CUPE EWBT Update February 24, 2020 1 Todays agenda Trust update - - PowerPoint PPT Presentation

CUPE EWBT Update

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February 24, 2020

Today’s agenda

▪ Trust update ▪ Benefit plan review ▪ OTIP update ▪ Canada Life update ▪ Questions?

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Trust update

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Overview of recent developments

Impact of negotiations

Memorandum of Settlement of Central Terms, 2019-2022 ▪ Benefits plan costs held to one per cent increase in each of the three years of the agreement: ▪ September 1, 2019: 1% (5,544.01 per FTE) ▪ September 1, 2020: 1% ($5,599.45 per FTE) ▪ September 1, 2021: 1% ($5,655.45 per FTE)

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2019 CUPE EWBT benefit survey results

▪ In June 2019, Trustees contacted members for opinions on the CUPE EWBT benefits plan and potential areas of improvement ▪ More than 11,000 members responded ▪ 71.4% of members who responded agree the CUPE EWBT plan met their needs and the needs of their family ▪ 70.9% believe that benefits in the plan were current and up-to-date ▪ 78.3% are satisfied with the plan’s prescription drug coverage ▪ 77.5% are satisfied with the plan’s basic dental coverage

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2019 CUPE EWBT benefit survey results

▪ Survey question: Which benefit should be improved, should there be an

• pportunity to do so?

▪ CUPE EWBT members identified the following priorities.

▪ Paramedical services → 26.6% ▪ Vision care → 18.0% ▪ Major dental → 17.0% ▪ Orthodontics → 9.6% ▪ Prescription drugs → 8.7%

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▪ When determining plan design changes we also considered the following:

▪ Providing greater access to benefits for our members ▪ Comparison of CUPE EWBT plan to other plans in the sector ▪ Plan member usage to see where members were consistently spending over the plan limits for particular expenses

Benefit improvements coming March 1, 2020

CATEGORY Before March 1, 2020 As of March 1, 2020 Minimum hour requirement for 4% member premium share (Health & Dental) 17.5 hours regularly scheduled work hours 15 hours regularly scheduled work hours Major Dental 60% coverage 70% coverage Dentures 60% coverage 70% coverage Hearing Aids $1,000 / 60 rolling months $2,500 / 24 rolling months Audiologist / Speech Therapist $500 / benefit year $1,000 / benefit year Physiotherapist / Occupational Therapist / Athletic Therapist $1,500 / benefit year $1,750 / benefit year Osteopath $500 / benefit year $750 / benefit year Psychologist / Registered Marriage

• r Family Therapist / Registered

Social Worker / Registered Psychotherapist $750 / benefit year $1,500 / benefit year Chiropractor $500 / benefit year $750 / benefit year CPAP Machines Coverage up to Reasonable & Customary (R&C) limit Up to $2,500 / benefit year beyond the Assistive Devices Program reimbursement Scoliosis Braces Coverage up to R&C limit Remove R&C limit Eye Exam $120 / 2 benefit years 1 exam / 2 benefit years; no maximum

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Retiree benefits update

▪ In 2015, CUPE, the Ontario government and the Council of Trustees’ Associations agreed to adopt a province-wide benefits plan for eligible CUPE members in the education sector, including retirees ▪ To be eligible, retiree must have been (and continue to be) a member

• f a Board retiree benefits plan as of February 28, 2018

▪ Initial 2018 start date was postponed due to implementation/contract issues ▪ CUPE/OSBCU and Crown Trustees Associations are negotiating the terms of the Retirees Participation Agreement

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Funding for Life and AD&D during unpaid medical leave

▪ Prior to September 1, 2019, CUPE EWBT members on unpaid medical leave, pending Long-term Disability (LTD) and pending WSIB, paid 100% of their Basic Life and Accidental Death and Dismemberment (AD&D) premiums after the 60-day grace period ▪ Effective September 1, 2019, the CUPE-EWBT funds Basic Life and AD&D insurance for up to 24 months for members on unpaid medical leave (pending LTD and pending WSIB) ▪ The Trust now funds coverage for up to 24 months – from when paid sick leave ends

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Funding during pregnancy and/or parental leave

▪ To align with recent changes to Ontario’s Employment Standards Act, members can maintain benefits coverage while on pregnancy and/or parental leave of up to 18 months (formerly 12 months) ▪ The usual cost share (4%, 50% or 100%, depending on regularly scheduled work hours) still applies

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CUPE EWBT Appeals

▪ 56 Appeals were submitted from Jan 1, 2019 to Dec 31, 2019 ▪ Types of Appeals include:

▪ 14 Appeals – Benefit eligibility (member missed enrolment deadline, member did not elect coverage when enrolling, member was declined health coverage under “late applicant” process) ▪ 10 Appeals – Dental appeals (above benefit year maximum, uncovered dental expenses, benefits pre-approved by prior carrier) ▪ 6 Appeals – Reasonable and customary charges for medical devices/items and paramedical practitioners ▪ 4 Appeals – Drugs (highly specialized drugs, drugs not covered and over-the- counter medication) ▪ 4 Appeals – Coverage above benefit year maximum ▪ 2 Appeals – Laser eye surgery (ongoing payment of laser eye surgery performed prior to establishment of CUPE EWBT)

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Administrative process: CUPE EWBT communications with CUPE Locals representing members

• 1. Member with a benefit claim or administration issue should first contact

Canada Life, Chubb or OTIP, individually or with a CUPE Local representative.

• 2. Member, or CUPE Local representative on member’s behalf, who has

difficulty resolving an issue after contacting Canada Life, Chubb or OTIP may then contact the CUPE EWBT.

• 3. CUPE EWBT Benefits Manager or designate will investigate and respond.
• 4. Authorization to Release Benefits Information – Member must sign;

Local submits to CUPE EWBT

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Benefits plan review

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Plan experience and other metrics

Membership at Dec 31, 2019

▪ 64 school boards ▪ 52,386 members; 46,579 have elected benefits coverage

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Benefits Coverage No Benefits Coverage Total Work Status 4% 50% 100% 4% 50% 100% Active 42,754 403 239 27 626 3,810 47,859 91% LTD - Approved 1,113 5 168 164 5 100 1,555 3% Other 1,734 25 138 598 46 431 2,972 6% Total 45,601 433 545 789 677 4,341 52,386 100%

Funding

▪ Trust receives $5,489 per FTE (FTE count established semi-annually) up to September 1, 2019 ▪ 1.0% increase effective September 1, 2019 (i.e., $5,544 per FTE) ▪ Total funding received from January to December 2019 ▪ Plan is in good financial situation, however, Trustees are aware of how fast benefit costs are increasing relative to funding

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Funding ($ in millions) FTE Funding $247.2 Member Contributions 12.3 Investment Income 2.5 Total Funding 262.0

Funding and expenses (January 1 to December 31, 2019)

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Assets Funding $262.0 Expenses Health and Dental Claims (Canada Life) $186.4 Life Insurance Premiums (Canada Life) $9.9 Global Assistance (Canada Life) $0.2 Other Charges and Premium Taxes (Canada Life) $10.7 AD&D Premiums (Chubb) $0.7 Other Trust Expenses $1.4 OTIP Fees $4.2 Taxes $19.4 Operating Surplus $29.1 Unallocated Reserves (beginning) $11.0 Unallocated Reserves (end) $40.1

Unallocated Reserves 11% Taxes 8% Trust Expenses 2% Claims and Premiums 79%

Required trust reserve

▪ The terms of the Trust require a minimum reserve of 8.3% of total costs ▪ Anything lower, and the Trustees are required to cut plan costs or increase member funding ▪ The recent collective agreement requires a minimum reserve of 25.0% of total costs until the end of the contract (August 31, 2022) ▪ If it gets too high, the government may try to reduce the FTE amount or not increase it

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Monthly cost and funding

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• 5,000,000

10,000,000 15,000,000 20,000,000 25,000,000 1-Jan 1-Feb 1-Mar 1-Apr 1-May 1-Jun 1-Jul 1-Aug 1-Sep 1-Oct 1-Nov 1-Dec

Total Monthly Costs and Funding

January 2019 - December 2019

All Health Dental Basic Life and AD&D Premium Expense and Premium Tax Pooling Charges Total Benefits Funding

Benefits – Health and Dental

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$68.7 $66.2 $39.7 $11.8 17.3% 0.0% 4.1% 4.2% $83.1 $66.2 $41.4 $12.3 $0 $10 $20 $30 $40 $50 $60 $70 $80 $90 Dental Drug EHC Vision

Millions

Amou

• unt Paid

id vs s El Elig igib ible le by by Benefit it

For the period Jan 2019 - Dec 2019

Benefits – Health and Dental

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The percentages labeled represent the percentage of total drug claims paid.

2.9% 2.9% 1.4% 1.4% 1.1% 1.1% 1.0% 1.0% 1.0% 1.0% $0.0 $0.5 $1.0 $1.5 $2.0

Remicade Humira Stelara Janumet Revlimid Jardiance Ozempic Enbrel Saxenda Symbicort

Millions

Top

• p 10

10 Dr Drugs by Am Amount Paid aid

Benefits – Life and AD&D

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Life and AD&D Volume of Coverage (in millions) Basic $4,081.4 Supplementary $467.9 Member Optional $319.8 Spousal Optional $180.7 Child Optional $79.8

Eligibility change, New hire process, Beneficiary designation, Late applicant, Leave status, Life conversion and T4A slips

Administration processes

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Regularly Scheduled Hours Basic Life and Basic AD&D Member Share Health and Dental Member Share Optional Benefits Member Share 15.0 or more 0% 4% 100% 10 but less than 15.0 0% if Health/Dental selected, if not 50% 50% 100% Less than 10 0% if Health/Dental selected, if not 100% 100% 100%

Change to eligibility for funding

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March 1, 2020

*NEW* opportunity for approx. 400 CUPE members to enroll for Health and/or Dental benefits, or change from Single to Family coverage. Enrolment emails sent to designated/board email addresses.

AD&D = Accidental Death and Dismemberment

How to enroll for benefits

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Life, AD&D, Health and Dental Benefits provided by the CUPE EWBT More Information at www.cupe-ewbt.ca New hires receive a “New Hire Letter” from your board OTIP sends email to register and enroll for benefits to your board email After you enroll, you can change your email contact information to your personal/preferred email

How to complete your enrolment

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Register on OTIP’s secure member site Review and update your personal and coverage information Add dependent information, coordination of benefits, and student status Make any Optional Life coverage selections Designate a beneficiary Provide banking information Review and confirm

Protect your family and designate a beneficiary

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✓ Your estate won’t be reduced by extra probate fees ✓ Tax-free insurance proceeds to your beneficiary(ies) 13,000+ outstanding beneficiary designations for active members! To review, add or change your beneficiary, after logging in at www.otip.com and select My Benefits If a printed and signed Beneficiary Designation form is not received by OTIP, your default beneficiary is your estate Pre-fill the Beneficiary Designation form online Print, sign and mail the Beneficiary Designation form to OTIP

Missing your enrolment deadline

▪ If you do not enroll within 31 days of receiving your enrolment email, you will need to provide proof of good health (evidence of insurability) to be covered under the plan ▪ You or your dependant(s) may not be approved for coverage. ▪ Your Dental coverage, if applicable, will be subject to a maximum of $200 per person, for the first 12 months of coverage

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When you go on leave

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Board notifies OTIP of leave via file submission. During your 60-day grace period, you continue to pay your monthly member costs for the plan. OTIP sends a notice to your email on file a month before the end of your grace period. If you are on a leave without pay (e.g., long-term disability

• r sick leave), we will mail the notice to your home address.

After your 60-day grace period has passed, benefits are on hold until you log in and confirm which benefits you wish to continue.

Trust funding for those not actively at work

Not Actively at Work Category Premium Share = Active? Duration 100% Member-paid Option? How Long? Paid Sick Leave (11 days) or Short-term Disability (STD) (120 days) Yes End of Sick Leave

• r STD

n/a n/a Long-term Disability (LTD) or WSIB Yes 24 months Yes Termination of LTD or WSIB claim Personal Leave, Unpaid Sick Leave or Medical Leave Yes 60 days Yes 24 months School Break layoffs (10-month members) Yes Period of regular layoff n/a n/a Other layoffs Yes 60 days Yes Up to 24 months from day of layoff

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Trust funding for those not actively at work

Not Actively at Work Category Premium Share = Active? Duration 100% Member-paid Option? How Long? Maternity or Parental Leave (code* as active if return over the summer) Yes Up to 18 months* No NA Other statutory leaves (e.g., compassionate care) Yes Duration of leave No NA Secondments or “exchanges” Yes Indefinite n/a NA Deferred leaves Yes 12 months n/a NA

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Protect your Life and AD&D insurance if disabled

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✓ If approved, all Life and AD&D insurance continues with no premium payment on your part The board will complete the employer statement and send directly to Canada Life If disabled and < age 65, you need to file for a Life insurance premium waiver. Covers all Life and AD&D insurance that you have in force. OTIP sends employer statement to your board, and Life waiver package to you for completion Complete application and include medical information, LTD approval letter (if applicable) and send to Canada Life

Life and AD&D insurance waiver FAQ

Q: When will I get the package? A: Upon your request, when your sick leave ends, or you have been approved for LTD/WSIB. Q: Why do I have to file a Life waiver of premium application? A: It is required by the CUPE EWBT, for your protection.

▪ Effective Sept. 1, 2019, CUPE EWBT is paying the cost of the Basic Life and AD&D benefits for up to 24 months for members on LTD, WSIB and unpaid medical leave while you file your Life waiver. ▪ After 24 months:

▪ Members on LTD and WSIB who are still employees of their board can continue Basic Life and AD&D coverage at 100% member-paid premium for the duration of their claim. ▪ Members on unpaid medical or personal leave – coverage will terminate.

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Life and AD&D insurance premium waiver FAQ

Q: So, if I am on LTD or WSIB I don’t need to worry about applying? A: The cost of coverage over several years will be expensive (on average, about $240+ per year for Basic Life and AD&D):

▪ No Life waiver – If your employment ends, your Life insurance will end. ▪ With Life waiver – If your employment ends, your Life insurance continues, while you qualify, to age 65.

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Life conversion upon termination/retirement

▪ Can convert your Group Basic Life, Member Optional Life and Basic AD&D coverage to an individual life policy if you contact Canada Life/Chubb within 31 days of your termination/retirement

▪ Call OTIP for a conversion form.

▪ Conversion premiums are much higher than group plan costs, but proof of good health (evidence of insurability) is NOT required – option of last resort

▪ You must be under age 65 ▪ Amount is limited to $200,000

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Life conversion upon termination/retirement

▪ You can convert your group spousal life and AD&D coverage to an individual Life policy

▪ Child Optional Life insurance can only be converted if you are a resident of Quebec

▪ OTIP will email you and send a letter to your home address on file ▪ We encourage you to seek other Life insurance options prior to your retirement

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Accessing your 2019 T4As

▪ Basic Life and AD&D premiums paid by the CUPE EWBT are taxable income to you ▪ As the plan administrator, OTIP will be issuing T4A tax slips to report your 2019 taxable income ▪ Starting on February 28, you can access your CUPE EWBT T4A slip online, through OTIP’s secure member site

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Member support – OTIP

▪ Call OTIP Benefit Services for help with eligibility, benefits enrolment and changes, and coverage during leaves ▪ No access to a computer? Not computer savvy? We’re here to help! We will complete your enrolment/benefit change over the phone ▪ English/French not your first language? Let us know your preferred language and we will do our best to help you ▪ Monday to Friday: 8 a.m. – 8 p.m. | 1-866-783-6847 ▪ Visit www.otip.com/enrolmenthelp (FAQs, Help Centre)

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Canada Life update

We’re changing – but your plan isn’t

There’s nothing you need to do.

Our vision and purpose

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Our vision: Customers are at the centre

• f what we do

Our purpose: To improve the financial, physical and mental well- being of Canadians

Your benefits with us

Your benefits are provided under the following policy numbers: ▪ Policy 172510 – Life Insurance & Travel Assistance ▪ Policy 50210 – Health, including Drugs and Vision & Dental

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March 2020 benefits improvements

Chiropractor Example

▪ Current max is $500 ▪ Increasing to $750

▪ For the period Sep 1/2019 to Aug 31/2020:

▪ From Sept 1, 2019, you have $500 to use, plus an additional $250 beginning Mar 1/2020. ▪ If you used $400 prior to Mar 1st, then you will have $350 to use before Aug 31st ($500 - $400) + $250 ▪ If you used $500 prior to Mar 1st, then you will have $250 to use before Aug 31st ($500 - $500) + $250

▪ The additional $250 is for claims incurred

• n/after Mar 1st

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March 2020 benefits improvements

Hearing Aids

▪ Current max is $1,000 every 5 years ▪ Increasing to $2,500 every 2 years

▪ Please contact Canada Life to confirm your next eligible claim date and balance applicable ▪ The additional $1,500 is for claims incurred on/after Mar 1st

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Ask us your questions

Dedicated Call Centre: 1-866-800-8058 (toll-free) 8am to 7pm, Monday to Friday ▪ Benefit details ▪ Claim status ▪ Confirm Out of Country coverage ▪ Service available in many languages

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More features for you

▪ GroupNet for Plan Members ▪ On-line / mobile / Apple Watch ▪ Download the app on all devices ▪ Register online:

▪ www.canadalife.com ▪ Or for new members, when you enroll at www.otip.com/enrol

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Smart benefits on the go

▪ Same access to benefits and card through your:

▪ Smart phone ▪ Apple Watch

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▪ An expanded, mobile-friendly offering

▪ Health assessments ▪ Digital health coach ▪ Team and solo challenges ▪ Works with top fitness apps

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Health Connected

Make smart choices

▪ Don’t submit claims for services you didn’t receive ▪ Don’t give a service provider a blank claim form ▪ Check your explanation of benefits ▪ Report at confide@gwl.ca or 1-866-810-8477

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Defining fraud, waste and abuse

▪ Fraud: Intentionally providing the wrong information to ensure payment ▪ Abuse: Excessive or inappropriate use

• f benefits

▪ Waste: Unintentional errors resulting in improper payment ▪ Fraud is a crime – abuse and waste are not

Closing thoughts

▪ We have launched a benefit plan that is highly regarded ▪ Prudent decisions have allowed us to make enhancements to the plan ▪ Our providers continue to work diligently to provide the best possible service ▪ We will continue to seek your feedback to continuously improve your plan ▪ Contact the CUPE EWBT at: info@cupe-ewbt.ca or visit our website www.cupe-ewbt.ca/home

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Questions?

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