retrieved and accessed by the Cpa.

Participating Providers are authorized to deliver documents to the CPA electronically as described above, and to access information electronically from the CPA, once they have completed the appropriate enrolment process (see Enrolment Of Users And Providers below).

A Participating Provider may elect to enrol for either electronic submission or paper submission, but not both at the same time.

As noted below under Rules Governing Date of Receipt of Documents By Insurers, any document delivered to the CPA by a Participating Provider that has not completed this enrolment process will be deemed not to have been received by the insurer, and will not be processed.

(2) Paper Submission

The CPA has established a data entry centre that is equipped to receive paper documents delivered by a Participating Provider in accordance with this Guideline. These documents will be transcribed, validated and submitted electronically from the Data Entry Centre (Dec) to the insurer.

Documents may be delivered to the Cpa in paper form, by mail, fax or personal delivery in accordance with ss. 64 (2) (a), (b), (c) or (d) of the Sabs if addressed to the CPA’s data entry centre as follows:

Hcai Processing – Data Entry Centre
P.O. Box 254
Orangeville ON L9W 3Z5
Fax number: (866) 346-6744

Participating Providers are authorized to deliver documents in paper form as described above, once they have completed the appropriate enrolment process (see Enrolment Of Users And Providers below).

A Participating Provider may elect to enrol for either electronic submission or paper submission, but not both at the same time.

As noted below under Rules Governing Date of Receipt of Documents By Insurers, any document delivered to the CPA’s data entry centre by a Participating Provider that has not completed this enrolment process will be deemed not to have been received by the insurer, and will not be processed.

Attachments To Documents That Are Subject To This Guideline

For the purposes of this Guideline, “attachments” means any material (e.g., additional pages, reports, test results) submitted in support of a document to which this Guideline applies.

If a Participating Provider determines that it is necessary to send one or more attachments rather than including in the document itself all information that the sender determines to be desirable or necessary to accomplish its purpose, the following special rules apply:

1. The Participating Provider must specify, in the field provided in the document for that purpose, how many attachments are being delivered.
2. The document itself (but not the attachments) must still be delivered to the CPA (if in electronic format) or the CPA’s data entry centre (if in paper form) as described above.
3. The attachments are not to be delivered to the CPA (or the CPA’s data entry centre), but instead must be delivered directly to the insurer by one of the delivery methods described in s. 64 (2) of the Sabs. Although it is preferable that all attachments be delivered to the insurer at the same time, it is not mandatory to do so.

Please note that any attachment delivered to the CPA or the CPA’s data entry centre will be deemed not to have been received by the insurer, and will not be returned, but will be destroyed.

4. The attachments are not to be sent to the insurer before the document is sent to the Cpa.
5. Each attachment must be identified with the claimant’s name, either the claim number or policy number, the date of the accident, and the document type (i.e., OCF-18, OCF-21 or OCF-23) to which the attachment relates, to enable the insurer to identify the document for which the attachment is intended.

Rules Governing Date of Receipt of Documents By Insurers

Section 64 of the Sabs sets out the rules that determine when a document delivered to the CPA as required by this Guideline, is deemed to be received by the insurer to whom it is addressed. Briefly summarized, those rules provide:

1. Document with no attachments – is deemed to be received by the insurer to whom it is addressed when the document has been delivered to the CPA in a manner specified in this Guideline, and the CPA has determined that the document is duly completed and contains all information required by the Sabs to be included in it.
2. Document with attachments – is deemed to be received by the insurer to whom it is addressed when:
   1. the document (exclusive of attachments) has been delivered to the Cpa in a manner specified in this Guideline, and the Cpa has determined that the document is duly completed and contains all information required by the Sabs to be included in it; and
   2. all of the attachments have been received by the insurer.

The Sabs provides (s. 64 (20)) that a document delivered to the CPA by fax, personal delivery or by electronic submission later than 5:00 p.m. Eastern Time is deemed to have been delivered to the CPA on the following business day.

The Sabs also provides (s. 64 (10)) that the Cpa will be deemed to have determined, on the day a document was delivered to it in a manner specified in this Guideline, that the document is duly completed and contains all information required by the Sabs to be included in it, unless the CPA notifies the sender to the contrary, in a manner specified in this Guideline.

For the purposes of s. 64 (10), the manner in which the CPA is to notify the sender is by one of the delivery methods provided for in s. 64 (2) of the Sabs. The Cpa may also deliver the notification verbally (e.g., by a telephone call or message), provided written confirmation is given as soon as practicable afterwards by one of the delivery methods provided for in s. 64 (2) of the Sabs.

As previously noted, the Sabs further provides (s. 64 (7)) that a document to which this Guideline applies is deemed not to have been delivered to an insurer unless it is delivered as required by this Guideline. Any document delivered to the CPA (either directly or through its data entry centre) by a Participating Provider that has not completed the enrolment process, is not delivered as required by this Guideline and therefore shall be deemed not to have been delivered to an insurer.

Completion of Documents

A document to which this Guideline applies will be deemed not to have been completed and not to contain all the information required by the Sabs to be included in it, unless all fields (other than those that are optional in the circumstances indicated on the form as approved by the Superintendent of Financial Services) are completed as required by this Guideline.

The information in any completed field must comply with the validation rules set out in Appendix 3 of this Guideline.

Where the form specifies the format in which certain information (e.g., a date) is to be provided, the information must be provided in that format.

If the document is delivered in paper form, all completed fields must be legible.

All attachments must be legible.

Codes To Be Used In Submitting Information

The following information shall be provided utilizing the codes specified below:

• To describe injuries and sequelae, codes listed in the International Statistical Classification of Diseases and Related Health Problems, 10^th Revision, Canadian Enhancement (ICD-10-CA) which is maintained by the Canadian Institute for Health Information and available through www.cihi.ca. An abridgment of the ICD-10-CA list of codes, developed to assist stakeholders in the Ontario automobile insurance system, is available at www.hcaiinfo.ca.
• To describe health interventions, codes listed in the Canadian Classification of Health Interventions (Cci) which is maintained by the Canadian Institute for Health Information and available through www.cihi.ca. An abridgment of the CCI list of codes, developed to assist stakeholders in the Ontario automobile insurance system, is available at www.hcaiinfo.ca.
• To describe provider types, the list of Provider Type Codes is available at www.hcaiinfo.ca.
• To describe payment categories under a Pre-approved Framework, the list of Pre-approved Framework Reimbursement Codes is available at www.hcaiinfo.ca.
• To describe payment categories under the Minor Injury Guideline, the list of Minor Injury Reimbursement Codes available at www.hcaiinfo.ca.
• To describe items billed to automobile insurers by providers that are not covered by the CCI, the list of Goods, Administration, and Other Codes is available at www.hcaiinfo.ca.
• To describe unit measures and for converting minutes to hours, the list of Unit Measure Codes and the Minutes to Hour Conversion Table is available at www.hcaiinfo.ca.

The information at www.hcaiinfo.ca is maintained by Insurance Bureau of Canada in cooperation with the professional associations referred to at www.hcaiinfo.ca/links.asp.

Requirements For Insurers

Where the Sabs requires a Participating Insurer to provide information to the Cpa, such information shall be delivered to the Cpa in electronic form in a manner that results in it being capable of being retrieved and accessed by the Cpa.

The information referred to in s. 49 (3) of the Sabs concerning the processing of an invoice must be provided to the CPA within five business days after the invoice has been processed by the Participating Insurer.

The information referred to in s. 64 (13) of the Sabs concerning any other document to which this Guideline applies must be provided to the CPA within five business days after the document has been processed by the Participating Insurer.

The information referred to in s. 64 (14) of the Sabs concerning receipt of attachments must be provided to the CPA within five business days after the last attachment has been received by the Participating Insurer.

The deadlines referred to above are independent of, and not to be confused with, the deadlines within which an insurer is to process and respond to a document as set out in the Sabs.

A Participating Insurer that has completed the enrolment process as an Insurer (see Enrolment of Users And Providers below), is authorized to deliver information to the CPA electronically and to access from the CPA information that has been delivered to the CPA by a Participating Provider.

Enrolment Of Users And Providers

Before submitting information to, or receiving information from the CPA, a provider, facility or insurer that is a Participating Provider or Participating Insurer shall enrol with the CPA and agree to its user terms and conditions. As noted above, providers and facilities may elect to enrol for either paper submission or electronic submission, but not both at the same time. The user terms and conditions may include commercially reasonable provisions to address responsibilities including confidentiality, security, liability, access, and data integrity.

Temporary Suspensions Of This Guideline

In the event that the CPA becomes unable (e.g., by reason of temporary technical issues) to properly carry out its obligations to providers, facilities or insurers, the Superintendent of Financial Services may temporarily suspend the operation of this Guideline.

The Financial Services Commission of Ontario will post notice of any suspension and subsequent resumption of operation of this Guideline on its website (www.FSCO.gov.on.ca).

During the period of any such suspension, the requirements of this Guideline do not apply and documents are instead to be delivered directly to insurers using one of the standard delivery methods provided for in s. 64 (2) of the Sabs.

Appendix 1

Hcai Participating Provider List

Copies of the Hcai Participating Provider List in effect from time to time may be obtained at www.FSCO.gov.on.ca/english/insurance/auto/hcai.asp.

Alternatively, printed copies may be obtained by contacting the Financial Services Commission of Ontario at 1-800-668-0128 extension 7123.

Appendix 2

Invoices For Goods And Services That Are Subject To This Guideline – Sabs s. 49

Medical Benefits

Rehabilitation Benefits

Examinations, Completion of Reports/Certificates, etc

Appendix 3

Validation Rules

Common Document Submission Rules

Validation of unit of measure for goods and services rendered

Common Invoice (OCF-21) Submission Rules

OCF-18 Submission Rules

OCF-23 Submission Rules

OCF-21A Submission Rules- applies to DEC only

OCF-21B Submission Rules

OCF-21C Submission Rules

Facility Registry

(143-G451E)