PEBT CONFERENCE November 26 th and 27 th 2013. Today’s Program Schedule AM PM 9:00-10:00...
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Transcript of PEBT CONFERENCE November 26 th and 27 th 2013. Today’s Program Schedule AM PM 9:00-10:00...
PEBT CONFERENCE
November 26th and 27th 2013
Today’s Program Schedule
AM
PM
9:00-10:00
10:00-11:00
11:30-12:15
12:15-1:15
1:15-2:15
2:15-2:45
PEBT Financial and LTD Overview with Rob Hewitt, PEBT Trustee and Ray Parker, Desjardins
Guest Speaker Dr. Susan Biali: Wellness Expert, Medical Doctor and Life Coach
Break
JEIS Audit Review with Rob Hewitt, PEBT Trustee and Rochelle Morandini, Morneau Shepell
Lunch
Guest Speaker Rebecca Marino: Tennis Star, Speaker on Mental Health and Cyber Bullying
Q & A and Conference Closing
11:00-11:30
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
$10.0$11.9 $11.2
$16.2
$20.8
$16.5$14.6 $13.9 $14.8
LTD Program CostsMILLIONS OF DOLLARS
Financial Summary
$1.2
$3.0
$4.7
$6.2
$7.2 $7.3 $7.5 $7.3 $7.3
LTD Benefit PaymentsMILLIONS OF DOLLARS
Financial Summary
$0.5 $0.6$0.7
$0.9
$1.1
$1.3
$1.1$1.2
$1.3
JEIS Program CostsMILLIONS OF DOLLARS
Financial Summary
PEBT Causes of Disability – Full Benefit Claims
Nervous system and sensory organs
8%
14%
28% 19%
13%
5%
Accidental fractures – bones and skeletal muscles
Diseases of the skin – bones and skeletal muscles
Neoplasms
Mental disorders
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
Medical supplies/equipment
2%
22% 60%
9%
7%
Paramedicals
Vision Care
Drugs
Other
Other Benefits
Top 5 Drugs by Category as a Percentage of Total Drug ClaimsJANUARY-DECEMBER 2012
25%
17%
7% 7% 6%
Central Nervous System
Cardio-vascular
Gastro-intestinal
Anti-infective agents
Anti-diabetic
Other Benefits
• 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
Dental Coverage
Other Benefits
PEBT Dental Claims – 2012
22%
70%
8%
Major
Basic
Ortho
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
• Investment Committee continuously reviews investment diversification
This led to a search for another investment manager
Investment Summary
• Market fluctuations impact PEBT ability to support the fund
PEBT Fund Returns
Investment returns
2008 2009 2010 2011 2012
-10.2% 14.3% 8.1% 1.9% 8.4%
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
• Regular duties
• 'No surprises' approach
• Change of definition
• Any occupation 60%
• Transferrable skills 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
• Encouraged to provide within 60 days
• Supervisor review
If there is additional information
• Medical Appeal
- 60 days/One year
- Medical grounds only
- Three physicians
- Final
If there is no additional information
Questions?