UPDATES & REMINDERS - ETFO ELHT Teacher/LTO Plan Renewal, Administrative Plan Changes, Contingency Plan Summary, and Annual Plan Member Meeting



Dear ETFO ELHT Teacher/LTO Plan Member,

A similar email was sent to plan members on May 18, 2022. The following email acts as a reminder and provides additional updates where applicable. New or updated information is denoted by highlighted text.

1.    ETFO ELHT 2022 Teacher/LTO Benefits Plan Renewal - REMINDER

The ETFO ELHT Benefits Plan renews effective September 1st of each year. September 1, 2022 is the fifth renewal of our plan. If you are a teacher actively working in a 1.0 FTE position and have no supplemental or optional life, you are not affected by these rate changes.

After thorough analysis of plan usage, experience, funding, and rising dental and health care costs, the ETFO ELHT Board of Trustees approved the September 1, 2022 renewal. As a result, the Extended Health and Dental rates have been adjusted as follows effective September 1, 2022:

• Extended Health rates will increase by 4%
• Dental rates will increase by 4%
• NEW - There will be a rate decrease for: Basic and Supplemental Life (20% decrease)
• NEW - There will be a rate decrease*** for: Optional Member/Spouse /Child Life (15% decrease)
• No rate increases for:  Accidental Death and Dismemberment Coverage

These rate changes will only affect:

• Plan members on non-statutory leaves (e.g. unpaid leaves, deferred/member funded leaves, LTD/WSIB after 24 months) who pay for their Health and Dental premiums and/or
• Part-time teachers and Long-term Occasional teachers who pay a pro-rated share of their Health and Dental premiums and/or
• Any teacher who selected supplemental and/or optional life and/or teachers on non-statutory leave who maintained their basic life

Teacher and LTO Teacher Health and Dental Premiums – Effective September 1, 2022

**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.

***optional member/spouse/child life premium decreases can be viewed when you log into your OTIP secure member area

2. Administrative Plan/Practice Changes to the ETFO ELHT Benefits Plan – Effective September 1, 2022 - REMINDER

As communicated in the May 18, 2022 email to plan members, 

the ELHT Board of Trustees has reviewed the plan 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. 

1. Implement reference-based pricing on proton pump inhibitors
2. 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)
3. Change the Coordination of Benefits (COB) rules from reimbursement based on submitted amount to reimbursement based on eligible amount
4. Remove Dukoral from list of eligible drugs
5. Implement a surgical stocking preferred provider program
6. No longer allow lump sum payments for orthodontics
7. Switch from payroll deductions to pre-authorized deductions (PAD) for member-paid benefits (**UPDATE - OTIP emailed affected plan members in mid to late August with instructions how to take action to add their banking information; for more information, click here)
8. Further expand practitioners covered under the psychology/counselling paramedical benefit (effective retroactive January 1, 2022)

3. Teacher/LTO 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 Teacher/LTO 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 Teacher/LTO plan will fall below the 8.3% threshold before the end of 2024, 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 Teacher/LTO 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.

5. Questions?

To learn more about your benefits coverage, to view your benefits booklet, and access contact information for OTIP, please log in to the OTIP secure member site at www.otip.com.  

Visit www.etfo-elhtbenefits.ca for FAQs and ELHT announcements. Questions about this notice can be directed to the ETFO ELHT at [email protected].

Respectfully,

Suzanne Gill, Executive Director

On behalf of the ETFO ELHT Board of Trustees