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REGIONAL MEETINGS Spring 2012. Welcome and Introductions Financial Summary LTD Offsets, Third Party Claims & Overpayments JEIS Committees: Roles & Functions PEBT Website Feedback and Questions. Welcome & Introductions. Welcome & Introductions. PEBT Trustees. Welcome & Introductions.
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REGIONAL MEETINGS Spring 2012
Welcome and Introductions Financial Summary LTD Offsets, Third Party Claims & Overpayments JEIS Committees: Roles & Functions PEBT Website Feedback and Questions Welcome & Introductions
Welcome & Introductions PEBT Trustees
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: • Desjardins • Morneau Shepell • Other Attendees: • CUPE Staff Representatives • BCPSEA 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
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
Benefits Renewal Process • 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
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.
Annual Reports • 2010 annual report as well as previous reports are available on the PEBT website • Includes audited financial statements
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?
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
District JEIS Committees 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 Average JEIS Notification – January 2012
District JEIS Committees Monthly Report from Desjardins • Opportunity to review status of each case • Are there any concerns? • Can Committee members assist?
District JEIS Committees Accommodation Plans • Developed jointly • Assist in removing barriers • Resolve disputes • Collective agreement issues • Assist in implementing • Facilitate RTW plan
District JEIS Committees 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
PEBT Website 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
Website • Detailed information available for members, union local representatives and districts organized by: • About PEBT • About JEIS • About LTD • About 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