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Employee Benefits Plan Overview
AgendaYour People Statistics
Historical Plan Changes
Current Plan Highlights
Financial Summary
Employee & Family Assistance Program Updates
Larger Trends:
• Specialty & High Cost Drug Claims
• Government Updates
Risk Mitigation Review
Total Benefits Hierarchy
• Flexible Spending Accounts
• Rising Plan Costs
Your Service Statistics
Your People Statistics
Number of Active Employees - 119
Currently on Disability - 11
Leave of Absence - 2
Total Number of Enrolled
Employees(Both Classes)
132
Your People Statistics
29% 71% EmployeesWith
Dependents
60%
Percentage of Employees With 10+
Years of Service
30%
Percentage of Employees With 5+
Years of Service
55%
Your Service Statistics
Number & Source of Customer Service Inquiries – 480:Plan Administrators - 2Dental Providers - 158Employees - 237Other - 83
Reason for Customer Inquiries - 480:Administration - 43
Dental Coverage or Claim - 161Disability - 1General Inquiries - 18
Extended Health Coverage or Claim - 155
Technical Support - 61IVR - 41
February 2017 to October 2017:
Your Service Statistics
February 2017 to October 2017:
Health & Dental Claims Processing Turnaround Time – 2,681 Claims:1 to 5 Days – 2,6526 to 10 Days - 29 11 to 15 Days - 016+ Days - 0
Most Visited Manulife Webpages:
HomePage
OnlineClaims
Search My Claims
MemberForms
Claims Details
Your Service Statistics
February 2017 to October 2017:
Plan Member Website Metrics at a Glance – 2,681 Claims:
Registered Users – 55%
Registered for Direct Deposit – 46%
Electronic Claim Statements – 46%
Number of Online Claim Submissions – 388Average Number of Submissions Per Month – 43Average Number of Submissions Per Employee – 6
Online Claim Metrics:
Claims Trending By Month:Feb 2017
Mar 2017
Apr 2017
May 2017
Jun 2017
Jul 2017
Aug 2017
Sep 2017
Oct 2017
Total
Feb 2017 to Oct 2017
Online Claims 0 41 51 54 40 24 50 74 54 388Paper Claims 0 59 82 94 122 60 66 70 131 684Provider eClaims
0 3 9 8 12 16 16 1 9 74
Your Current Suite of Benefits
Extended HealthCare Insurance
Long Term DisabilityInsurance
DentalInsurance
Life & Accident Insurance
Emergency Medical Travel
Insurance
EmployeeAssistanceProgram
Your Current Suite of BenefitsExtended Health Care• No Deductibles• 100% co-insurance for all medical services/supplies
• Except 90% co-insurance for prescription drugs
Prescription Drugs• Unlimited• Lowest cost generic equivalent (brand name available if medically necessary)• Includes diabetic supplies, oral contraceptives & devices, vaccines, smoking
cessation, fertility drugs
Hospital Accommodation• Semi-Private Room
Private Duty Nursing• $10,000 per calendar year
Your Current Suite of BenefitsVision Care
• Children – Once per calendar year• Adults – Once per 2 calendar years
Eye Examinations
Ongoing Discounts: • Prescription Eyeglasses - 30%• Designer Sunglasses – 20%• Contact Lenses – 10%
Clear Focus Vision Discounts though Clearly.ca
How It Works:1. Go to www.clearly.ca2. Enter promo code:
CLEARSAVINGS
• Children – $200 per calendar year• Adults – $200 per 2 calendar years
Your Current Suite of BenefitsParamedical Practitioners• $500 per practitioner category, per calendar year, per person
Includes the following:• Acupuncturist
• Audiologist
• Chiropractor
• Dietician
• Massage Therapist
• Naturopath
• Occupational Therapist
• Osteopath
• Physiotherapist
• Podiatrist / Chiropodist
• Psychologist / Social Worker / Clinical Counselors
• Speech Therapist
Your Current Suite of BenefitsEmergency Medical Travel• Unlimited, worldwide, up to 90 consecutive days per trip
• Intended to coverage expenses related to unforeseen illness / injury that onset while already outside of Canada / home province
Medical Expenses:
• Doctor fees• Hospital fees• Emergency Room fees• Ambulance fees (air & ground)• Diagnostic services• Prescription Drugs
Non-Medical Expenses:
• Transportation fees• Return of vehicle• Meals and accommodation• Return to Canada• Repatriation of remains
• 24/7 Emergency medical assistance by phone
Your Current Suite of BenefitsMedical Services & Supplies• Ambulance fees
• Mobility aids durable medical equipment
• Custom-made orthopedic shoes and orthotics
• Prosthetics
• Surgical Bras
• Compression Hoses
• Orthopedic braces, trusses, collars, casts, splints
• Breathing equipment (CPAP machines, sleep apnea machines)
• Hearing aids
Your Current Suite of BenefitsDental Care• No deductibles
• Co-insurances:• Basic Services – 80%• Major Services – 50%• Orthodontic Services – 50%
• Maximums:
• Basic & Major Services Combined – $2,000 per calendar year• Orthodontic Services – $2,000 per lifetime
• Recall Exams – Once every 6 months• Scaling – 8 units per calendar year
Your Current Suite of BenefitsBasic Employee Life Insurance• Flat amount of $50,000
Dependent Life Insurance• Spouse - Flat amount of $5,000• Child - Flat amount of $2,500
Long-Term Disability Insurance• Elimination period of 119 days• Benefit equal to 66.67% of monthly earnings• Non-evidence maximum of $4,300• Overall maximum of $5,000 available
• Payable to age 65• Definition of 2 years, own occupation
• Non-taxable benefit payments
Providing Early Intervention Support for employer and
employee after 5th day absence from work
Your Current Suite of BenefitsAccident & Serious Illness Insurance• Accidental Death coverage equal to Basic Employee Life Insurance amount
• Flat amount of $50,000
• Loss or Loss of Use benefits included (percentage of of principle coverage amount payable in lump sum by injury)
• Paralysis, Critical Disease and Serious Illness benefits included
Optional Accident & Sickness InsuranceAvailable for Employees and Dependents (medical evidence required)
• Units of $50,000• Maximum $400,000
Your Current Suite of BenefitsOptional Life Insurance
Available for Employees and Spouses:• Units of $5,000• Minimum $10,000• Maximum $500,000
Available for Dependent Children:• Flat amount of $5,000
• Medical evidence required only for amounts over $50,000
• Medical evidence not required
Financial SummaryCSBT Program Effective Date – April 1, 2012:
January 1, 2014 --------------------------------- $510,000 Estimated Annual Costs
+0.1%
January 1, 2015 --------------------------------- $479,000 Estimated Annual Costs
+1.1%
January 1, 2016 --------------------------------- $571,000 Estimated Annual Costs
+8.7%
January 1, 2017 --------------------------------- $611,000 Estimated Annual Costs
+16%
January 1, 2018 --------------------------------- To Be Determined
Historical Plan Changes
February 2017• Extended Health and Dental Care benefits provider transitioned to Manulife
Financial, employees paid a lump-sum taxable payment to ease LTD increase in cost
December 2012• Co-insurances updated for Extended Health and Dental Care• Mandatory generic drugs, vaccines & fertility drug coverage implemented• Vision Care benefits enhanced for dependent children• Paramedical Practitioners maximum enhanced• Custom-Made Orthopedic Shoes & Orthotics coverage updated• Dependent child age updated (to age 22, from 22-26 if full-time student)
September 2012• Plan design updated to include specific contraceptive device at no rate change
Future Plan Changes?Update LTD elimination period to match EI elimination period, Dependent Life Insurance enhancements, Employee & Family Assistance Program enhancements, Promote Optional Life/AD&D/Critical Illness coverage, Contact all LTD excess coverage eligible employees, flex spending benefits
Your Employee and Family Assistance Program
A full-service, bilingual program that combines confidential counseling and comprehensive work-life services to assist employees and their families with personal problems and concerns.
Your Core EFAP Services Includes:• In person confidential counseling • No limit short-term counseling sessions• Expert counselors available 24/7/365 by phone• Face to face sessions available• Website and mobile app services• Referrals to community resources• Management and supervisor support
24/7Consultations
ReferralstoCommunityResources
OnlineResources
Information/ResearchServices
Counselling
Your Employee and Family Assistance Program
LifeWorks’ qualified program consultants provide practical work-life support and strategies to address everyday issues, as well as referrals to counsellors and other specialists:
ü Work-Life Balanceü Stress Managementü Health and well-beingü Legal Guidanceü Financial Guidanceü Parenting & Childcareü Eldercareü Naturopathicü Nutrition
Your Employee and Family Assistance Program
Online & Mobile App Support – wherever… whenever… however!
ü Platform optimized for use on iOS and Android devices
ü Access to toolkits, eBooks, podcasts & articles
ü One click to be connected to a consultant
ü Sophisticated content suggestions for read next & related articles
Your Employee and Family Assistance Program
NEW Enhanced EFAP Platform Available
ü Online platform enhanced to allow you to connect with your organization an your colleagues in one place
ü NewsFeed access to your own social network keeping you up to date on colleague birthdays, anniversaries, etc.
ü Recognition Leaderboard – send and celebrate praise to a fellow colleague
ü Online shopping through LifeWorks allows Cashback on hundreds of retailers
ü Discounted Gift Cards, Exclusive Offers and Daily Deals
Your Employee and Family Assistance Program
Client Testimonials
”LifeWorks technology now helps us to better manage our ever-changing employee environment whilst optimizing outcomes for the business and ensuring our employees feel valued and appreciated.”
- Emma Jayne, HR Director, The Savoy
”We promote LifeWorks valuable services to all our employees. And we promote them because LifeWorks supports one of Marriott Hotel’s key company values of taking care of our associates.
- Betsy Kiss, Senior Director of Workplace Strategies, Marriott International Inc.
LARGER Trends
Trends: Flexible Spending Accounts
Health Spending Accounts (HSA) and Personal Spending Accounts (PSA) provide greater plan member choice.
HSA - Non-taxable (outside Quebec), used for CRA approved medical expenses (e.g. prescription drugs, dental claims)
PSA - Taxable account used for lifestyle expenses (e.g. fitness classes, sports equipment, vitamins)
Rising Plan Costs
Specialty & High Cost Drugs
Government Updates
Canada’s 18-Month Parental Leave
Parents now have a flexible choice between:• 12-month leave at a benefit rate of 55%, or• 18-month leave at a benefit rate of 33% • Max payout $543 per week (as of January 1, 2017)
How are these changes affecting internal HR policies for employers?
How will the 18-month parental leave affect employer costs for increased top up programs?
Trends: Government UpdatesMedical Services Plan (MSP) Premiums for January 2018
As per the British Columbia September 2017 Budget, the premium rates for all British Columbians will be reduced by 50%.
The government indicates that MSP premiums will be eliminated within 4 years.
Where the employer pays the premiums, this is considered a taxable benefit to employees.
Be sure to check if some employees are eligible to apply for premium reduction.
Trends: Government Updates
Medical Cannabis
Currently no Drug Identification Number (DIN); does not qualify under existing prescription drug benefits
It can be claimed under any existing Health Spending Account (HSA) with a physician's prescription.
Some companies choosing to add it under the insured health benefit (e.g. Shoppers Drug Mart), alternatively some choose to fund under a separate HSA account designated for medical cannabis costs
How does this impact internal HR/discipline policies?
What does this mean in terms of employer duty to accommodate disabled employees?
Estimated that over 400,000 Canadians will soon be using medical cannabis for
treatment of an illness
Risk Mitigation Review
Pointbreak value-added support that ensures consistent plan administration is taking place within your organization to help avoid potential legal and tax liabilities and to ensure contract compliance.
ü Participation & Enrollment Guidelinesü Termination, Severance and Leave Guidelinesü Disability Claim Guidelinesü Cost Sharing, Salary, Billing and Taxability
Guidelines
Topics included in this discussion:
TOTAL BENEFITS HEIRARCHY™
TOTAL BENEFITS HIERARCHY™
RRSPCPPVacation Employment InsuranceMSPTransit EducationFitness DiscountsWorksafeEmployee ReferralService RecognitionHealthLong Term DisabilityDentalLife InsuranceShort Term DisabilitySalary ContinuanceVisionEAPAccident
TOTAL EMPLOYEE BENEFITS
100 person organization
$200,000
$270,000
$1.015 M