​Turnaround and high-speed growth (1950-1959)

 

 

In the aftermath of so much turmoil, 1950 did not start out as a promising year. Since 1948, the company's assets had been diminishing, while the deficit in 1949 represented 20% of total assets.1 The new general manager, Jacques de la Chevrotière, was forced to rectify this vulnerability without delay. One fact bears repeating: the company's survival was at stake.

Dealing with clients and competitors

The first order of business was to relocate SSQ's headquarters from the space it leased from Caisse populaire Notre- Dame-de-Grâce on Rue Franklin2 to the building occupied by Caisse populaire Jacques-Cartier at 38 Rue Caron. The goal here, clearly, was to improve the company's physical environment. A new philosophy, however, also began to make its influence felt—one that would go on to become one of SSQ's enduring hallmarks: service above all else. In SSQ's view, this meant meeting members' needs. Paradoxically, an analysis happened to show that service was the company's Achilles heel. The sales division, thanks to the efforts of Jean-Paul Drolet and Paul‑Émile Poirier, was doing quite well, even though insurance policies were often promoted using nationalistic or social welfare arguments. Once they came into effect, however, these policies were interpreted very restrictively. Despite what was meant to be interpretation "in good faith", the company was still a long way from offering members the level of service they expected. SSQ eventually came to understand this and changed as a result. A more realistic system took root, based not only on virtuous cooperative principles, but also on the notions of supplying and delivering a high-quality product. The company thus had to pursue two closely interconnected goals: making the company more profitable and providing good service.

 

Jacques de la Chevrotière
General Manager
(October 1949-March 1977)
Chairman of the Board
(March 1977-October 1990)

Shortly after this new change in attitude, a number of concrete decisions were made. In late 1949, for example, SSQ increased its contribution rates. In addition, new investments by the company were prohibited, thus freeing up the cash flow it needed to pay out claims. Still, in 1950, the company had to resign itself to a second year of red ink. This time around, the board attempted to address the problem by being more selective about new membership groups and by eliminating bad risks. A premium surcharge that increased in step with the membership group's "deficit" situation was then levied.3

Leaving behind an era of financial instability, SSQ had to carve out a place for itself in the highly competitive health/accident insurance market. In addition to Blue Cross, which exclusively offered health/accident insurance as well, SSQ was vying against various long-established companies (Sun Life, Metropolitan Life, Great West, etc.), all of which sold comprehensive insurance plans offering coverage against accidents and illness, among other services. During this period (i.e., in 1951 figures), the premiums collected by SSQ corresponded to only 5% of those collected by Blue Cross and 20% of those collected by Metropolitan Life. In Quebec's health/accident insurance market, SSQ was still the "little guy" at the bottom of the rankings, while Blue Cross was the undisputed leader. Over time, though, SSQ would gradually overcome the large gap separating them (see following table).

Health insurance premiums collected Blue Cross and SSQ (1946-1960)

(in thousands of dollars)

Year Blue Cross SSQ SSQ's performance as a % of Blue Cross's total
1946 1,281 6 -
1947 2,660 73 2.7
1948 4,435 161 3.6
1949 5,934 238 4.0
1950 7,421 365 4.9
1951 8,414 450 5.3
1952 10,126 561 5.5
1953 12,145 926 7.6
1954 13,043 1,379 10.6
1955 13,316 1,592 12.0
1956 14,046 1,653 11.8
1957 18,396 1,875 10.2
1958 19,701 2,249 11.4
1959 21,560 2,933 13.6
1960 23,583 3,753 15.9

Sources: Report of the Superintendent of Insurance and SSQ's financial statements.*
* Strictly speaking, the pre-1955 data are not comparable, which exaggerates SSQ's relative weight slightly.

Shortcomings and selling points

In the midst of such intense competition, SSQ's distinctive features became its chief selling points. Emphasis was placed on prevention as Dr. Tremblay's proverbial slogan remained the watchword: "An ounce of prevention is worth a pound of cure". The importance attached to homecare services also set SSQ apart. Democratic control within the company and the endorsement of Quebec's Fédération des sociétés médicales [provincial medical associations] also served to enhance the company's image. In addition, in February 1950, SSQ became affiliated with the Union des mutuelles-vie françaises d'Amérique [North American association of francophone life insurance mutuals] and the Conseil supérieur de la coopération [cooperation council], which ensured official recognition in the cooperative sector. Furthermore, SSQ's generous policy on payments by low-income individuals set it apart and facilitated access to a large pool of low and medium-wage workers. Under this policy, if an individual made less than a certain amount, participating doctors would accept the benefits allocated by SSQ as final payment; the individual thus had no additional personal financial contribution to make.

There was, of course, a downside to all this as a number of factors were working against SSQ. The company's strongly French-Canadian character had a significant influence on the composition of its clientele and actually limited its growth. More often than not, in the early years as well as in the 1950s, SSQ's outreach efforts targeting employees of mid-sized and large companies ended in frustration, with the language barrier and the issue of ethnicity as contributing factors. Because they were mostly anglophones, the executives and managers of these larger companies tended to favour Blue Cross.

The reluctance of these "English-oriented" companies kept them out of SSQ's reach, at least for a while. As a result, until the late 1950s, SSQ's advertising continued to focus on groups that were more receptive to nationalistic and socialistic arguments, with the caisses populaires pre-eminent among them. In the list of SSQ's main "potential" clients, the caisses were followed by clergy-run institutions such as hospitals, schools and recreation centres. Provincial government employees were also beginning to make their presence felt.

 

Paul‑Émile Charron
Chairman of the Board
(April 1951-May 1971)

Targeting a broader clientele

Even though it was SSQ's policy under the stewardship of Jacques de la Chevrotière to focus on product quality rather than presentation, the company's French-Canadian identity and its cooperative operating model figured prominently in its advertising campaigns because the only demographic group accessible to SSQ was receptive to these issues. As was the case when Dr. Tremblay was at the helm, sales arguments drew on the company's nationalistic and cooperative leanings. This time around, however, the nationalism card was played as much out of necessity as out of any deep-seated conviction.4

In actuarial terms, these natural demographic targets for nationalistic inspiration were often of limited economic interest. It was not possible, for example, to require a majority of caisse populaire members to take out insurance with SSQ. Therefore, smaller groups had to be formed, which meant that risk, because it was less broadly distributed, was more unpredictable.

If it truly wanted to make headway, SSQ would have to open its doors to a broader target market. Indeed, the composition of the board of directors was modified to reflect this new spirit of openness. The number of members was raised from 9 to 12.5 One-third of the board came from the business community,6 while one-third came from the "liberal professions" (three doctors7 and a lawyer8). Louis Bilodeau represented the hospital association, while Paul‑Émile Charron9 and Fernand Jolicoeur10represented the cooperative sector and the unions, respectively. The strong presence of businessmen on the board was no doubt meant to reassure the members of the financial community, who had thus far been resistant.

Province-wide goals

Once the board had been restructured, steps were taken to extend SSQ's range of operations, i.e., by finally moving beyond the Quebec City region. With this goal in mind, the decision was made in 1954 to focus more systematically on the Montreal region, which was home to a greater population base. Appointed manager of the Montreal branch office,11 Benoît Duchesne was mandated with revitalizing its performance. On October 1, 1952, the branch vacated its premises at 839 Rue Sherbrooke Est and moved into modest quarters in a building occupied by the Société des Artisans (333 Rue Craig Est). At that time, the Montreal branch office's annual revenues were less than $200,000.12

In a report submitted in 1955, the branch manager laid out the situation:

Most companies in Montreal already have health insurance plans in place. ...SSQ is not well known in the region, particularly since it has limited itself to plans covering hospitalization or medical/surgical expenses, while a growing number of groups are interested in more comprehensive coverage, including life insurance and compensation for loss of earnings...13

To overcome these obstacles, more employees were hired. Marcel Thorn was initially appointed information officer and later became a representative. 14 That meant that the Montreal branch now had four employees. The team, however, was barely large enough to prepare and sign its first significant contract, which covered the employees of the City of Montreal's transportation commission (CBRT).15 But thanks to this achievement, the vicious circle was broken and the branch office's series of relocations throughout the Société des Artisans building are a testament to its steady progress in the Montreal area. SSQ renewed its lease with the Société des Artisans on three occasions (January 1954, October 1956 and May 1957), adding more floor space with each renewal.16

However, the biggest factor driving sales in the Montreal region was SSQ's entry into new service areas, such as group life insurance, accidental death insurance and weekly salary indemnity (disability insurance) benefits, all of which were extremely attractive. From 1956 to 1958, the Montreal team added five representatives,17which meant that the Société des Artisans building became too small. On April 1, 1960, SSQ moved to more spacious premises at 7042 Pie IX Boulevard.18

The threat of state intervention

As SSQ recovered its footing and built up its operations, events were gathering pace in Quebec City. Rumours claimed that the healthcare sector would soon be taken over by the government. Since the 1930s, the idea of a more interventionist state had been finding favour with a wider audience. Similarly, in the social security field, certain ideas were slowly but surely taking hold, including the notion that risks incurred by individuals should be borne by society as a whole or that that universal access to healthcare should be guaranteed.

The Royal Commission of Inquiry on Constitutional Problems, chaired by Justice Thomas Tremblay, provided French Canadians with an opportunity to address various collective problems, with healthcare distribution being one of the most pressing issues. In keeping with its goal of making all healthcare more accessible to Quebecers, SSQ seized the opportunity and submitted a brief to the Commission.19

In the brief, SSQ's board supported the opinion shared by most doctors. Like them, SSQ's overriding fear was that the medical sector would be taken over by the state. Focusing on the English model, doctors decried the loss of medical professionals' autonomy and patients' freedom of choice. SSQ's fervent opposition to any state takeover was also motivated by its belief that "socialized" healthcare services would inevitably lead to a more secular society. In effect, such a move by the government would end the clergy's control over hospital services.20 In SSQ's view, attacking religious institutions in any way was tantamount to undermining one of the central pillars of the French‑Canadian nation.

Given the context, SSQ's recommendations to the Tremblay Commission are understandable. They limited the state to a subsidiary role, i.e., paying for the poor. As for the rest, SSQ called for the entire healthcare system to be entrusted to the private sector, provided that there was no profit motive and the "mutualist" formula was used. In addition, if access was to be universal, the system would have to offer comprehensive coverage, including hospital, surgical and medical services in the home as well as at the office. Doctors' fees would be limited by the insured member's ability to pay. Furthermore, SSQ wanted the system to operate on a regional and "federative" basis.

This proposal includes three elements that were characteristic of how SSQ operated: the mutualist formula,21comprehensive coverage placing great emphasis on prevention and a fee cap. The underlying philosophy was also in keeping with positions that SSQ had defended ever since its inception: ensuring the universal right to healthcare, forming an association as a means of self-protection and limiting the state's role.22

Despite protests and the presentation of a range of other potential options, massive state intervention in the social welfare field seemed imminent. In fact, the predictions were not far off the mark. On January 26, 1956, the Prime Minister of Canada proposed "a grant to each province that sets up a hospital treatment program."23If it ever came down to that, SSQ's range of action would be considerably reduced.

Solid and diversified

Against this backdrop, in 1955, SSQ began to regard diversification as both desirable and prudent. In addition to the prospect of government-run healthcare, several other reasons lay behind this decision. For one thing, until then, SSQ had operated as an insurance company; due to its incorporation under the Cooperative Syndicates Act of 1941, it did not fall within the remit of Quebec's Superintendent of Insurance. In this specific context, the company had been able to stay in business despite its perilous financial situation. That is another reason why SSQ had previously operated without the constraint of capital guarantees or other usual requirements. But after experiencing financial difficulties in 1954,24 the company was beginning to find a more stable footing. The time was right, then, to update the corporate charter (articles and bylaws) and to make it more reflective of SSQ's actual business activities, particularly since the social capital provisions of the Cooperative Syndicates Act made the company's operations needlessly complex. All in all, drafting a new charter would bring the company's bylaws more into line with reality while cautiously expanding its range of activity.

SSQ's membership approved this initiative at a special general meeting on October 21, 1955.25 On February 2, 1956, Quebec's Legislative Assembly adopted Bill 153, which transformed SSQ into "a mutual benefit association" within the meaning of Quebec's Insurance Act (revised statutes, 1941, chapter 299). Bill 153 also granted SSQ the power to issue insurance contracts covering personal accidents, disability, illness and other similar risks,26 together with contracts covering group life insurance and offering reimbursement of hospital, medical, surgical and pharmaceutical expenses.

This new corporate charter would certainly facilitate the company's operations. In any event, SSQ was now able to offer a comprehensive insurance plan as a genuine insurance company, while the social capital requirement was done away with. To a certain extent, this change offered official confirmation of the company's new course of action: the board of directors had recently made a key decision. The goals initially mapped out by Dr. Tremblay established SSQ as a cooperative organization encompassing not only healthcare "consumers", but also all of the personnel and facilities used to prevent and cure disease (i.e., technicians, nurses, doctors, administrators, hospitals, diagnostic centres, etc.).27 The company's new course of action meant that SSQ was now fully committed to providing member services by increasing the range of plans available and by maximizing benefits while minimizing costs. The conflict of 1949 had brought this choice into sharp relief.28 The cost/benefit goals reflected the opinion of many board members in 1946.

Expanded market

From now on, SSQ managed its affairs like a company whose success not only depended on market forces but also stemmed more directly from the standing of its board members and the pragmatism they embraced. Beginning in 1949, following Dr. Tremblay's departure and the adoption of Mr. de la Chevrotière's policies, SSQ resolutely embarked on the same path as its competitors. Now it was merely a question of maintaining momentum. In any event, despite financial difficulties, SSQ's only chance of survival hinged on its adoption of efficiency and profitability criteria without turning its back on its commitment to social justice.

The pragmatism displayed by SSQ's team was one of the company's many assets: imagination and ingenuity also played key roles. The task at hand, which involved extensive study and effort, was to find ways of expanding the client base. Paid a salary rather than a percentage of the company's sales (unlike the rest of the industry), SSQ's representatives dedicated themselves to this goal.

As previously mentioned, SSQ's representatives had had difficulty making inroads within Quebec's business community as most of the mid-size and larger firms favoured major anglophone companies. This no doubt reflected a certain cultural solidarity, although the determining factor was the delivery of solid financial benefits. Now the task was to determine what sort of benefits were needed and where they could be found.

An analysis of the situation revealed the following: it was customary for the employer−and only the employer−to select the insurer and the insurance plans for employees. In order to sign up a company, representatives were obliged to contact the company's management team and secure its interest. As a result, insurance companies devised plans in which the employer and the employees made relatively equal contributions (40% vs. 60%, for example), but in which only the policyholder (i.e., the employer) participated in the dividends generated by the entire group's financial results. And there lay the key to success: all that was needed was for the total premiums collected to exceed the actual cost of the coverage. That way, the workers' portion of the contribution sometimes covered much of the total cost all by itself. With plan surpluses virtually guaranteed, the policyholder's contributions were reduced or even completely offset by the dividends received.

SSQ and unions: shared interests

In parallel, union leaders had realized the importance of negotiating not only workers' pay, but also a range of fringe benefits that served to indirectly increase union members' income. In this regard, surgical, hospital and medical coverage, as well as life insurance and disability insurance, were key issues when negotiating collective agreements. For that reason, some unions sought to choose the insurer and the employee insurance plan themselves. In their view, choosing the insurer and the plan was the employees' right since they were the ones actually making use of the plan.

This is where SSQ's representatives came into play. Since they were well aware of the contribution-related scheme described above, it was easy for them to offer the same benefits at a lower cost. To be sure, this was not enough to change employer habits, although the unions saw an enormous benefit. To find common ground, the last step was to mention SSQ's social consciousness and nationalistic leanings.

But let us not be deceived: SSQ may have discovered certain affinities with certain unions, but they did not automatically become loyal clients. Truth be told, the unions at this time (1952-1955) were only a "potential" clientele. It was only through the hard work of SSQ's province-wide sales team that a large and loyal client base was built.

The Canadian and Catholic Confederation of Labour (in Quebec, the CTCC, now known as the CSN) and the provincial Catholic teachers' association (CIC) were among the first to come on board. As early as 1948, SSQ had insured various teachers' associations.29 On July 29, 1957, the CIC officially recognized SSQ and recommended that its members do business with the company. Under this agreement, any surpluses would be refunded to the CIC and its affiliated unions.30 So now the roles were reversed: the unions were the policyholders and the recipients of the refunds.

The CTCC had provided SSQ with signs of encouragement at its convention in 1952; its support was officially confirmed in 1960. It decided to:

"Maintain its traditional position of showing preference for SSQ."31 It was also committed to "favouring union control over contribution-based insurance plans".32

Long before the 1960s, the CTCC opened its doors to SSQ: the manager of its education department, Fernand Jolicoeur, had joined SSQ's board on January 26, 1951. Familiar (and popular) with the unions, he gave SSQ's representatives excellent advice on how to reach out to workers and union leaders.

The issues of organization, solidarity and nationalism affected union members as well as SSQ's representatives and served to strengthen collaborative ties between both groups. Indeed, in 1952, SSQ began insuring the CTCC's employees and permanent staff.33

As regards Quebec's labour federation (the FTQ), official recognition took much longer, mainly because the federation prevented its members from directly choosing their insurer and insurance plan lest bribes be offered during insurance policy negotiations. It usually preferred to acquiesce to employer decisions in this area. In the 1960s, however, ties slowly began to form between the FTQ and SSQ, although they never became fully visible until the late 1970s. The following quotation offers a reason for this slowness:

… the issue of the multinationals. Regardless of the union, in 99% of cases, the company selects the insurer and in all the cases I've ever seen, the insurer is an English-Canadian or an American company.34

Once again, SSQ's social consciousness and, more importantly, its cultural identity were determining factors in its contacts with the cooperative sector and nationalistic circles. Once again, these same characteristics disqualified the company in the eyes of the anglophone business community, as well as in certain francophone circles.35 Although this meant that SSQ received a warm welcome from the unions (primarily headed by French‑Canadians), it also hindered efforts with "international unions", in particular those with links to the FTQ.

Encouraging steps

SSQ had received a new lease on life thanks to its expanded range of operations, as well as to the new services it offered, its more effective legal structure and the efficiency gains it had made by creating an executive committee.36 In 1956, it celebrated its 10th anniversary in grand style:37 a reception was held at Kerhulu restaurant in Quebec City on November 12, followed by a gathering 10 days later at the University Club in Montreal. Many prominent figures attended, while the press made sure to mark the occasion by extolling SSQ's virtues.38

Meanwhile, the company had grown and now occupied two floors of the Caisse populaire Jacques-Cartier building at 38 Rue Caron.39 Not long afterwards, this space became too small to keep pace with the company's rapid expansion. As the business volume grew, the company's staff rose from 26 employees in 1955 to no fewer than 84 in 1959. Another relocation took place: on July 1, 1958,40 the SSQ team left the Caisse populaire Jacques-Cartier building and set up shop on the first floor of a building at 190 Rue Dorchester. At that time, the company's headquarters and offices in Quebec City took up 6,000 square feet.41

Technological progress

Despite improved work conditions, the problem of slow benefit payments persisted. But instead of hiring more staff, the board decided to embrace technological progress and to automate this service.42

Seeking information, Charles Lapointe and Benoît Duchesne paid an incognito visit to IBM in 1955 and returned in an official capacity in July 1956. After various studies and negotiations, IBM and SSQ signed an agreement in December 1957. Transferring from IBM to SSQ, Elzéar Asselin was mandated with automating the benefits service between July 1958 and January 1959. He was also put in charge of training employees, designing forms and developing procedures. This process was completed as scheduled in January 1959. Thought was then given to the next step: automating contributions. Young people of today, whose lives are steeped in computer technology, will no doubt be amused to learn that the first computer used by SSQ could add, subtract, print and sort, but was unable to multiply or divide! Improvements were gradually made to this system, in particular via new equipment acquired in 1965.43

All of these changes became essential due to SSQ's remarkable progress since 1950. In any event, the below table clearly shows how swift and sustained the company's growth was (it also provides information on premium revenues, benefits, assets, etc.).

Although SSQ got off to a shaky start, the situation improved considerably beginning in 1953; the company's survival was no longer in question. Insurance plan diversification enhanced SSQ's performance even further and left it able to take on the major social policy changes ushered in by the 1960s.

Main financial statement items (1950-1960)

(in thousands of dollars)

  Premium revenues Total revenues Surplus (deficit) Total assets Investments Liabilities Policy holder equity
1950 365 368 (19) 73 58 54 19
1951 450 453 0.4 82 65 59 22
1952 561 566 7 116 93 83 33
1953 926 928 41 214 168 134 80
1954 1,379 1,383 (5) 257 227 177 81
1955 1,592 1,596 13 269 231 170 99
1956 1,954 1,958 17 335 280 219 115
1957 2,191 2,197 23 418 361 279 138
1958 2,656 2,667 38 515 420 338 176
1959 3,506 3,516 29 720 580 515 206
1960 4,522 4,543 46 1,033 845 781 251

A natural alliance

SSQ's recent entry into the group life insurance field meant that the company was unable to take on major risks. However, a plan offering life insurance, disability insurance and health insurance attracted clients by offering expanded coverage tailored to their needs. Therefore, sharing life insurance risks seemed to be the best solution. Everyone involved saw Desjardins' life insurance division (Assurance-Vie Desjardins)44 as the ideal collaborator. In addition, Desjardins Life Insurance also benefited from reciprocity: it could now offer comprehensive insurance plans while entrusting SSQ with healthcare coverage.

Under this arrangement, SSQ would insure a group for hospital, medical and surgical expenses while taking on 50% of the life insurance risks; meanwhile, Desjardins Life Insurance would take on the remaining 50% of the life insurance risks, in addition to all of the disability insurance.45 This arrangement allowed some groups (such as CIC) to offer their members "a comprehensive social security plan".46 In addition, SSQ and Desjardins Life Insurance took out joint advertising in the monthly publication L'Enseignement.47 Their agreement was so successful that SSQ and Desjardins Life Insurance could barely keep up with the demand or meet the related deadlines.48

Unionizing the staff

As we have seen, SSQ's progress was achieved in large part with the assistance of the union movement, and the company was well aware of this fact. Union organizations had been among SSQ's key collaborators and had provided it with much-needed support. The company's representatives worked closely with union members and their advisors and usually shared their opinions on employee benefits. So there was only one possible course of action when it came to putting into practice the union values held by many SSQ employees. As a result, the company's representatives were the driving force behind the creation of the first union at SSQ. Needless to say, the difficult conditions associated with extensive travel and long workdays, not to mention the somewhat arbitrary nature of the company's salary system, influenced opinions on whether unionization was actually necessary.

From its roots in the Quebec City branch office, the unionization movement extended to include the administrative staff in Quebec City and the Montreal branch office. At the end of this process, two unions emerged: the SSQ chapter of the Syndicat des employés d'assurance du Québec (representing insurance-sector employees) on May 25, 1959,49 and the Association professionnelle du personnel de vente de SSQ (representing sales personnel) on November 19, 1959.50 The six-month gap between these two dates most likely stemmed from management's refusal to include department managers in the representatives' union. Given how few "manager unions" there are (even today), one can only imagine how unpopular they were in the 1950s!

As a general rule, however, the board members seem to have accepted the process quite readily, even though some were unimpressed and regarded unionization as a necessary evil at best. SSQ's business was increasingly geared towards the union movement, with which the company highlighted its affinities. The unionization of SSQ's employees was a predictable and "natural" consequence of this. In fact, the company's stance reflected the board's consensus: SSQ should do nothing that might harm freshly minted business relationships between the company and the unions.

Assets, liabilities and revenues (1946-1961)

(in thousands of dollars)

 

Plan member equity and surplus (deficit) (1946-1961)

(in thousands of dollars)

 

Next chapter : Adapting to social change (1960-1972)

  1. As at December 31, 1949, the deficit was $12,610.43, while assets totalled $66,128.93 (1949 Annual Report). 
  2. From April to December 1949, SSQ's headquarters were located beneath the Caisse populaire Notre-Dame-de-Grâce at the corner of Rue Franklin and Rue Arago. From January 1, 1950 to December 31, 1954, space at 38 Rue Caron was leased (SSQ occupied the first floor of the building; since those premises proved too small, two offices were sublet until June 1, 1951). 
  3. Board meeting minutes (February 6, 1951, p. 113). 
  4. Links with nationalistic movements were discreetly maintained.
  5. Special SSQ board meeting minutes ( February 29, 1952, p. 136). 
  6. Édouard Coulombe, Paul Champoux, François Morisset and J.B. Villeneuve. 
  7. Jules-Édouard Dorion, J.-Émile Pelletier and Paul Rochette. 
  8. Jean Grenier. 
  9. Paul-Émile Charron of the Fédération des Caisses populaires Desjardins. 
  10. Fernand Jolicoeur of the CTCC. 
  11. Board meeting minutes (December 17, 1953, p. 172).
  12. Benoît Duchesne, "La petite histoire de la succursale de Montréal", (Échanges, February 1965, p. 5). 
  13. Board meeting minutes (March 24, 1955, p. 203). 
  14. Benoît Duchesne, op. cit., p. 6. 
  15. Idem, p. 6. 
  16. The branch office moved from Suite 209 to Suite 202 (January 1954), then to Suite 210 (October 1956) and finally Suites 213, 214 and 215 (May 1957) (leases with the Société des Artisans, J. de la Chevrotière archives, "Leases" file). 
  17. Gérard Boudreau; André Laperrière; André Levac; César Simon, branch office secretary; and Paul Thorn (Benoît Duchesne, op. cit., p. 6). 
  18. Board meeting minutes (March 14, 1960, p. 296) and lease between Paul Goyer and SSQ (J. de la Chevrotière archives, "Leases" file).
  19. Brief submitted by SSQ to the Royal Commission of Inquiry on Constitutional Problems, February 1954, 49 pp. 
  20. J.É. Pelletier. Speech to the annual banquet of Université Laval's medical students association (Château Frontenac, Quebec City, April 9, 1958, p. 11). 
  21. This is the equivalent of the cooperative formula in the insurance field. 
  22. "La santé étant un bien personnel, l'État ne peut se substituer à la personne et lui ravir ses droits comme ses responsabilités en ce domaine."[Since health is a form of personal property, the state cannot supplant the individual and strip him of his rights and responsibilities in this area.] (Brief submitted by SSQ to the Royal Commission of Inquiry on Constitutional Problems, February 1954, p. 13). 
  23. L'assurance-santé, quelques données (Ottawa, Canadian Welfare Council, 1956, p. 49). 
  24. The excess of expenses over revenues was $4,667.71, while revenues had exceeded expenses by $41,154.69 in 1953. 
  25. Legislative Assembly of Quebec. Private Member's Bill 153 on "Les Services de santé du Québec", adopted on February 2, 1956, p. 2. 
  26. Idem. 
  27. Diagnostic centres were intended to respond to hospital overcrowding resulting from "unjustified" hospitalizations. See J.E. Pelletier, Speech to the annual banquet of Université Laval's medical students association (Château Frontenac, Quebec City, April 9, 1956, p. 6) and J.E. Dorion, L'hospitalisation non motivée (undated, 1 p.). (SSQ. Brief submitted to the Tremblay Commission, 1954, p. 21).
  28. Jacques Tremblay, Mémoire sur l'autonomie médicale [Brief on medical autonomy], March 14, 1949, submitted to the medical advisory committee on March 16, 1949. 
  29. See "Corporation des enseignants du Québec" for statistics on these groups in 1950 and 1960 (J. de la Chevrotière archives). 
  30. "La C.I.C. vous offre un plan complet de sécurité sociale par l'entremise des Services de santé du Québec et de l'Assurance-vie Desjardins." [The CIC offers you a comprehensive social security plan through SSQ and Desjardins Life Insurance] ("Questions-réponses au sujet d'une entente profitable", La Mutuelle SSQ advertising brochure on the CEQ/SSQ agreement, undated). 
  31. "Syndicats − coopération − assurance-groupe" (La Mutuelle SSQ advertising brochure, undated). 
  32. Idem. 
  33. Circular letter by Jean Marchand, CTCC secretary general, addressed to CTCC staff (Quebec City, March 14, 1952, 1 p.). 
  34. Ronald Bérubé, FTQ report (for the Island of Montreal/1974), preamble (see "Fédération des travailleurs du Québec", J. de la Chevrotière archives). 
  35. A number of French-Canadian companies did not do business with SSQ because their day-to-day operations were financed in part by English-Canadian or American insurance companies, which also offered them group insurance plans. 
  36. Board meeting minutes (October 25, 1956, p. 239). 
  37. The 10th anniversary does not include the period associated with the Coopérative de Santé de Québec (1944-1945). 
  38. "10e anniversaire des Services de santé de Québec", Le Soleil, November 13, 1956. Clément, Marcel. "Une société mutuelle d'assurance accident-maladie qui a particulièrement progressé depuis une décennie" (Le Devoir, November 24, 1956). 
  39. Board meeting minutes (November 24, 1953, p. 169). 
  40. Letter from J. de la Chevrotière to P.-H. Corriveau, Caisse populaire Jacques-Cartier (December 27, 1957, 1 p., "Leases" file, J. de la Chevrotière archives). 
  41. "Excerpts from the report submitted to the annual general meeting by general manager J. de la Chevrotière" (Annual Report, December 31, 1958, p. 4). 
  42. Idem. 
  43. P.-E. Poirier, "Elzéar Asselin nous quitte" (Le Joint, vol. 4, no. 9, May 1982). 
  44. The Quebec City branch office of Desjardins Life Insurance was located in the same premises as SSQ (38 Rue Caron) in 1954 and 1955. Sharing the same space, "community of ideals" and interests helped forge closer ties between the two companies. Cf. letter from Jacques de la Chevrotière to Alfred Rouleau, general manager of Desjardins Life Insurance (November 15, 1954, 1 p.); letter from Alfred Rouleau to J. de la Chevrotière (September 15, 1955, 1 p.) ("Leases" file, J. de la Chevrotière archives). 
  45. Executive committee minutes (April 17, 1968, pp. 31 and 32). 
  46. "La C.I.C. vous offre un plan complet de sécurité sociale par l'entremise des Services de santé du Québec et de l'Assurance-vie Desjardins."(Advertising brochure, undated, 1958?). 
  47. See correspondence between Gérard Barbin, external relations department, Desjardins Life Insurance, and Jacques de la Chevrotière ("Desjardins Life Insurance" file, 1959-1960, J. de la Chevrotière archives). 
  48. Correspondence between Hervé Hébert, actuary, Desjardins Life Insurance and advisor to SSQ, and J. de la Chevrotière, SSQ general manager (Desjardins Life Insurance" file, March-April 1960. J. de la Chevrotière archives). 
  49. Board meeting minutes (May 25, 1959, p. 267). 
  50. Board meeting minutes (November 19, 1959, p. 291.