Welcome to the benefits plan information session - University ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Welcome to the benefits plan information
session
Please make yourself comfortable we will be starting in a few
minutes.
Please turn off your
camera and microphone
Use the Chat feature for any
comments and/or questions
Please be advised this session will be recorded.
ONLINE ENGAGEMENT ▪ Use the Raise Your Hand feature when contributing and turn on your microphone a moderator will invite you to speak ▪ Use the Chat function when contributing, but cannot verbally – we will be monitoring and responding ▪ Be courageous and participate whenever possible ▪ Say your name when you speak ▪ As needed, select closed captioning feature in Microsoft Teams
Benefits Information Sessions University of Waterloo Pension & Benefits Committee January 19-20, 2021 Presentation to University of Waterloo
Agenda for Benefits Information Sessions
Welcome (5 minutes)
Pension & Benefits Committee Membership and Role (5 minutes)
Purpose of Benefits Information Session (5 minutes)
Presentation (15 minutes)
Q&A (30 minutes)
January 19-20, 2021 2Pension & Benefits Committee Membership
Role
Peter Barr, Chair Board of Governors Representative
Mike Grivicic, Secretary Associate University Secretary
Members
Terrence Birmingham CUPE Local 793 Representative
Ted Bleaney UW Staff Association Representative
Tony Giovinazzo Board of Governors Representative
Michael Herz UW Staff Association Representative
Dennis Huber Vice-President, Administration & Finance
Ranjini Jha UW Faculty Association Representative
Jim Rush Vice-President, Academic & Provost
David Saunders UW Faculty Association Representative
Mike Steinmann Representative of Affiliated and Federated Institutions of Waterloo
Mary Thompson UW Retiree Representative
Marilyn Thompson President's Appointee
Ken Vetzal UW Faculty Association Representative
Resources
Linda Byron Consulting Actuary – Senior Partner, Aon
Scott Palmer Consulting Actuary – Associate Vice President, Aon
Allan Shapira Consulting Actuary – Managing Director, Aon
Sarah Hadley Director, Finance
Lee Hornberger Director, Total Compensation
January 19-20, 2021 3Terms of Reference of Pension & Benefits Committee ▪ Pension & Benefits (P&B) Committee is a Committee of the Board of Governors. The Committee is accountable to the Board for the administration of employee pension and benefits plans ▪ Terms of Reference include “recommending changes in pension and benefits plans to keep them current with respect to other universities and major employers, being mindful of the financial context within which the University operates” ▪ P&B Committee plays a key role in the stewardship of the University of Waterloo active and retiree benefits plans January 19-20, 2021 4
Guiding Principles
▪ The following guiding principles are used to inform the decisions made by the Pension &
Benefits Committee:
– There will be one pension and benefits plan for all members of the University
community regardless of the type of work performed or the employee group to which
one belongs;
– Benefits are provided for both the employee and their family, where relevant;
– Employees should be covered for catastrophic events;
– The current level of benefits should be maintained;
– Cost implications to both the University and its employees should be considered
▪ Eligible University of Waterloo retirees are provided with the same Health Plan as active
employees, based on Policy 23
January 19-20, 2021 5Purpose of Benefits Information Session
▪ In the context of its stewardship role, the P&B Committee will be recommending to the
Board of Governors changes to the University of Waterloo active and retiree benefits
plans, effective May 1, 2021
▪ This session is designed to achieve two goals:
1) Describe the changes proposed by the P&B Committee including the background to
explain the changes
2) Respond to your questions and hear your perspectives on the proposed changes
▪ Following the Benefits Information Sessions:
– The P&B Committee will finalize the recommendations in late January and take them
to the next meeting of the Board of Governors in February 2021
January 19-20, 2021 6Overview of Plan Changes January 19-20, 2021 7
Overview of Proposed Changes
Coverage Administrative Changes to
Enhancements Prescription Drug Management
▪ Increased Mental Health coverage ▪ Mandatory generic substitution
(annual maximum and eligible requirement for prescription drugs
practitioners) ▪ Implementation of Canada Life’s
▪ Addition of coverage for continuous Health Case Management (HCM)
glucose monitors and in-vitro program
fertilization ▪ Implementation of Canada Life’s
▪ Removal of doctors note SMART drug management program
requirements for certain paramedical
practitioners
▪ Addition of Athletic Therapist as an
eligible practitioner
▪ Increased emergency Out of Country
lifetime maximum to $5,000,000
▪ Increase eligible dependent child age
to 25 (for full-time students only)
More details to follow but first some background to
explain these changes
January 19-20, 2021 8Background Information— Holistic Benefits Review January 19-20, 2021 9
Background – Goals
▪ In 2018 the University of Waterloo embarked on a Holistic Benefits Review
– The working group for this project included University of Waterloo administration
representatives as well as stakeholders from the various groups across the
organization (CUPE, Staff, Faculty, Retirees) and the University’s affiliated and
federated university colleges
– The goal of the review was to ensure the benefits plan was competitive against the
University’s competitors and to address any gaps in coverage within the benefits plan
– The goal was for the proposed plan to be cost-neutral relative to the current design
• Existing funds could be redistributed amongst the benefits
• If plan improvements were still required after University funds were redistributed,
employees would need to fund the improvements
▪ Additional information can be found on the Holistic Benefits Working Group website:
https://uwaterloo.ca/holistic-benefits-working-group/informing-recommendation
January 19-20, 2021 10Background – Competitiveness
▪ In early 2018 the benefits program was benchmarked against a selected group of 21
University and non-University competitors
▪ Overall, the University of Waterloo’s benefits program was competitive when
benchmarked against other University comparators
– Strengths of the program:
• Life Insurance and Disability coverage;
• Dental coverage (including the 1/1/2019 coverage enhancements);
• No employee contributions required for full-time members towards Health and
Dental coverage
– Coverage gaps:
• No coverage for:
⬧ Vision Care (eye exams, glasses, contact lenses);
⬧ Continuous glucose monitors;
⬧ In-vitro fertilization
⬧ Dental coverage
• Lower than average coverage for:
⬧ Chiropractor;
⬧ Emergency Out of Country coverage
January 19-20, 2021 11Background – Employee Survey
▪ A survey was released to University plan members in the fall of 2019 to allow members
to provide their input into the benefits program review process
▪ 40% of eligible plan members responded to the survey
▪ Key takeaways from the survey include the following:
– 77% of active employees were in favour of some form of change to the plan
– Priority coverage enhancements included:
• Addition of Vision coverage
• Removal of physician referral requirements for coverage;
• Increased coverage for mental health providers
• Addition of Dental coverage for retirees
– Acceptable cost reductions for active members included:
• Required use of generic drugs, when available;
• Addition of mandatory employee contributions
January 19-20, 2021 12Background – Redesign
▪ The HBR working group reviewed the results of the competitiveness review and
employee survey data, and considered alternate benefit plan design options
▪ Feedback was received from the stakeholder groups on these design options
– Most stakeholder groups were concerned about the impact of any design changes on
lower income groups
▪ Based on the feedback from the stakeholder groups, a final set of plan design changes
were developed for recommendation to the Pension & Benefits Committee
– Final recommendations only contain proposed changes to Health coverage
– No changes are being proposed to Life Insurance, Disability, or Dental coverage
January 19-20, 2021 13Details on Proposed Changes January 19-20, 2021 14
Health Plan Overview ▪ The University’s Health plan provides coverage to eligible members and their dependents for the following categories: – Prescription Drugs – Paramedical Practitioners (including Physiotherapist, Psychologist, etc) – Medical Services & Supplies (including hearing aids, orthotics, etc) – Hospital – Out of Country coverage ▪ The Health plan is 100% University paid for full-time members and cost-shared for part-time members January 19-20, 2021 15
Administrative Changes to Drug Plan Management
▪ Prescription drug coverage is the biggest cost category within the Health plan, so it’s
also the category with the most potential for cost savings
▪ The proposed design changes should have minimal impact to employees, so long as
members switch from taking brand name drugs to generic drugs (where a generic exists)
Current Plan Proposed Plan
▪ Plan reimburses for the cost of the ▪ Plan reimburses for the cost of the
generic drug unless “no substitution” generic drug unless medical evidence
is written by physician on the is provided through a Brand Request
prescription Form
▪ Introduction of Canada Life’s Health
Case Management (HCM) program
▪ Introduction of Canada Life’s SMART
program
January 19-20, 2021 16Drug Management: Mandatory Generic Substitution
▪ Important Definitions
– Single Source Brand: drugs that do not have a generic equivalent available and are
still covered by a patent
– Multi Source Brand: drugs that have a generic equivalent available in the market but
are sold under a brand or trade name
– Generic: drugs that share the same active medicinal ingredient to the brand name
version and are available to consumers once a patent has expired
▪ Most generic drugs are a small fraction of the cost of their brand name equivalent
This change is responsible for the majority of plan savings,
which are being reinvested back into the program through the
Coverage Enhancements
January 19-20, 2021 17Drug Management: Health Case Management
▪ Canada Life’s Health Case Management (HCM) program is designed to assist plan
members who have been prescribed specialty medications to treat complex, chronic
conditions (like rheumatoid arthritis and Crohn’s disease)
▪ Canada Life has engaged HealthForward Inc. to provide this service
▪ Plan members who have been prescribed a certain specialty medication will be
connected with a health case manager, who is a qualified health care professional
– Health case managers work with plan members and their physicians to help identify
the most effective and appropriate treatment as well as provide ongoing support and
monitoring, including:
• Providing support services
• Ensuring medication is taken as directed
• Monitoring medications for a trial period
▪ Cost savings will be realized by directing members taking these specialty medications
towards Canada Life’s designated pharmacy network
Research conducted in 2017 by Canada Life shows that HCM
administered with routine care delivered better health outcomes
to the plan member than routine care alone!
January 19-20, 2021 18Drug Management: SMART
▪ Canada Life’s “SMART” – Sustainable, Managed, and Reasonable Treatment – drug
management program focuses on how drugs are added to the plan moving forward
– Currently all drugs approved by Health Canada would be automatically added to the
plan
– Under this program, new drugs are added to plan only if they are cost and clinically
effective
• Process is triggered when a new drug (or new indication on an existing drug) is
approved by Health Canada
• Independent consultants and TELUS experts conduct the review process by
assessing the drug’s clinical effectiveness, safety, cost effectiveness, economic
impacts, and product listing agreements
• As a result of the process, the new drug is either:
⬧ Added to the drug plan;
⬧ Added to the drug plan with prior approval required; or
⬧ Excluded from coverage
• Review process should take 6-9 months
If a drug is currently being reimbursed by the plan, it will continue
to be reimbursed by the plan. SMART only applies to new drugs, or
new indications for an existing drug, moving forward
January 19-20, 2021 19Coverage Enhancement: Paramedical Practitioners
Current Plan Proposed Plan
▪ Psychologist coverage: $743/year ▪ Psychologist coverage: $943/year
▪ Eligible practitioners under this ▪ Eligible practitioners under this
maximum include registered maximum include registered
psychologists or a qualified psychologists, a qualified social
social worker who has a worker who has a master’s
master’s designation designation, registered social
workers, and psychotherapist
▪ Physiotherapist coverage: $743/year ▪ Physiotherapist coverage: $743/year
▪ Eligible practitioners under this ▪ Eligible practitioners under this
maximum include maximum include
physiotherapists or physiotherapists, occupational
occupational therapists therapists, and athletic
therapists
▪ Doctors notes (i.e. physician ▪ Doctors notes (i.e. physician
referrals) are required for Massage referrals) will no longer be required
Therapists, Speech Therapists, for Massage Therapists, Speech
Psychologists, and Dieticians Therapists, Psychologists, and
Dieticians
January 19-20, 2021 20Coverage Enhancement: Other Items
Current Plan Proposed Plan
▪ Dependent child coverage: unmarried ▪ Dependent child coverage: unmarried
children under age 21, or under age children under age 21, or under age
23 if they are full-time students 25 if they are full-time students
▪ Out-of-Country Emergency Care ▪ Out-of-Country Emergency Care
Maximum: $1,000,000 lifetime Maximum: $5,000,000 lifetime
▪ No coverage for continuous glucose ▪ Addition of coverage for
monitors continuous glucose monitors
▪ Maximum of $4,000/year
▪ No coverage for in-vitro fertilization ▪ Addition of coverage for in-vitro
fertilization
▪ Reasonable and customary
limits will apply
January 19-20, 2021 21No Other Changes
▪ No changes are being made towards coverage for non-Health benefits, including:
– Life Insurance
– Disability
– Dental
▪ The proposed design does not address existing coverage gaps to Vision or Chiropractic
coverage
– Existing coverage was highlighted as an area needing improvement when reviewed
through the competitive review process
– Employee survey feedback also highlighted the need to address these items
▪ The HBR group investigated a few alternatives to get improved Vision and Chiropractic
coverages, including mandatory employee contributions, increased out of pocket
maximums, or reductions in coverage in other areas
– Ultimately, no palatable option could be found to fund these benefits given the existing
cost constraints and desire to minimize negatively impacting lower income members
January 19-20, 2021 22Additional Next Steps
▪ The Pension & Benefits committee will also be reviewing the following items highlighted
by the Holistic Benefits Review working group:
– Investigating the expansion of plan eligibility to provide access on a premium-paying
basis for those current ineligible. Examples include:
• Temporary employees
• Retiree Coverage for those not meeting the 10 years of service eligibility
requirement
⬧ Required member contributions for those with less than 10 years of service
determined on a pro-rata basis
– Review of the University’s existing insurance partners
– Investigate opportunities/partnerships to add Dental coverage for retirees outside of
the current University benefits plan
– Maintaining a working group to review ongoing change suggestions to the Benefits
plan
January 19-20, 2021 23Summing It Up
Three administrative changes to drug
plan management are proposed to ensure
1 funds are being spent wisely
Generated drug plan savings are being
2 reinvested back into the Health plan
through coverage enhancements
Proposed plan design balances cost
3 neutrality requirement with enhanced plan
features with little member impact
January 19-20, 2021 24Q&A January 19-20, 2021 25
You can also read
