From: John Meyer, Chair WURA Benefits & Pension Comm.; 3rd Rev. 4.17.02
A COMPARATIVE ANALYSIS OF INDIVIDUAL HEALTH BENEFIT PLANS
FOR & FROM WURA
CURRENT UNIVERSITY-GREEN SHIELD PLAN:
Upon regular retirement (65 yrs), the retiree is given a opportunity to enrol in a special plan, group plan no. 5231, for retirees carried by the University and contracted to Green Shield. You have four options (SEE APPENDIX 1) of selecting various components, e.g., drugs, hospital, dental, travel. Presently, there is an open window for enrolling in the more expensive component, i.e., drugs. This plan is now available to an individual, couple, or a family. All the liability is carried by the Univ. Windsor. The DENTAL PLAN IS NOT under this plan but under the active Faculty plan and by means of the collective agreement (F 3bi, p. 127) is paid $50% by the University & 50% by the subscriber (2002 = $23.00/45.00/63.00)
Individual Couple Family
all included | $ 214 | 427 | 577 |
no drugs | 71 | 142 | 185 |
Conditions:
* 8% prov. tax INCLUDED in Human Resource table (See APPENDIX 1)
* the retiree subscribers (12) to the drug component are so minimal that premiums must be high;
* the plan does have "luxury" items that most other plans do not have, e.g.,
over-the counter, paid deductibles including for ODB, 180 days out of province,
no maximums for many components, an open OPT IN for drug component.
A "PROPOSED" (2003) UNIV.-GREEN SHIELD REDESIGNED RETIREE PLAN:
In order to lower premiums and include the drug component, Green Shield has
prepared a proposal that requires the following premiums.
Individual Couple Family
all incl. | $ 180 | $ 359 | $ 460 |
Conditions:
* 8% prov. tax NOT INCLUDED;
* Includes: drugs, extended heath service (= EHS or EHB), semi-private, dental, travel, (usually 80%+ reimbursement; a few maximums);
* every subscriber must take the drug component;
* one window of opportunity to enrol;
* liability assumed by Green Shield rather than University as is currently the case;
* would include all current and future retirees;
** FURTHER REFINEMENTS WOULD REDUCE THE PREMIUMS BUT ADD LIMITATIONS:
Individual Couple
all -coverage | $ 135 | $ 270 |
Conditions: subscriber pays dispensing fee, a $100 deductible; no
over-counter, generic drugs first; $1200 max p.yr. drugs; 150 max on semi-priv.
per day; & EHS (co-pay 10% + limit on physio $300 per yr. & chrio)
ALTERNATE HEALTH PLANS AVAILABLE TO ON A PRIVATE BASIS:
The following health benefit plans have been reviewed and compared. It should be noted that a retiree subscribing to his/her first retirement plan or a retiree changing from one plan to another normally has a limited window of opportunity, e.g. immediately upon Univ. retirement, or within 60/90 days when switching plans. Obviously, one would not want to be without the appropriate insurance for any period of time.
The following plans apparently pose no problem for academics retiring from an Ontario college or university. They are considered educators.
RTIP = Retired Teachers Insurance Plan: THE GOLD PLAN (drugs,
hospital, ext. services, travel (NO dental as must pay Univ. for 50% co-pay; NO
drugs at and after age 65 beginning Jan. of birthday year.)
Indiv. Couple Family
all exc. dental & drugs 65+ | $ 60 | $ 115 | $ 145 |
* Includes: eye exam every two yrs., trip cancellation ($6000), hearing tests & aids $500 every 3 yrs., up to $200 every 3 yrs for vision care
* Limitations: couple rated on ages 65-69; 20% co-pay & maximums on EHS components, 60 days out-of-prov. travel but top-up at cost
OSSTF = Ontario Secondary School Teachers Federation: THE ARM (Active Retired Members Health Ins. Plan) Annual mem. fee required = $50.00 per yr.
Indiv. Couple Family
all except dental | $ 71 | $ 142 | $ 169 |
* Inc.: all as in other plans above;
* Limitations: drug max. of $1200 p.yr.; hearing ($400 max 3 yrs); vision
max; travel = 60 days & top-up; cancellation ins. ($2000); max on some items
CURC = Comprehensive Union Retiree Coverage: PLAN F, carrier
Green-Shield
Indiv. Couple Family
all except travel & dental | $ 72 | $ 140 | $ 170 |
* Includes: no co-pay required to maximum of covered benefit;
* Limitations: indiv. member fee = $25.00; NO travel ins. but can purchase at
CARP = Canadian Association of Retired Persons (annual membership fee
including spouse = $25.00) - carrier Liberty Health
Combined dental*** & health: FOUR STAR PLAN (EHB, hospital, drugs,
dental)
Indiv. Couple* Family**
all except travel | $ 92 | $ 166 | $ 193 |
* rated on ages of partner (here both in 65-69 range);
** rated as addition to couple rate on 1-2 children 5-20 yrs;
***this is a package that requires that dental benefits be included hence one could not make use of the dental component of the Univ-Green-Shield at 50/50.
CAA = Canadian Automobile Association: membership required ; carrier =
Liberty Health: ENHANCED PLAN ( dental, EHB, hospital)
Indiv. Couple* Family**
all except travel | $ 79 | $ 150 | $ 181 |
* couple rated on ages of partners;
** rated as addition to couple rate on 1-2 children, 5-20 yrs.
*** limitations: as above plans
GREEN SHIELD: "Individual" PLAN 2 (drugs, EHB, semi- private)
Indiv. Couple Family
all except travel | $ 79 | $ 153 | $ 186 |
* Limitations: as some above, maximums on most items, some dependent on years
in the plan; assume family is same as other plans = 1-2 children 5-20.
LIBERTY HEALTH INSURANCE: "flexcare" Plan: largest health insurer
Indiv. Couple
all except travel & drugs | $ 40 | $ 80 |
ONTARIO BLUE CROSS Indiv. Couple
all except dental | $ 82 | $ 162 |
* 80% to specified maximums for extended health; no drugs covered after 65, travel benefits limited to 15 days per trip for multiple trips.
CLARICA (+ SUN LIFE): Indiv. Couple
Clarica, includes
dental |
$ 82 | $ 145 |
* 3 PLANS, "STANDARD" PLAN CITED: 70% drugs to $2000 per year; 75% extended
health @20.00 per visit; 100% vision every 2 yrs; 70% dental to $750 max.;
travel first 30 days per trip; hospital $175 max p.day for lst 30 days.
GREAT-WEST LIFE: Indiv. Couple
Basic Plan Direct, exc. dental & travel | 91 | 164 |
* 5 PLANS & 3 CATEGORIES OF RATES, above is basic preferred rate, hosp.
$175 p.d. up to 90 days; drugs 90% to max. $750 p.yr.; in-home nursing 36 mon.,
max. $3500 p.yr.; no vision, no hearing, no dental or travel, total max
p.yr.$15,000
CONCLUSION: General Similarities of the health plans
reviewed above:
Current Plan Indiv. ** Couple Family
drugs + all | $ 214 | $ 427 | $ 577 |
no drugs | $ 71 | $ 142 | 185 |
GREEN SHIELD
UWINDSOR Individual Couple Family
Proposed luxury | $ 180 | $ 359 | $ 460 |
(BOTH exclude dental)
Individual Couple
Proposed Design Changes (max) | $ 135 | $ 270 |
ALTERNATE PLANS: (all = every component except where indicated + 8% Prov. tax)
Individual Couple Family
RTIP - all-except dental & drugs after 65 | $ 60 | $ 116 | $ 145 |
OSSTF-ARM- all ex. Dental | $ 71 | $ 142 | $ 169 |
CURC - all exc. Dental/travel | $ 72 | $ 140 | $ 170 |
CARP - all - exc.
dental & travel |
$ 92 | $ 166 | $ 193 |
CAA - all exc. travel | $ 79 | $ 150 | $ 181 |
Green Shield indiv. plan - all except travel | $ 79 | $ 153 | $ 186 |
Indiv. Couple
Manulife Financial: "Follow Me Plan", negotiated, all except dental & travel | $ 70 | $ 125 |
Liberty Ins. "flexcare" plan
Execept travel & dental |
$ 40 | $ 80 |
Ontario Blue Cross, except dental | $ 82 | $ 162 |
Clarica, includes
dental |
$ 82 | $ 145 |
Great-West Life, except dental & travel | 86 | 155 |
APPENDIX 1:
2002-03, UNIVERSITY OF WINDSOR- FACULTY RETIREMENT GREEN SHIELD PLAN
COVERAGE | OPTION 1 | OPTION 2 | OPTION 3 | OPTION 4 |
TOTAL PACKAGE | NO DENTAL | NO DRUGS | DENTAL ONLY | |
INDIVIDUAL | $ 213.73 | $ 190.99 | $ 71.03 | $ 22.74 |
COUPLE | 427.43 | 381.96 | 142.03 | 45.47 |
FAMILY | 577.15 | 514.63 | 184.73 | 62.52 |
APPENDIX 2
A COMPARISON OF POST RETIREMENT BENEFITS OF CANADIAN UNIVERSITIES OFFERING BENEFITS THROUGH COLLECTIVE AGREEMENTS
Compiled by John R. Meyer, rev. June, 2001 (from: COU & CAUT reports in
2000 (1999 stats); life insurance benefits not included as too much variance;
HEALTH/DENTAL BENEFITS ONLY).
University Carrier Who Pays? Comments
Univ. 70%; dental 50/50% $10 S, $30 F Life Major med.=$10,000 lifetime Life 175 S, $275 F; *** The above table will be up-dated as relevant information appears from new
"collective agreements".
RECOMMENDATIONS : 1. KEEP CURRENT "LUXURY" PLAN BUT GET MORE CONTRACTUAL SUBSIDIES IN NEXT
COLLECTIVE AGREEMENT COMPARABLE TO MANY OTHER UNIVERSITIES (SEE APPENDIX 2 TABLE
currently being monitored for any changes)
2. CONTINUE TO EXPLORE THE FEASIBILITY OF AN ACADEMIC RETIREES' NATIONAL OR
PROVINCIAL PLAN THAT WOULD PROVIDE LOWER PREMIUMS. This has already been suggested for the May 30-31, 02 meeting in Toronto of
the Canadian College and University Retirees (presently called "CAERA". Perhaps
OCUFA and COU should also be involved in this type of initiative. 3. CONTINUE THE FEASIBILITY STUDY OF THE 10 GREEN-SHIELD-UNIVERSITY HEALTH
BENEFIT PLANS WITH AN OBJECTIVE OF A POTENTIAL FOR UNIFICATION OF PLANS AND
THEREBY INCREASING VOLUME AND LOWERING PREMIUMS.
Calgary
Johnson
Extended benefits ARTA
Prov. Teacher's Assoc.
Carleton
Clarica
Univ. = 100%
Min. employ of 5 yrs
Concordia
Clarica
50%/50%
Max=100,000 out prov
Guelph
Clarica
Health: mem 30%-
Manitoba
Great-West
Univ. 100% , incl. dental
until 75 but 25k max
McGill
Aetna
50% / 50%
life, health, dental
McMaster
Clarica
Univ. = 100%
dental employer paid
Ottawa
Clarica
Per schedule of Ont.Munic.Ret.Organ
retiree= $35 S, $90 F
PEI, ('94)
Blue Cross
Univ. 100%
Queen's
Great-West Life
shared: Mem. pays
add: Semi-priv. $12 S, 30 F
SimonFraser
Blue Cross
50%/50%
max=150k; ret. mem cat.
Toronto
Liberty
Univ.75%; Mem. 25%
Waterloo
Great-West
Univ. 100% , no dental
Limit on travel out, 60days
Western
Blue Cross
Univ.= 100%
travel ?
Wilfrid Laurier
Equitable
Univ. = 100% incl. dental;
2002 coll.agreement
York
Great-West
Univ.= 80%; MEM. pays month prem = $18 S, $ 34 F;
dental= Univ.65%;Mem. 35%
annual deductible =
WINDSOR
Green Shield
Univ.= 50% dental ONLY
INFERIOR TO ALL OF
ABOVE