Retirees Health and Travel Benefit Plans

Report
Retirees
Health and Travel
Benefit Plans
June, 2013
General Information
The following information is provided to assist you in understanding the major differences
between the current retiree plan with Pacific Blue Cross (PBC), and the new plan, effective
July 1, 2013, with Johnson Inc. Should there be any discrepancies, the official plan contracts
with the individual carriers will govern in all cases.
Please note that plan benefits, especially provisions for the stand alone travel plans and
premium rates, are subject to change.
It is important that you fully understand the provisions and exclusions of your health plans,
especially in terms of pre-existing conditions and out of province/country travel coverage.
It is also important to note that the UVRA is not able to assist you in determining which of
these plans may be best for your own personal situation. Please contact PBC or Johnson’s
directly for specific provisions and limitations of the various plans.
Plan Design Features
Eligibility
One time open
enrolment period – for
retirees currently not
covered by an employer
sponsored group plan
Ongoing enrolment – for
retirees covered by
another similar group
plan
Johnson’s Plan
PBC Plan
UVRA Members in good UVic retired faculty and
standing – age 55 or staff – age 55 or older
older
From July 1, 2013 to
August 31, 2013, without
evidence of insurability
Within 60 days of the
termination of a
employer sponsored
group plan – otherwise
evidence of insurability is
required
Closed
Within 60 days of the
termination of the UVic
group plan – otherwise
plan is not available
Extended Health Benefits
Plan Design Features
Deductible per year
Lifetime Maximum per
insured person
Pay Direct Card
Co-Insurance
Medical & Ambulance
Private Duty Nursing
Johnson’s Plan
PBC Plan
None
$100 or $1,000
$200,000
$50,000 or $100,000
Yes
No
80%
80%
Yes
Yes
$3,000 per 3 years
$10,000 per year or
$25,000 per lifetime,
whichever occurs first
Plan Design Features
Hearing Aids
Paramedical Services
Health Education
Programs
Vision Care
Eye Exams
Hospital Care
Orthotics
Johnson’s Plan
PBC Plan
$600 per 3 years
No
$1,000 combined per
year
$300 combined per year
$100 per year
No
$400 per 2 years
No
1 exam per 2 years – up
to $100
No
Up to $165 per day
Semi-private room
$300 per 3 years
$250 per year
Plan Design Features
Johnson’s Plan
PBC Plan
Prescriptions
All drugs (some
exceptions apply)
Those covered by
Pharmacare Formulary
Annual Drug Maximums
$2,000 or $4,000
options PER
HOUSEHOLD
No Annual Maximum
(other than lifetime max)
Dispensing Fee Cap
$10 per prescription
None
Drug Mark Up Limit
8%
As per Pharmacare Limits
Subject to Pharmacare
Limits
Yes
Yes
Required
Required
Registration with
Pharmacare
Monthly Premiums
as of July 1, 2013
Johnson’s
By Drug Max Option
PBC
By Annual Deductible - for
the $100,000 lifetime
maximum plans
$2,000
$4,000
$1,000
$100
Single
$107
$193
$30.94
$108.58
Couple
$182
$328
$70.24
$195.44
Family
$246
$442
Dental Benefits
Plan Design Features
Johnson’s Plan
PBC Plan
Option A - Enhanced
Can be together with
EHB, or stand alone
Must also join EHB Plan
Basic Preventative
80% - no annual max
70%
Minor Restorative
80% - combined to a
max of $750 per year
70%
Major Restorative
50% - max $700 for
crowns, $700 for
bridges per year
50%
For a total overall
combined max of $1,500
per year
Basic Preventative
80% - no annual max
No second option
available
Minor Restorative
80% - combined to a
max of $750 per year
Major Restorative
Not Covered
Option B - Basic
Monthly Premiums
as of July 1, 2013
Johnson’s
PBC
Enhanced
Basic
Option
A
Option
B
Single
$51.50
$42.00
$47.34
N/A
Couple
$103.00
$84.00
$89.95
N/A
Family
$123.00
$97.00
N/A
N/A
Travel Benefits
Johnson’s
Type of Plan
Part of the
Johnson’s
Package
Medoc
PBC
Stand Alone
Stand Alone
Maximums
$2 million lifetime
$5 million during
period of policy
$5 million per
policy year
Multiple Trips
Up to 62 days per 17 or 35 day plans
trip
available
Plans available
for 30 days or
less, or 31 days
and over
Trip Cancellation
Interruption
Pre-Existing
Conditions
Qualifying for
Coverage
$6,000 per trip
per insured
$8,000 per trip
Limited to
per insured amount shown on
travel certificate
“Sudden and
Unforeseen”
Stable in the 90 Depending on age
days prior to
and type of
departure or
condition – may
booking
not be covered
Automatic if
signing up during
open enrollment
Must qualify year
by year
Must qualify year
by year
Johnson’s
Travel Premiums
Premium Costs
Medoc
PBC
Everyone pays the
same premium, Rates differ based Rates differ based
regardless of age on age and health on age and health
or health
condition
condition
condition
Can not purchase
this travel plan on
its own, must be
combined with
the EHB Plan
Can purchase this
travel plan on its
own
Can purchase this
travel plan on its
own
Add the following
to the Johnson’s
EHB Rates:
Single - $21
Couple - $41
Family $50
Rates vary
according to age
and health
condition
Rates vary
according to age
and health
condition
Which Plan is right for You??
One size does not fit all
Both plans have advantages and disadvantages
Depends on individual circumstances – health, age, drug
usage, travel, etc
UVRA can not recommend which plan is best for your
personal circumstances
Need to review the benefits & limitations of each plan, as
well as overall costs, to determine which is best for you
Important to remember that these are insurance plans –
intended to protect you in case of catastrophic events
Also important note for members of the PBC retirees plan –
if you opt out of it, you can not reinstate it at a later date
Please visit the UVRA website http://web.uvic.ca/retirees/
for access to the Johnson plan details

similar documents