Group Insurance Forum

Kimball Blanchard has indicated he will provide an article about our group insurance plan to be posted to this page. The article is expected early in the new year (2009), after negotiations. Kimball has also agreed to respond to questions/concerns about our group insurance plan and coverage. We are fortunate to have his services and expertise.

Group Insurance Report

by Kimball Blanchard, January 2009

The P.E.I.T.F. Group Insurance Programme provides continuing coverage for teachers who retire and were active participants in the programme when they retired. The life insurance coverage may be continued to age 65 with the retiree paying the full cost of the premium. If a retired teacher decides to retain the life insurance coverage, the principal amount remains at the level she/he had at retirement to age 65. For example, if the principal amount at retirement was $90,000, that is the amount in effect to age 65 even though the coverage was increased for active teachers. At age 65 the principal amount is reduced to $10,000 fully paid by the teacher at the rate of $12.70 per month.

At age 65 the retiree has the option to convert to a private plan at current market rates for the age group with no evidence of insurability required. The amount of coverage is determined by the retiree, but the decision to select this option must be made within 31 days after reaching the age of 65. This option is of particular value to people who are not able to obtain coverage from other sources. The life insurance provided free to active teachers under the terms of the Memorandum is terminated upon retirement.

Full Accidental Death and Dismembership (AD&D) can be retained to age 65, and at age 65 the amount of coverage will be reduced to a maximum of $100,000, and this amount can be retained to age 75 at which time the coverage is terminated.

In the area of health coverage we are fortunate that, because of the positive experience with the overall plan, we are able to maintain the rates at last year's level. Many factors go into determining the rates for any health plan. Inflation rates in health coverage are much higher than inflation rates in the overall economy. New drugs entering the market often have very high costs associated with them. Increased reliance on medication as a solution to health problems is a major factor since prescription drug costs make up 70 -75% of the total cost of our health care programme.

As a member of the plan, anything you can do to reduce costs to the plan will have an overall effect on our annual rates. In determining the rates for our plan each year, the experience of the members is recorded for three distinct groups: (1) active teachers; (2) retired teachers; and (3) a closed group of retired teachers. If retired teachers were rated alone this past year we would require a rate increase of 20.6% so we must make every effort to help keep costs under control.

A very significant thing that retirees who reach the age of 65 can do to help to control rates is to be sure to register for the Provincial Government Health Plan. Many, but not all, of the prescription drugs covered under our plan are covered under the Provincial Plan and by using the Provincial plan the cost to our programme may be reduced considerably. Your local pharmacy can provide you with the details of the Provincial Plan and how it works. The use of generic drugs, where possible, can also have a positive effect on our costs.

Two areas of coverage in the health plan were improved this year. The allowable expense for hearing aids was increased to $1,200 with the maximum payment to the member being 80% of that amount, or $960. While this will not cover the total cost of modern hearing aids, it will provide some improved benefits to the members. The second area of improved coverage is in the area of Paramedical Practictioners. The allowable expense was increased to $30 per visit with an 80% payment to the teacher of $24 available to the teacher.

Our health plan provides travel coverage to the members with the premiums of $1.75 per month for single coverage, and $3.50 per month for married coverage included in your total monthly premium. If you require emergency treatment while travelling, you should contact Medavie Blue Cross. If the amount is under $200, you will be asked to pay and you will be reimbursed. If the amount is over $200, arrangements will be made to pay allowable expenses. Before you travel, you should check with Medavie Blue Cross with regards to any pre-existing conditions you have which may influence your coverage. As trustees we have no control over the travel aspect of our plan because only a small amount of the travel claims are actually charged to our plan and the rest are pooled in Medavie Blue Cross' total travel business.

In other insurance news, booklets outlining our insurance plan are now available in French. You can contact Michel Plamondon at the Teachers' Federation (569-4157) to receive a booklet. If you are involved in the electronic age, you can contact Johnsons to receive a pass word which will allow you to find your personal information about your insurance coverage.

Home and Auto coverage to teachers is on an individual contract basis. If you have any questions about your coverage, or, if you wish to have quotes provided to you, please contact Johnsons office.

Insurance rates are constantly rising, especially in the area of health coverage. Since we are a self-insured group, we operate on a "pay in - pay out" basis. While the plan was created to meet the health needs of teacher, and we want to ensure that these needs are met, any way that the cost of this care can be reduced will assist in keeping the total costs at a reasonable level.

Any questions about the Group Insurance Plan can be directed to Michel Plamondon at the P.E.I.T.F. or to Johnsons office in Charlottetown. Inquiries can be made in French and will be directed to Johnsons office in Halifax or Fredericton where bilingual services are available. People in these offices will have access to any information required to answer your questions. If you have issues/concerns you feel the Group Insurance Trustees should be engaging, please contact me, Kimball Blanchard, at 892-3765, and I will bring them to the next Trustees' meeting.

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If you have questions/concerns that you would like to see posted here, send them by email to Bill Oehlke (click on name to left for email). Bill will post the questions to this page and Kimball will respond in a timely fashion.