Frequently Asked Questions
Table of Contents
- What has RCDSO decided about PLP?
- Is PLP still accepting new claims?
- What is the College looking for in a new third-party provider?
- What will happen with the current annual membership fee amount?
- Every year, you say that a portion ($1,000) of annual fees is related to PLP liability malpractice protection (which includes $2M of coverage). How do you calculate this?
- What will new malpractice protection cost for dentists? And what minimum limits will be required?
- When would these changes become effective?
- When do I have to look for a new provider?
- What happens to my coverage when I retire?
- When will we hear more?
- Have you consulted with the profession?
- What is happening with PLP?
- Why was the Task Force struck in the first place?
- What did the Task Force recommend?
- The program has been working well for 50 years, why change now?
- I have further questions about PLP changes, who can I contact?
What has RCDSO decided about PLP?
At the December 2023 meeting, Council directed staff to proceed with exploring the transfer of the Professional Liability Program (including current liabilities and staff) to a third party, with the goal of allowing the program to continue to operate, under separate ownership.
Council asked staff to begin the procurement process under the guidance of a Procurement Review Group. An external mergers and acquisitions advisor, PricewaterhouseCoopers (PwC) has been retained.
Council is provided with regular progress reports.
Council deliberations are viewable on the RCDSO YouTube channel.
Is PLP still accepting new claims?
It is business as usual for PLP and there have been no changes made to the operation of the program. Stability for both patients and dentists will be maintained throughout the transition process. New and existing PLP cases will continue to be handled in the usual manner.
Once a third party has been selected, additional information will be provided to all registrants. When registrants pay their fees in fall of 2024, professional liability coverage will continue for the entire 2025 calendar year.
Dentists should continue to contact PLP directly for advice or assistance with potential, new or existing claims online at plp.rcdso.org or info@plpservices.org.
What is the College looking for in a new third-party provider?
Expectations of the new program include:
- Minimum liability limits, as determined by the RCDSO.
- A comparable rate for all dentists (generalist or specialist) or types of dental procedures performed.
- Indefinite tail coverage for dentists if they move to another jurisdiction to practice, when they retire, or if they pass away.
- Acceptance of current PLP policy wording, or close to it, with no unreasonable additional terms, conditions, or exclusions adverse to the profession or public.
- Coverage in the group model for all dentists to whom the college grants a licence
- Integrating PLP’s current staff into the new program.
- Supporting dentists beyond the claims process such as: providing advice to de-escalate and manage difficult situations; drafting legal release documents that provide refunds properly; supporting and guiding dentists through a litigation process.
- Risk management initiatives such as continuing education courses, advisories/publications, and exploring and identifying trends in the profession (e.g. injuries, procedures).
- Fair and reasonable cost.
What will happen with the current annual membership fee amount?
RCDSO will collect fees for the 2025 year in the usual manner. However, once the transfer takes place, RCDSO fees will be revised to reflect the change in operations of the PLP program and the impact of the transition on the College.
Every year, you say that a portion ($1,000) of annual fees is related to PLP liability malpractice protection (which includes $2M of coverage). How do you calculate this?
The portion of the annual fee attributed to PLP is an estimate based on the costs of running the program. It does not include certain shared costs (technology, human resources, building, insurance, finance) that the College provides in order to support the cost-effective operation of the program.
What will new malpractice protection cost for dentists? And what minimum limits will be required?
It is too early in the process to know what the new operator will charge for liability protection. One of Council’s expectations for the new operator is that the cost be fair and reasonable.
Consistent with other Ontario health Colleges, RCDSO will mandate minimum limits. Currently, liability limits are $2 million which is consistent with most Canadian regulators’ requirements although a couple require higher limits.
Once the RCDSO no longer owns and operates the program, it will need to find an alternative way to establish requirements for professional liability protection.
Over the next few months, RCDSO staff, with advice from the Procurement Review Group (PRG) and legal counsel will be working on By-Laws that will establish what each registrant must obtain by way of protection to ensure that the public is protected. The By-Law will establish what coverage each registrant must obtain in order to protect the public. The profession will have an opportunity to provide feedback during be consulted, as the 60-day consultation period is required, on any new or revised by-law.
When would these changes become effective?
At the June 2024 meeting, the Registrar and CEO (and PwC) reported to Council noting that flexibility in the transaction closing date would optimize outcomes for the College and staff as well as the profession.
PLP continues to operate as a program of the RCDSO. When registrants pay their fees in fall of 2024, professional liability coverage will continue for the entire 2025 calendar year.
Once an operator has been selected, additional information will be provided to all registrants.
However, a new provider may be in place before January 1, 2026, depending on the negotiated transfer date.
The profession will be provided with a minimum of 12 months’ notice of any changes to the program that will require alternative coverage.
When do I have to look for a new provider?
It is anticipated that members will not need to look for a new program, as the new provider will take on the existing program and dentists will continue to have seamless liability protection for a period of time. Once paying registration fees for 2025, dentists will have coverage in place for the calendar year, regardless of when the transition happens.
When a new provider is announced, the goal is to maintain stability and allow for continued coverage for all registrants.
It should also be noted that, as directed by the assumptions and key elements approved by Council in December 2023, it is the intention to negotiate similar terms and coverage for members beyond 2025. RCDSO is in the process of developing by-laws outlining minimum liability coverage requirements, regardless of who is providing it in the future.
What happens to my coverage when I retire?
By direction of Council, one of the expectations we have laid out for potential new providers is that they provide a "claims made" policy, which allows for indefinite tail coverage for dentists if they move to another jurisdiction, when they retire or if they pass away.
When will we hear more?
RCDSO will report regularly at Council meetings. We will continue to update the public, registrants and stakeholders as we progress.
Have you consulted with the profession?
RCDSO has been communicating regularly with registrants and stakeholders through e-blasts, newsletters and Council Highlights. In November 2023 RCDSO sent a survey to the profession on what they consider the most important elements of the program. Over 1600 responses were received. A full report on the survey results was presented at Council in December 2023 and is posted on the website here.
What is happening with PLP?
The Professional Liability Program (PLP) has been providing assistance to Ontario dentists for over 50 years. During that time, numerous staff and Council members have been dedicated to the promotion of patient safety and responsible dentistry.
In 2022, the Audit Committee and the Finance, Property and Administration (FPA) Committee reviewed the PLP program, its history, legislation, financial structure and assessed other comparable programs in Canada. As a result, Council established a PLP Expert Review Task Force to do a thorough review of the PLP program, outline any risks and recommend options to mitigate these risks on or before the September 2023 Council meeting.
The Expert Review Task Force, composed of liability and regulatory experts (including former Council members) met from February to July of 2023 and developed a report for review by the (now) Finance, Audit and Risk (FAR) Committee. After that review, the report findings and FAR’s analysis were presented to Council on September 21st. There, Council unanimously agreed that the College should not continue to directly operate PLP as it is currently structured.
With Council’s direction, RCDSO staff developed an implementation plan, with deliverables and timelines and created a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of four divestment approaches.
At the December 2023 meeting, after reviewing the options and key considerations, Council directed staff to proceed with the option of exploring the transfer of the Professional Liability Program (including current liabilities and staff) to a third party, with the goal of allowing the program to continue to operate, under separate ownership.
Council directed staff to begin a procurement process, guided by the proposed assumptions and key elements outlined, and under the guidance of a procurement review group. The procurement process resulted in the appointment of PricewaterhouseCoopers (PwC) as advisors. The Procurement Review Group was formed in early 2024 and is meeting regularly.
Council is receiving regular progress reports on the divestment project.
Council deliberations are viewable on the RCDSO YouTube channel.
Why was the Task Force struck in the first place?
Several risks have been identified with PLP, foremost among them are reputational, regulatory and financial risks.
RCDSO is one of the few health regulatory Colleges in Canada that directly operates an in-house liability program.
Over the past several years, negative media stories, changing expectations of professional regulation, and the RCDSO’s commitment to act in the public interest have caused RCDSO to consider the benefits, risks and appropriateness of this non-legislated program as an operational department of the College.
PLP’s mission and function are distinct from the rest of the College’s, whose mandate is to “serve and protect the public interest.”
One of the College’s primary regulatory responsibilities is to hold dentists accountable for conduct and practice issues; PLP serves as the primary malpractice protection provider for those same dentists. While there is a firewall between PLP and our regulatory programs, this divergence in mandate and function is confusing to both the public and dentists and raises questions about how we can effectively serve both mandates.
The College is also expected to be a responsible steward of its financial resources in achieving its statutory objectives and regulatory mandate, and the direct operation of PLP has presented some challenges to the RCDSO’s financial position including the completion of an adequate non-PLP operating reserve.
What did the Task Force recommend?
The Task Force Report presented a number of options with benefits and risks to help Council determine the best option for RCDSO.
The Task Force identified three options:
- Status Quo: RCDSO retains the current structure of PLP with minor modifications that could mitigate risk.
- Subsidiary: RCDSO establishes a subsidiary corporation. This would create structural separation of mandate and finances, while RCDSO would retain ownership of the program.
- Divest: RCDSO stops directly offering its liability protection program over time and moves to transfer, sell or end the program
The report provided Council with considerable information to help make this decision.
The program has been working well for 50 years, why change now?
There are a number of environmental changes, including public expectations that have changed since PLP was first established.
RCDSO is one of the few health regulatory Colleges in Canada that directly operates an in-house liability program.
Over the past several years, negative media stories, changing expectations of professional regulation, and the RCDSO’s commitment to act in the public interest have caused RCDSO to consider the benefits, risks and appropriateness of this non-legislated program as an operational department of the College.
PLP’s mission and function are distinct from the rest of the College’s, whose mandate is to “serve and protect the public interest.”
One of the College’s primary regulatory responsibilities is to hold dentists accountable for conduct and practice issues; PLP serves as the primary malpractice protection provider for those same dentists. While there is a firewall between PLP and our regulatory programs, this divergence in mandate and function is confusing to both the public and dentists and raises questions about how we can effectively serve both mandates.
If an unexpected major financial event were to occur (one that exceeds the current $22 million reserve fund plus the $20 million available in reinsurance), the RCDSO would be required to draw from its regulatory reserves or to impose a fee to the profession.
I have further questions about PLP changes, who can I contact?
For general information, please contact the RCDSO’s Practice Advisory Service at practiceadvisory@rcdso.org or call 416-961-6555 or toll-free 1-800-565-4591.