PEA Benefits 101 Suzanne Helston Manager, Benefits May 2015 - PowerPoint PPT Presentation

PEA Benefits 101 Suzanne Helston Manager, Benefits May 2015

Session Outline • Benefits Office • PEA benefits package • Group Plan Coverage • Claim reimbursement • Q & A

Benefits Office • Located in Sedgewick B wing • Administers enrolment & determines eligibility for all faculty and staff in the University’s Group Plans • Life events/transitions • Leave management for CUPE members • Liaison with service providers and carriers

Benefit Package for Regular PEA Members • BC Medical Services Plan • Extended Healthcare Plan • Dental Plan • Pension Plan • Basic Group Life Insurance • Long Term Disability Plan • Employee & Family Wellness Program

Medical Services Plan of BC MSP covers: • Services of Physicians and Specialists • Maternity care • X-ray and lab services • Inpatient hospital accommodation and services • Outpatient services including emergency, casting, daycare surgery, renal dialysis, cancer therapy, diabetic counselling etc. • Emergency out-of province Physician’s charges • Access to Fair PharmaCare

Extended Healthcare Plan • Administered by Pacific Blue Cross (PBC) • PBC is a not for profit entity • We pay PBC for adjudication and administration of claim reimbursement only • Premiums paid by employees and the University cover the cost of each claim • www.pac.bluecross.ca

Prescription Drug Coverage • Special Authority designation. – small number of prescription drugs are eligible for Special Authority designation. – ensures that the Provincial PharmaCare program will be the first payor once your family deductible has been met. – Physician or pharmacist will advise if your prescription is eligible for Special Authority. • Regardless of the decision by PharmaCare to accept or deny Special Authority coverage, the plan covers the drug when you provide proof of PharmaCare’s decision prior to or with your first claim submission.

Prescription Drug Coverage cont’d • Generic Pricing – only applied when there is a generic drug available – If there is not a generic alternative, a brand name drug is provided. • You may request the brand name and pay the difference between the brand and the lowest cost generic drug. • Your physician can transcribe “no substitutions” on the prescription. • Cost of generic drug is approx 35% of brand name

PBC Pharmacy Compass • Free on-line tool • List of pharmacy names, locations and per-pill prices for the drug, as well as dispensing fees • Access by computer, smartphone or tablet • Comparison shop for prescription medications at B.C. pharmacies • www.pharmacycompass.ca

Paramedical Coverage Therapy Limit Massage $30 per visit for first 12/ annual maximum $500 Chiropractor $30 per visit for first 12/ annual maximum $500 Physiotherapy $30 per visit for first 12/ annual maximum $500 Naturopath $20 per visit for first 12/ annual maximum $500 Acupuncture $500 per year Podiatrist $20 per visit for first 12/ annual maximum $500

Travel Coverage • Emergency coverage only • For business or pleasure • Covers hospital charges, Physicians & Surgeons, prescription drugs, and ambulance services in an EMERGENCY only • (Emergency is a sudden unexpected injury or an acute episode of disease that requires immediate treatment or surgery and it is not possible to return to BC before treatment) • Lifetime maximum applies • Discounted rates available to University employees for additional travel insurance bought through Pacific Blue Cross

Medi-Assist – provides assistance while travelling outside of your province of residence. – 24/7 medical travel assistance line – Helps locate medical care, provide advisory services, refer you to interpreters, assist with transportation, contact relatives and more.

When and How to Contact Medi-Assist • Call Medi-Assist within 24 hours of an emergency • Available 24/7 • Have a pen and paper ready • Know your PBC Group # ( 40704 ) and ID# • How to connect to Medi-Assist: In Canada and the US: 1 888 699-9333 (toll-free) Outside of Canada/US: Contact an international operator and request a collect call to: 604 419-4487

Reimbursement for eligible health care claims • Direct Billing: pharmacist or practitioner directly submits expense on your behalf to PBC • Online claims through CaresNet www.pac.bluecross.ca • Complete paper claim form, attach receipts and mail

Submit eligible claims on-line for … • Health Care: chiropractor naturopath physio podiatrist massage psychologist acupuncture • Vision Care: Eye exams & eye wear • Drugs: Prescription Drugs Diabetic Supplies

Dental Care PEA Dental Care Plan Annual deductible 0 Plan A – covers basic diagnostic and 80% preventative services. This includes examinations, radiographs, basic restorations, root canals, periodontal cleaning, maintenance of dentures, and extractions. Plan B – covers major restorative 50% procedures such as crowns, onlays, veneers, bridgework and dentures. Plan C – covers services related to 50% orthodontics ($3,000 max per person)

University of Victoria Pension Plans • Administered by the Pensions & Investments Office • PEA members participate in either: – Combination Pension Plan or – Money Purchase Pension Plan (for part-time or sessional PEA appointments)

BC Life & Casualty Co. Insurance Plans – Basic Life Insurance • 2 X annual salary • Term insurance for employee only • Premiums cost-shared with UVic – Optional Life Insurance • Up to $500,000 for you and/or spouse • Employee pays full premium • Rates based on age and smoking status – Accidental Death & Dismemberment • Maximum $250,000 • Employee pays full premium

Travel Life Insurance • Provides accident insurance while travelling on approved University business • Coverage up to $100,000 in event of accidental death or dismemberment • Automatically covered without application • University pays full premium

Long Term Disability • Administered by BC Life & Casualty Co. • Income replacement plan • Recommended to apply after 3 months absence for illness or injury • 6 month elimination period if applying • Must meet definition of totally disabled and unable to perform the duties of your job • Long Term Disability benefits are based on 80% of your NET basic salary. • Full pension contributions paid on your behalf

Employee & Family Wellness Program • Optum Canada • Confidential program that includes professional counselling, information and referral services. • 100% paid for by UVic • On-line health and wellness tools • In person, telephonic or e-counselling services

Employee & Family Wellness Program cont’d • dietary concerns • elder care • financial planning • health coaching • parenting • relationship challenges Every month a free webinar, covering a variety of topics, is available to employees.

Resources • Benefits Handbooks/guides/FAQ http://www.uvic.ca/hr/services/home/compensation/ benefits/handbooks/index.php • Pacific Blue Cross CaresNet https://service.pac.bluecross.ca/ACESWeb/Pages/ Authentication/SignIn.aspx?userType=1 • Optum Canada LiveWell (username = healthy) https://www.livewell.optum.com/public/welcome.asp

Q & A