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REGIONAL MEETINGS Spring 2012
REGIONAL MEETINGS
Spring 2012
1. Welcome and Introductions
2. Financial Summary
3. LTD Offsets, Third Party Claims & Overpayments
4. JEIS Committees: Roles & Functions
5. PEBT Website
6. Feedback and Questions
Welcome & Introductions
Welcome & Introductions
PEBT Trustees
Member Trustees Employer TrusteesAnne Bell CUPE Local 459 - SD 62 SookeChair
Alan Chell, SD 19 Trustee, BCPSEA Vice ChairVice Chair
Tina Meadows - CUPE National Representative Loris Pante - SD 36 Surrey
Colin Pawson - CUPE Local 1091 - SD 37 Delta Bryan Mix - SD 57 Prince George
Elaine Smith - CUPE Local 1260 - SD 35 Langley Joe Strain - SD 37 Delta
Rob Hewitt - Assistant Regional Director, CUPE BC
Lynda Minnabarriet - SD 74 Gold Trail and SD 53 Okanagan Similkameen
Leslie Franklin - CUPE Local 703 - SD 42 Maple Ridge-Pitt Meadows
Laura Buchanan - BCPSEA Labour Relations Consultant
Welcome & Introductions
All Trustees serve on one or more committees
Committees meet regularly and provide updates and recommendations to the Board for discussion and formal adoption JEIS Committee Finance and Audit Committee Investment Committee Administration Committee Plan Design Committee Litigation Committee
Welcome & Introductions
Service Providers:DesjardinsMorneau Shepell
Other Attendees:CUPE Staff RepresentativesBCPSEA Staff
Welcome & Introductions
PEBT Conference & Regional Meetings
2010 - Fall Conference 195 attendees Health and wellness focused speakers Pre-conference workshop for new JEIS committee members LTD Plan and Financial Overview of the Plan JEIS Survey results
2012 - Regional meetings April/May
2013 - Conference
JEIS Poster Distribution
Welcome & Introductions
JEIS Posters
Welcome & Introductions
FINANCIAL SUMMARY
Long Term Disability (LTD)
Predominant benefit
Funding for Core LTD - $19.4M
PEBT must work within funding for Core LTD excess of funds can increase benefit shortage of funds must decrease benefit
JEIS funded initially by government advance
Other Benefits
Financial Summary
Financial Summary
Financial Summary
Financial Summary
Renewal proposals are received from PEBT Benefit Providers by Morneau between October and December each year
Morneau reviews proposals, analyzes the numbers and presents their findings and recommendations to the Finance and Audit Committee.
Benefits Renewal Process
Renewal Process
As part of the renewal process, extended health and dental surpluses are reviewed to determine if premium holidays for districts/members (if applicable) in the pool are warranted.
Finance and Audit Committee make recommendations to the Board regarding renewal negotiations. The Board considers recommendations and finalizes direction of proceedings Underwriting and Rate Setting Policy is followed
Renewals are effective July 1st of each year
Benefits Renewal Process
Renewal Process
Once benefits provider renewal negotiations have concluded, renewal reports are prepared
Each school district/union local receives a custom report which includes: Premium rates for each benefit Summary of the surplus/deficit position if extended health and/or dental is ASO Explanation for the underwriting methods, descriptions of trends and issues and usage
data that may be affecting the cost of benefits
Providing information to both parties gives everyone increased awareness of benefit costs
Benefits Renewal Process
Cost Drivers Higher Drug & Service Costs Higher Usage Increased Carrier Admin Costs Shifting costs by government to private plans
Benefits Renewal Process
Investment Summary
Investment strategy - actively managed
Funds distributed between two investment managers: McLean Budden bcIMC
Investment Committee continuously reviews investment diversification
Investment Summary
PEBT Fund Returns:
2008 investment return -10.2%
2009 investment return 14.3%
2010 investment return 8.1%
2011 investment return 1.9%
Market fluctuations impact PEBT ability to support the fund.
2010 annual report as well as previous reports are available on the PEBT website
Includes audited financial statements
Annual Reports
Questions?
LTD OFFSETS AND OVERPAYMENTS
Cost Controls
Direct Offsets
Canada Pension Plan Third party benefit offset:
– Sick leave, weekly indemnity etc Worksafe BC Proceeds from 3rd party Claim – ICBC
CPP Disability – must apply for
Failure to apply means no LTD benefits
Desjardins follows up based on PEBT policy
LTD Offsets and Overpayments
Overpayments: How do they occur? CPP decision & retroactivity Worksafe BC Return-to-work
Ending Overpayments
Some will always occur Key is follow up
LTD Offsets and Overpayments
PEBT Policy Recover overpayments
To not recover jeopardizes benefits of all
Not fair to have overpayment
Desjardins to work out satisfactory repayment schedule
Not saving money for Desjardins
Money goes back into the LTD program
LTD Offsets and Overpayments
Reasonable Repayment Schedule PEBT policy – if overpayment is made then recover
Member must repay - reasonable and fair
Interest is charged on repayments over 6 months
Each case determined on its own merits
Failure to repay means no benefit
LTD Offsets and Overpayments
Third Party Claims
MVA
“Slip and Fall”
Product Liability
Medical Malpractice
Other
LTD Offsets and Overpayments
Third Party Claims
Must sign the reimbursement agreement prior to receiving LTD benefits
Must keep Desjardins updated on settlement status
LTD Plan contains provisions which require repayment of past benefits and offset of future benefits when settlement received
LTD Offsets and Overpayments
Questions?
LTD Offsets and Overpayments
JOINT EARLY INTERVENTION SERVICE
JEIS
The primary goals of the JEIS program include:
Providing early identification of member needs and active, caring assistance of plan member health issues
Facilitating gradual return to work (GRTW) of members
Promoting open discussion and support for JEIS by local unions and school districts
Ensuring long term viability of “Core” LTD program
Contact from Health Care Management Specialist (HCMS) after 6 working days absence
JEIS
JEIS Process
Initiated when District Absence Advisor notifies Union Representative and Desjardins that a member has been absent for 6 consecutive scheduled working days
Union Representative calls member first to explain the JEIS program and let them know that they will be receiving a call from a Health Care Management Specialist (HCMS) from Desjardins
HCMS contacts the member within 24 hours of notification to offer assistance
JEIS
HCMS involvement
Varies depending on the member’s needs
Sends out Early Notification Package (if required)
Explains how JEIS works
Arranges face-to-face meeting with member, if appropriate
Gathers and reviews information about member’s injury/illness and develops a GRTW/accommodation plan when appropriate
Communicates with all stakeholders to monitor the member’s progress and to ensure GRTW plan is being followed
Remains in contact with member until their successful return to work or transition to LTD
Provides District JEIS Committee with monthly status reports to facilitate discussion of individual cases
Meets with Districts JEIS Committee to discuss status report, as needed
Role of District JEIS Committee
Different level of involvement depending on your district/union member needs
Heartbeat of the JEIS Program
Front line – you make it work
You are the champions for this program
Program will not reach its potential without you
District JEIS Committees
Early intervention critical
JEIS program only 120 days
Are you meeting the 6 day notification requirement?
If not, what are the barriers?
How do we reduce those barriers?
Average JEIS Notification Times Report is available on the PEBT website (updated quarterly) provided by Desjardins
District JEIS Committees
District JEIS Committees
Average JEIS Notification – January 2012
Monthly Report from Desjardins
Opportunity to review status of each case
Are there any concerns?
Can Committee members assist?
District JEIS Committees
District JEIS Committees
Accommodation Plans
Developed jointly
Assist in removing barriers
Resolve disputes
Collective agreement issues
Assist in implementing
Facilitate RTW plan
JEIS Integration with Wellness Programs
District Employee and Family Assistance Plan (EFAP)
For non-medical issues do we have a strategy in place for resolving issues with the assistance of the EFAP, if necessary?
Are members aware of the services available through their EFAP?
District Wellness Programs/Committees
Do our wellness initiatives assist those employees on a GRTW?
Do our sick leave policy procedures align with and support the efforts of the JEIS program?
District JEIS Committees
Promote Program
Program’s ambassadors
Is this high profile in your district?
Are people educated in its importance?
JEIS posters
Online Pamphlet
District JEIS Committees
Provide PEBT JEIS Committee with Feedback
Positive and negative
What is working, what is not working?
Share best practices with us
Tell us what you need
District JEIS Committees
JEIS Committees Roundtable Discussion
Objectives of the PEBT website
Help plan members better understand the benefits and programs provided by the PEBT
Strengthen the identity and understanding of the PEBT among the various constituents
Communicate who, what, where the PEBT is
Clarify roles of the PEBT and its partners/providers
Make information more useful and easy/intuitive to use for members
Help members find answers to their questions
Educate members and other audiences
PEBT Website
Website
Detailed information available for members, union local representatives and districts organized by:
About PEBTAbout JEISAbout LTDAbout Other Benefits
Archives
Financial Plan information
PEBT System User Group
Set up to enable users of the benefits administration system to provide feedback on the system and the user experience
Represents a cross section of school districts
2010 discussions resulted in several more changes made to improve the user experience of the website
Communication with the User Group intended to be ongoing with feedback requested as issues or problems arise
Questions?
Thank you!
www.pebt.ca
