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* 0.5 part-time Member cost or 1.0 refers to a Member on a full-time non-statutory/unpaid leave
Rates include taxes. Rates are subject to change annually.
2. Administrative Plan/Practice Changes to the ETFO ELHT Education Worker Benefits Plan – Effective September 1, 2022 - REMINDER
The ETFO ELHT Board of Trustees is entrusted with the care and financial accountability of the ETFO ELHT Benefits Plans. As such, the Board of Trustees regularly monitors the Benefits Plans relative to available funding and makes plan adjustments as needed, to ensure we are providing valuable benefits to members within the available funding. The funding is negotiated by the parties to the agreement (i.e., ETFO, Crown, OPSBA).
With this in mind, the ELHT Board of Trustees is always reviewing the plans for ways to make administrative changes or implement best practices that allow plan coverage to be maintained to support plan members and their families. As a result, the following changes have been implemented effective September 1, 2022.
For more details about the below changes, please click here to view the information communicated on May 18, 2022 .
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Implement reference-based pricing on proton pump inhibitors
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Switch from reference biologic drugs (Humira, Enbrel, Lantus) to biosimilar drugs (**UPDATE - Manulife mailed affected plan members in June 2022 with specific information information regarding this change and action required)
- Change the Coordination of Benefits (COB) rules from reimbursement based on submitted amount to reimbursement based on eligible amount
- Remove Dukoral from list of eligible drugs
- Implement a surgical stocking preferred provider program
- No longer allow lump sum payments for orthodontics
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Switch from payroll deductions to pre-authorized deductions (PAD) for member-paid benefits (**UPDATE - OTIP emailed affected planmembers in mid to late August with instructions how to take action to add their banking information; for more information, click here)
- Further expand practitioners covered under the psychology/counselling paramedical benefit (effective retroactive January 1, 2022)
3. Education Worker Benefits Plan Contingency Plan - UPDATE
As communicated in the May 18, 2022 email to plan members, the 2019-2022 ETFO Central Agreement requires the ETFO ELHT Board of Trustees to make changes to the Education Worker Benefits Plan should the three-year valuation projections show the claims fluctuation reserve falling below the required 8.3% threshold. This year's valuation again showed that the Education Worker plan will fall below the 8.3% threshold before the end of 2023, with positive funding levels remaining extremely sensitive on the outcomes of the 2022-2023 round of Central Bargaining.
The Board of Trustees completed preliminary Contingency Plans with options to reduce plan benefits and/or introduce a member-paid premium share if the 2022-2023 round of Central Bargaining does not result in the necessary increases to funding.
The ETFO ELHT Board of Trustees committed to communicating a summary the Contingency Plans with ETFO ELHT Plan Members no later than September 2022. Any of the possible Contingency Plan changes to the benefits plan will be contingent on the outcome of Central Bargaining, and if required, are not expected to be implemented prior to September 1, 2023. Click here to view the Education Worker Contingency Plan summary. An updated Contingency Plan, if required, will be communicated to plan members at the conclusion of the 2022 valuation in June 2023.
4. ETFO ELHT Annual Plan Member Meeting - REMINDER
As communicated in the May 18, 2022 email to plan members, the Board of Trustees for the ETFO Employee Life and Health Trust (ELHT) invites you to attend the 5th ETFO ELHT Annual Plan Member Meeting, scheduled for September 22, 2022 at 4:30 p.m. EST. This will be a virtual meeting, and all ETFO members who are eligible for the ETFO ELHT Benefits Plan may participate through a live audio stream. The ELHT Board of Trustees will provide their yearly update based on the 2021 Annual Report, which was posted on the website at the end of June 2022.
Live audio streaming details:
This is a virtual meeting. A live audio stream of the presentation will be available by clicking here OR use the following link in your web browser: https://video.teleforumonline.com/video/streaming.php?client=13879
If you are unable to participate on September 22, 2022, you will be able to view the presentation at a later date. A link to a recording of the meeting will be posted on the website the week following the meeting.
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