Transcript Other Benefits

PEBT CONFERENCE
November 26th and 27th 2013
Today’s Program Schedule
AM
9:00-10:00
10:00-11:00
Guest Speaker Dr. Susan Biali: Wellness Expert,
Medical Doctor and Life Coach
11:00-11:30
Break
11:30-12:15
JEIS Audit Review with Rob Hewitt, PEBT Trustee
and Rochelle Morandini, Morneau Shepell
12:15-1:15
PM
PEBT Financial and LTD Overview with Rob Hewitt,
PEBT Trustee and Ray Parker, Desjardins
Lunch
1:15-2:15
Guest Speaker Rebecca Marino: Tennis Star,
Speaker on Mental Health and Cyber Bullying
2:15-2:45
Q & A and Conference Closing
FINANCIAL SUMMARY
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 funding initially loaned by government
• Other Benefits
Long Term Disability
• 20,915 active members (December 31, 2012)
• Total number of active claims under 5 years
increased marginally in 2012 to 578
compared to 567 claims in 2010
• An additional 141 claims are being paid
beyond 5 years (durational pooling limit) as of
December 2012
• LTD Program costs have increased in 2012
Financial Summary
LTD Program Costs
MILLIONS OF DOLLARS
$20.8
$16.2
$16.5
$14.6
$11.9
$10.0
$11.2
$13.9
$14.8
Financial Summary
LTD Benefit Payments
MILLIONS OF DOLLARS
$7.2
$6.2
$4.7
$3.0
$1.2
$7.3
$7.5
$7.3
$7.3
Financial Summary
JEIS Program Costs
MILLIONS OF DOLLARS
$1.3
$1.1
$0.9
$0.7
$0.5
$0.6
$1.1
$1.2
$1.3
Financial Summary
PEBT Causes of Disability – Full Benefit Claims
Nervous system and
sensory organs
8%
Accidental
fractures –
bones and
skeletal muscles
28%
Neoplasms
13%
19%
Mental disorders
5%
14%
Diseases of the skin –
bones and skeletal muscles
Heart and circulatory
system diseases
Other Benefits
• Plan design and funding in accordance with
Collective Agreements
• Economies of scale
• Reduced expense charges
• Managing risk to reduce benefit costs
• Shared services approach (common
administration system) = efficiencies/savings
Other Benefits
Basic Group Life
• Pooled with other Districts
• Paid $2.7M in claims in 2012
• Premium is based on overall Plan
claims experience
Other Benefits
AD&D (including optional)
• Pooled with “similar block of business”
• Paid claims in 2012:
- No Basic AD&D claims
- One Optional AD&D claim
totalling $200,000
Other Benefits
Extended Health Care (EHC)
• ASO with Stop-Loss for large claims
- Stop-Loss coverage for large claims
transfers risk to insurer
• Small Districts initially had opportunity
to enter into a pooled arrangement
Other Benefits
Extended Health Coverage
• Approximately 20,980 covered members
• $19.9M claims paid in 2012
• 3.7% increase in extended health claims from
2011 to 2012
• Number of members increased slightly from 2011
• Primary cost drivers: drugs and paramedical
services
Other Benefits
PEBT EHC Claims – 2012
Vision Care
Medical supplies/
equipment
Other
9%
2%
7%
Paramedicals
22%
60%
Drugs
Other Benefits
Top 5 Drugs by Category as a Percentage of Total Drug Claims
JANUARY-DECEMBER 2012
25%
17%
Central
Nervous
System
Cardiovascular
7%
7%
Gastrointestinal
Antiinfective
agents
6%
Antidiabetic
Other Benefits
Dental Coverage
• Approximately 21,000 covered members
• $23.1M claims paid in 2012
• 2.6% increase in Dental claims from 2011 to 2012
• Number of members increased slightly from 2011
• Primary cost drivers: new and expensive treatments,
aggressive marketing by dental community
Other Benefits
PEBT Dental Claims – 2012
Ortho
8%
Major
22%
70%
Basic
Investment Summary
• Investment strategy – actively managed
• Funds distributed between two investment
managers:
- bcIMC
- Mawer
• Mawer replaced McLean Budden June 2012
- Performance was consistently below
-
benchmark
Ownership changes
This led to a search
for another
investment manager
• Investment Committee continuously reviews
investment diversification
Investment Summary
PEBT Fund Returns
Investment returns
2008
2009
2010
2011
2012
-10.2%
14.3%
8.1%
1.9%
8.4%
• Market fluctuations impact PEBT ability to support the fund
Annual Reports
• 2011 annual report as well as previous
reports are available on the PEBT website
• Includes audited financial statements
• 2012 annual report will be available on the
website in mid-December
Available at: www.pebt.ca
Questions?
Up Next
LTD Overview
Ray Parker, Manager Disability Claims, Desjardins
Financial Services
Long Term Disability Benefit
• For Members who are regular employees working 15
hours or more per week with the Employer
• 66.67% of monthly earnings from the Employer
• $50 per month minimum benefit
• $10,000 per month maximum
• 120 calendar days elimination period
First 24 Months
• Elimination period
• Change of definition
• Regular duties
• Any occupation 60%
• 'No surprises'
• Transferrable skills
approach
analysis
Limitations and Exclusions
• Pre-existing conditions
• Layoff
• Committing or attempting to commit a criminal offence
• Riot, insurrection or civil commotion
• Alcohol and drug abuse
• Driving while impaired by drugs or alcohol
Offsets
• Paid Sick Leave
• WorkSafe BC
• Canada Pension Plan
• ICBC Part VII Benefits
Third Party Claims
• Types of claims
• Reimbursement Agreement
• Settlement follow-up
• Repayment
• Net Settlement
Termination of LTD Benefits
• No longer disabled
• Neglects or refuses to
provide proof of disability or
undergo a medical
examination
• Outside of Canada for more
than 2 weeks; 2 months
• Death or retirement
• 55 years of age and 35 years
of pensionable service
• Fails to comply with third
party claim requirements
• Not under continuing medical
care
• Refuses to participate in
disability management
program
Appeals
If there is additional
information
If there is no additional
information
• Encouraged to provide
• Medical Appeal
within 60 days
• Supervisor review
- 60 days/One year
- Medical grounds only
- Three physicians
- Final
Questions?