Presentation on theme: "Retirees Health and Travel Benefit Plans June, 2013."— Presentation transcript:
Retirees Health and Travel Benefit Plans June, 2013
General Information The following information is provided to assist you in understanding the major differences between the current retiree plan with Pacific Blue Cross (PBC), and the new plan, effective July 1, 2013, with Johnson Inc. Should there be any discrepancies, the official plan contracts with the individual carriers will govern in all cases. Please note that plan benefits, especially provisions for the stand alone travel plans and premium rates, are subject to change. It is important that you fully understand the provisions and exclusions of your health plans, especially in terms of pre-existing conditions and out of province/country travel coverage. It is also important to note that the UVRA is not able to assist you in determining which of these plans may be best for your own personal situation. Please contact PBC or Johnsons directly for specific provisions and limitations of the various plans.
Plan Design FeaturesJohnsons PlanPBC Plan Eligibility UVRA Members in good standing – age 55 or older UVic retired faculty and staff – age 55 or older One time open enrolment period – for retirees currently not covered by an employer sponsored group plan From July 1, 2013 to August 31, 2013, without evidence of insurability Closed Ongoing enrolment – for retirees covered by another similar group plan Within 60 days of the termination of a employer sponsored group plan – otherwise evidence of insurability is required Within 60 days of the termination of the UVic group plan – otherwise plan is not available
Plan Design FeaturesJohnsons PlanPBC Plan Deductible per yearNone$100 or $1,000 Lifetime Maximum per insured person $200,000$50,000 or $100,000 Pay Direct CardYesNo Co-Insurance80% Medical & AmbulanceYes Private Duty Nursing$3,000 per 3 years $10,000 per year or $25,000 per lifetime, whichever occurs first
Plan Design FeaturesJohnsons PlanPBC Plan Hearing Aids$600 per 3 yearsNo Paramedical Services$1,000 combined per year $300 combined per year Health Education Programs$100 per yearNo Vision Care$400 per 2 yearsNo Eye Exams1 exam per 2 years – up to $100 No Hospital CareUp to $165 per daySemi-private room Orthotics$300 per 3 years$250 per year
Plan Design FeaturesJohnsons PlanPBC Plan PrescriptionsAll drugs (some exceptions apply) Those covered by Pharmacare Formulary Annual Drug Maximums$2,000 or $4,000 options PER HOUSEHOLD No Annual Maximum (other than lifetime max) Dispensing Fee Cap$10 per prescriptionNone Drug Mark Up Limit8%As per Pharmacare Limits Subject to Pharmacare Limits Yes Registration with Pharmacare Required
Monthly Premiums as of July 1, 2013 Johnsons By Drug Max Option PBC By Annual Deductible - for the $100,000 lifetime maximum plans $2,000$4,000$1,000$100 Single$107$193$30.94$108.58 Couple$182$328$70.24$195.44 Family$246$442
Plan Design FeaturesJohnsons PlanPBC Plan Option A - EnhancedCan be together with EHB, or stand alone Must also join EHB Plan Basic Preventative80% - no annual max70% Minor Restorative80% - combined to a max of $750 per year 70% Major Restorative50% - max $700 for crowns, $700 for bridges per year 50% For a total overall combined max of $1,500 per year Option B - Basic Basic Preventative80% - no annual maxNo second option available Minor Restorative80% - combined to a max of $750 per year Major RestorativeNot Covered
Monthly Premiums as of July 1, 2013 JohnsonsPBC EnhancedBasicOption A Option B Single$51.50$42.00$47.34N/A Couple$103.00$84.00$89.95N/A Family$123.00$97.00N/A
JohnsonsMedocPBC Type of Plan Part of the Johnsons Package Stand Alone Maximums$2 million lifetime$5 million during period of policy $5 million per policy year Multiple TripsUp to 62 days per trip 17 or 35 day plans available Plans available for 30 days or less, or 31 days and over Trip Cancellation Interruption $6,000 per trip per insured $8,000 per trip per insured Limited to amount shown on travel certificate Pre-Existing Conditions Sudden and Unforeseen Stable in the 90 days prior to departure or booking Depending on age and type of condition – may not be covered Qualifying for Coverage Automatic if signing up during open enrollment Must qualify year by year
JohnsonsMedocPBC Travel Premiums Everyone pays the same premium, regardless of age or health condition Rates differ based on age and health condition Can not purchase this travel plan on its own, must be combined with the EHB Plan Can purchase this travel plan on its own Premium CostsAdd the following to the Johnsons EHB Rates: Single - $21 Couple - $41 Family $50 Rates vary according to age and health condition
Which Plan is right for You?? One size does not fit all Both plans have advantages and disadvantages Depends on individual circumstances – health, age, drug usage, travel, etc UVRA can not recommend which plan is best for your personal circumstances Need to review the benefits & limitations of each plan, as well as overall costs, to determine which is best for you Important to remember that these are insurance plans – intended to protect you in case of catastrophic events Also important note for members of the PBC retirees plan – if you opt out of it, you can not reinstate it at a later date Please visit the UVRA website http://web.uvic.ca/retirees/ for access to the Johnson plan detailshttp://web.uvic.ca/retirees/
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