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REGIONAL MEETINGS Spring 2012. 1.Welcome and Introductions 2.Financial Summary 3.LTD Offsets, Third Party Claims & Overpayments 4.JEIS Committees: Roles.

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Presentation on theme: "REGIONAL MEETINGS Spring 2012. 1.Welcome and Introductions 2.Financial Summary 3.LTD Offsets, Third Party Claims & Overpayments 4.JEIS Committees: Roles."— Presentation transcript:


2 1.Welcome and Introductions 2.Financial Summary 3.LTD Offsets, Third Party Claims & Overpayments 4.JEIS Committees: Roles & Functions 5.PEBT Website 6.Feedback and Questions Welcome & Introductions

3 PEBT Trustees Member TrusteesEmployer Trustees Anne Bell CUPE Local 459 - SD 62 Sooke Chair Alan Chell, SD 19 Trustee, BCPSEA Vice Chair Vice Chair Tina Meadows - CUPE National RepresentativeLoris Pante - SD 36 Surrey Colin Pawson - CUPE Local 1091 - SD 37 DeltaBryan Mix - SD 57 Prince George Elaine Smith - CUPE Local 1260 - SD 35 LangleyJoe Strain - SD 37 Delta Rob Hewitt - Assistant Regional Director, CUPE BC Lynda Minnabarriet - SD 74 Gold Trail and SD 53 Okanagan Similkameen Leslie Franklin - CUPE Local 703 - SD 42 Maple Ridge-Pitt Meadows Laura Buchanan - BCPSEA Labour Relations Consultant

4 Welcome & Introductions  All Trustees serve on one or more committees  Committees meet regularly and provide updates and recommendations to the Board for discussion and formal adoption  JEIS Committee  Finance and Audit Committee  Investment Committee  Administration Committee  Plan Design Committee  Litigation Committee

5 Welcome & Introductions  Service Providers:  Desjardins  Morneau Shepell  Other Attendees:  CUPE Staff Representatives  BCPSEA Staff

6 Welcome & Introductions PEBT Conference & Regional Meetings  2010 - Fall Conference  195 attendees  Health and wellness focused speakers  Pre-conference workshop for new JEIS committee members  LTD Plan and Financial Overview of the Plan  JEIS Survey results  2012 - Regional meetings April/May  2013 - Conference  JEIS Poster Distribution

7 Welcome & Introductions JEIS Posters

8 Welcome & Introductions


10  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 funded initially by government advance  Other Benefits Financial Summary




14  Renewal proposals are received from PEBT Benefit Providers by Morneau between October and December each year  Morneau reviews proposals, analyzes the numbers and presents their findings and recommendations to the Finance and Audit Committee. Benefits Renewal Process

15 Renewal Process  As part of the renewal process, extended health and dental surpluses are reviewed to determine if premium holidays for districts/members (if applicable) in the pool are warranted.  Finance and Audit Committee make recommendations to the Board regarding renewal negotiations. The Board considers recommendations and finalizes direction of proceedings  Underwriting and Rate Setting Policy is followed  Renewals are effective July 1 st of each year Benefits Renewal Process

16 Renewal Process  Once benefits provider renewal negotiations have concluded, renewal reports are prepared  Each school district/union local receives a custom report which includes:  Premium rates for each benefit  Summary of the surplus/deficit position if extended health and/or dental is ASO  Explanation for the underwriting methods, descriptions of trends and issues and usage data that may be affecting the cost of benefits Providing information to both parties gives everyone increased awareness of benefit costs Benefits Renewal Process

17 Cost Drivers  Higher Drug & Service Costs  Higher Usage  Increased Carrier Admin Costs  Shifting costs by government to private plans Benefits Renewal Process

18 Investment Summary  Investment strategy - actively managed  Funds distributed between two investment managers:  McLean Budden  bcIMC  Investment Committee continuously reviews investment diversification

19 Investment Summary PEBT Fund Returns:  2008 investment return -10.2%  2009 investment return 14.3%  2010 investment return 8.1%  2011 investment return 1.9%  Market fluctuations impact PEBT ability to support the fund.

20  2010 annual report as well as previous reports are available on the PEBT website  Includes audited financial statements Annual Reports

21 Questions?


23 Cost Controls  Direct Offsets  Canada Pension Plan  Third party benefit offset: –Sick leave, weekly indemnity etc  Worksafe BC  Proceeds from 3 rd party Claim – ICBC  CPP Disability – must apply for  Failure to apply means no LTD benefits  Desjardins follows up based on PEBT policy LTD Offsets and Overpayments

24  Overpayments: How do they occur?  CPP decision & retroactivity  Worksafe BC  Return-to-work  Ending Overpayments  Some will always occur  Key is follow up LTD Offsets and Overpayments

25 PEBT Policy  Recover overpayments  To not recover jeopardizes benefits of all  Not fair to have overpayment  Desjardins to work out satisfactory repayment schedule  Not saving money for Desjardins  Money goes back into the LTD program LTD Offsets and Overpayments

26 Reasonable Repayment Schedule  PEBT policy – if overpayment is made then recover  Member must repay - reasonable and fair  Interest is charged on repayments over 6 months  Each case determined on its own merits  Failure to repay means no benefit LTD Offsets and Overpayments

27 Third Party Claims  MVA  “Slip and Fall”  Product Liability  Medical Malpractice  Other LTD Offsets and Overpayments

28 Third Party Claims  Must sign the reimbursement agreement prior to receiving LTD benefits  Must keep Desjardins updated on settlement status  LTD Plan contains provisions which require repayment of past benefits and offset of future benefits when settlement received LTD Offsets and Overpayments

29 Questions? LTD Offsets and Overpayments


31 JEIS The primary goals of the JEIS program include :  Providing early identification of member needs and active, caring assistance of plan member health issues  Facilitating gradual return to work (GRTW) of members  Promoting open discussion and support for JEIS by local unions and school districts  Ensuring long term viability of “Core” LTD program  Contact from Health Care Management Specialist (HCMS) after 6 working days absence

32 JEIS JEIS Process  Initiated when District Absence Advisor notifies Union Representative and Desjardins that a member has been absent for 6 consecutive scheduled working days  Union Representative calls member first to explain the JEIS program and let them know that they will be receiving a call from a Health Care Management Specialist (HCMS) from Desjardins  HCMS contacts the member within 24 hours of notification to offer assistance

33 JEIS HCMS involvement  Varies depending on the member’s needs  Sends out Early Notification Package (if required)  Explains how JEIS works  Arranges face-to-face meeting with member, if appropriate  Gathers and reviews information about member’s injury/illness and develops a GRTW/accommodation plan when appropriate  Communicates with all stakeholders to monitor the member’s progress and to ensure GRTW plan is being followed  Remains in contact with member until their successful return to work or transition to LTD  Provides District JEIS Committee with monthly status reports to facilitate discussion of individual cases  Meets with Districts JEIS Committee to discuss status report, as needed

34 Role of District JEIS Committee  Different level of involvement depending on your district/union member needs  Heartbeat of the JEIS Program  Front line – you make it work  You are the champions for this program  Program will not reach its potential without you District JEIS Committees

35  Early intervention critical  JEIS program only 120 days  Are you meeting the 6 day notification requirement?  If not, what are the barriers?  How do we reduce those barriers?  Average JEIS Notification Times Report is available on the PEBT website (updated quarterly) provided by Desjardins District JEIS Committees

36 Average JEIS Notification – January 2012

37 Monthly Report from Desjardins  Opportunity to review status of each case  Are there any concerns?  Can Committee members assist? District JEIS Committees

38 Accommodation Plans  Developed jointly  Assist in removing barriers  Resolve disputes  Collective agreement issues  Assist in implementing  Facilitate RTW plan

39 JEIS Integration with Wellness Programs  District Employee and Family Assistance Plan (EFAP)  For non-medical issues do we have a strategy in place for resolving issues with the assistance of the EFAP, if necessary?  Are members aware of the services available through their EFAP?  District Wellness Programs/Committees  Do our wellness initiatives assist those employees on a GRTW?  Do our sick leave policy procedures align with and support the efforts of the JEIS program? District JEIS Committees

40 Promote Program  Program’s ambassadors  Is this high profile in your district?  Are people educated in its importance?  JEIS posters  Online Pamphlet District JEIS Committees

41 Provide PEBT JEIS Committee with Feedback  Positive and negative  What is working, what is not working?  Share best practices with us  Tell us what you need District JEIS Committees

42 JEIS Committees Roundtable Discussion

43 Objectives of the PEBT website  Help plan members better understand the benefits and programs provided by the PEBT  Strengthen the identity and understanding of the PEBT among the various constituents  Communicate who, what, where the PEBT is  Clarify roles of the PEBT and its partners/providers  Make information more useful and easy/intuitive to use for members  Help members find answers to their questions  Educate members and other audiences PEBT Website

44 Website  Detailed information available for members, union local representatives and districts organized by:  About PEBT  About JEIS  About LTD  About Other Benefits  Archives  Financial Plan information

45 PEBT System User Group  Set up to enable users of the benefits administration system to provide feedback on the system and the user experience  Represents a cross section of school districts  2010 discussions resulted in several more changes made to improve the user experience of the website  Communication with the User Group intended to be ongoing with feedback requested as issues or problems arise


47 Questions? Thank you!

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