PLAN YEAR 2014 Flexible Benefits Guide A GUIDE TO YOUR BENEFITS FOR EXCLUDED EMPLOYEES IN THE BC PUBLIC SERVICE

Transcription

1 PLAN YEAR 2014 Flexible Benefits Guide A GUIDE TO YOUR BENEFITS FOR EXCLUDED EMPLOYEES IN THE BC PUBLIC SERVICE

2 TABLE OF CONTENTS Welcome 2 Program Overview 4 Eligibility 6 Co-ordination of Benefits 8 Effective Dates of Coverage 9 Initial Enrolment 12 Updating Benefits Coverage 14 Work Status Changes 16 Benefit Choices at a Glance 20 Medical Services Plan 23 Extended Health Plan 24 Dental Plan 35 Life Insurance Plans 41 AD&D Insurance Plans 47 Health Spending Account 51 Taxation 53 Other Benefit Programs 54 Contacts and Resources 55 Glossary 56 1

3 WELCOME Introduction Welcome to the Flexible Benefits Program for excluded employees of the BC Public Service. The BC Public Service recognizes that competitive compensation and benefit programs are integral to our ability to attract and retain employees who foster excellence in the public service. Under your Flexible Benefits Program, you can tailor your health and life insurance benefits to best meet your needs. Your health and life insurance benefits program provides choices in the following benefit plans: Medical Services Plan of B.C. (MSP) Extended health Dental Employee life insurance Optional life insurance Optional accidental death and dismemberment insurance Health Spending Account Value of your benefits program Benefits are an important component of your total compensation package. Your MSP premiums are 100 per cent employer paid and valued at over $800 per year (more if you have a family). The employer pays the full cost of your extended health and dental claims reimbursement, which, in some years, may be several thousand dollars. The group life insurance plan provides life insurance at a reasonable group premium rate and a portion of your premium is paid by the employer. These are just some of the benefits that comprise your total compensation package. A list of other benefit programs and leave provisions can be found on page 54. Know your benefits. Know your options. With choice comes responsibility. You must enrol in the Flexible Benefits Program to take an active role in choosing your benefits. Take the time to learn about your options and to decide how to best apply them to your personal situation. You will have the opportunity to update your options every year during Open Enrolment and after an eligible life event. Did you know? On average your benefits add over 20 per cent to your total compensation. The Flexible Benefits Program provides benefits in a tax effective manner. See page 53 for more information. 2

4 WELCOME How to use this guide This guide provides a comprehensive overview of your benefits program. Share the information in this guide with your family so you can make the most of your benefits program. We recommend that you review each section so you understand the benefits program available to you and any eligible dependents. Once you are familiar with your benefits program, you can use the guide as a quick reference for benefits information and related online forms. Important Pay particular attention to information in the sidebars important information is highlighted here. Features of this guide Sidebars: Sidebars on each page highlight particularly important information related to each section of the guide. Pay careful attention to information in the sidebars. Glossary: A glossary with terms that may be unfamiliar to you is available on page 56. Other benefits: Information about other benefit programs and leave provisions available to you can be found on page 54. Contact information: There is a contact page on page 55. This page also includes a link to a discussion forum where you can provide feedback on the usefulness of this guide. Note: This document provides details of benefit plans but it is not a legal document. In the event of any conflict between the contents of this guide and the actual plans and contracts or regulations, the provisions outlined in those documents apply. 3

5 PROGRAM OVERVIEW Flexible Benefits Program - It s all about choice In recognition of the diversity that exists in today s workplace, the Flexible Benefits Program helps you tailor a benefits package that meets the specific needs of you and your family. So rather than all employees having the same benefits coverage, eligible employees get to decide how to spend the money that the BC Public Service allocates to them for benefits coverage. You decide what suits you best. The plans A number of health and life insurance benefit plans make up the Flexible Benefits Program. They fall into the categories of core and optional plans. The difference between the two is that the employer provides funding towards coverage under each of the four core benefit plans. You fund your participation in the optional benefit programs. Core benefits: Medical Services Plan of B.C. (MSP) Extended health plan Dental plan Employee basic life insurance (mandatory) Optional benefits: Health Spending Account Optional family funeral benefit Employee optional life insurance Spouse optional life insurance Child optional life insurance Employee optional accidental death and dismemberment insurance Spouse optional accidental death and dismemberment insurance Child optional accidental death and dismemberment insurance Important You can adjust your coverage over time by making changes to your options during the annual Open Enrolment period. See page 14 for information. 4

6 PROGRAM OVERVIEW Your choices Only one core plan, Employee Basic Life Insurance, is mandatory, which means you must maintain a minimum level of coverage you cannot waive coverage. You can, however, waive coverage in any or all of the remaining plans. It s your choice. All core and optional plans offer multiple levels of coverage ranging from basic to more comprehensive coverage. Each level of coverage is called an option and has a cost (or price) associated with it. In a given plan, the higher the option, the greater the coverage and the more it costs. See Your choices at a glance, starting on page 20. Your costs and flex credits Funding dollars are called flex credits and each flex credit equals $1. Flex credits are allocated to employees as follows: 1. You receive $200 general flex credits that you can spend however you choose (e.g. higher dental coverage). 2. You receive the number of flex credits required to pay for a middle option (called fully funded) in each core benefit plan regardless of your family status (employee only; employee plus one; employee plus two or more). If you choose that fully funded option, the cost is $0. If you choose an option that is below that fully funded option, you will have additional flex credits to use elsewhere. If you choose an option that is above that fully funded option, you will pay for the coverage using unallocated flex credits or by paying monthly premiums based on your family status. Important Flex credits are treated as regular income for the purpose of income tax and statutory deductions. See page 53 for information. 5

7 ELIGIBILITY Who is eligible for benefits? Employees The Flexible Benefits Program is offered to regular excluded employees and eligible excluded auxiliary employees in the following categories: Orders in Council: Categories A, B and C. Managers in the three bands of Applied, Business and Strategic Leadership. Schedule A, legal counsel, executive administrative assistants and senior executive assistants. Salaried physicians. Deputy ministers, associate deputy ministers and assistant deputy ministers. Provincial Court Judges and Masters of the Supreme Court. Judicial Justices. Officers of the Legislature. Dependents Some benefits available to you as an employee can also be extended to your spouse and to any dependent children who meet eligibility requirements. However, only those dependents you enrol and select for coverage will have MSP, extended health and dental coverage. Throughout this guide, the term dependent includes your spouse and children. Spouse Your legal or common-law spouse (same or opposite sex) who is living with you is eligible for coverage. By enrolling your common-law spouse in the Flexible Benefits Program, you are declaring that person as your common-law spouse. A separate form is not required. If you separate from your spouse, s/he is no longer eligible for coverage under your benefit plans. Any terms and conditions under separation and divorce agreements are the responsibility of the employee, not the employer. Once a common-law spouse has been enrolled in your benefits plan, a different common-law spouse and any eligible dependents may be enrolled in the plan 12 months after you have cancelled coverage for the previous commonlaw spouse and applicable dependents. You are responsible for cancelling your spouse s coverage when s/he is no longer eligible for coverage. Children Your children (natural, adopted, step children or legal wards) are eligible for coverage if they are unmarried/not in a common-law relationship, mainly supported by you, dependents for income tax purposes, and who are: Under the age of 19. Under the age of 25 and in full-time attendance at a school, university or vocational institution which provides a recognized diploma, certificate or degree. Mentally or physically disabled and past the maximum ages stated above, provided they became disabled before Definitions A glossary with terms that may be unfamiliar to you is available on page 56. 6

8 ELIGIBILITY reaching the maximum ages and that the disability has been continuous. The child, upon reaching the maximum age, must still be incapable of self-sustaining employment and must be completely dependent on you for support and maintenance. Residing with a former spouse who is not eligible for coverage under an extended health plan, dental plan or MSP. Certification of dependents over the age of 19 Coverage for dependents will automatically terminate at age 19 if you do not certify student status. You must certify student status every year. Recertification notices for each plan (MSP, extended health and dental) are sent to you by the appropriate benefit carrier. It is your responsibility to ensure that the requested recertification forms for each benefit are submitted to the Benefits Service Centre. (See Contacts and resources on page 55.) Returning the recertification form for MSP only will not renew coverage under extended health or dental. Students over age 25 are no longer eligible for coverage unless they have disable status. You are responsible for cancelling coverage for dependent children who are no longer eligible for coverage (e.g. If they decide not to attend school after you have certified their status as a student). Important Dependent children are removed from coverage at the end of the month they no longer meet eligibility requirements (e.g. when they turn 19). 7

9 CO-ORDINATION OF BENEFITS When can you co-ordinate benefit programs? If your spouse has benefits from an employer (including the BC Public Service), you may be able to co-ordinate the two benefit programs. Check the wording of your spouse s plan; you may be able to submit your extended health and dental receipts to both plans and get up to 100 of your eligible expenses reimbursed. Note that the co-ordination of benefits rules apply if both you and your spouse work for the BC Public Service and either of you are eligible for the Flexible Benefits Program. Insurance industry guidelines determine where to send claims first to the BC Public Service Flexible Benefits Program or to your spouse s program. The order is important! Here s why - After submitting your receipts to the first program, you will receive a reimbursement and Statement of Claim (or Explanation of Benefits). Next, submit the Statement of Claim along with a new claim form and photocopies of receipts to the second program to claim the balance of your expense. Follow the insurance industry guidelines below: Your claims: Submit your claims to your extended health and dental plans first. Note: If your pharmacy participates in the Pay Direct program, your pharmacist will reimburse you for prescriptions according to your plan (Coverage will depend on the option you choose). Your spouse must then submit an extended health claim form to his/her program to be reimbursed for the balance of your claim. Your spouse s claims: Submit claims to your spouse s program first. Note: If your spouse s program includes Pay Direct for prescriptions, only your spouse s claims will be reimbursed through Pay Direct according to his/her program provisions. You will then submit an extended health claim form (to your program) for the balance of your spouse s claims. Your children s claims: If your birthday is earlier in the calendar year than that of your spouse, you will submit your children s claims to your program first. If your spouse s birthday is first in the calendar year, s/he will submit claims to his/her program first. For example, if your spouse s birthday is July 18 and your birthday is November 18, then any expenses incurred by your children should be submitted to your spouse s program first. Pay Direct will reimburse according to the program provisions for the first parent s claim submission. An extended health claim form must be submitted to the second parent s plan to be reimbursed for the remainder of the claim. Important Keep photocopies of all claim forms and receipts. Pacific Blue Cross does not keep receipts when you file an expense claim, and you may need to refer to your claims at a later date. 8

10 EFFECTIVE DATES OF COVERAGE When does coverage begin? Benefit Regular Employee Auxiliary Employee MSP, extended health and dental plans Basic employee life insurance Optional family funeral benefit Optional life & optional accidental death and dismemberment (AD&D) insurance You can enrol immediately. You must enrol within 30 days of becoming eligible or you will receive the default options (see page13). Coverage begins the first day of the month following enrolment. Coverage begins immediately. You must enrol within 30 days of becoming eligible or you will receive the default option (see page 13). It s strongly recommended that you designate a beneficiary for your life insurance. You can enrol immediately. You must enrol or you will receive the default option, which is waive. Coverage is effective for all dependents listed on the enrolment form. If selected, coverage begins the first of the month following enrolment. You can enrol immediately. You must enrol or you will receive the default option, which is waive. You must list which dependents you wish to cover under each insurance plan. If selected, coverage begins the first of the month following enrolment except where evidence of insurability and approval is required. Coverage will begin once approval is granted by the carrier. You can enrol after meeting eligibility requirements. You must enrol within 30 days of becoming eligible or you will be assigned to the default options (see page 13). Coverage begins the first day of the month following enrolment. Coverage begins upon meeting eligibility requirements. You must enrol within 30 days of becoming eligible or you will be assigned to the default option (see page 13). It s strongly recommended that you designate a beneficiary for your life insurance. Eligible to enrol after meeting eligibility requirements. You must enrol or you will receive the default option, which is waive. Coverage is effective for all dependents listed on the enrolment form. If selected, coverage begins the first of the month following enrolment. You can enrol after meeting eligibility requirements. You must enrol or you will receive the default option, which is waive. You must list which dependents you wish to cover under each insurance plan. If selected, coverage begins the first of the month following enrolment except where evidence of insurability and approval is required. Coverage will begin once approval is granted by the carrier. Coverage for eligible dependents Coverage is effective on the date on which your coverage is effective, or on the first of the month following the date the enrolment form is received and processed by the Benefits Service Centre, whichever is later, except where evidence of insurability and approval is required. Then, coverage will begin once approval is granted by the carrier. Note: Coverage for a newborn child is effective from the date of birth provided you enrol him/her within 60 days. Otherwise, coverage for your newborn will be effective on the date of application. 9

11 EFFECTIVE DATES OF COVERAGE When does coverage end? Medical Services Plan of B.C. (MSP) Coverage ends on the last day of the month in which any of the following occurs: Your employment ends. You request that coverage end. You take a leave of absence without pay greater than a calendar month (if you do not pay the required premiums). The last day of the month in which you change from regular to auxiliary status or from an excluded to a bargaining unit position. Extended health and dental plans Coverage ends on one of the following: Your last day of employment. The day you request that coverage end. The last day of the month of a leave of absence without pay greater than a calendar month (if you do not pay the required premiums). The last day of the month in which you change from regular to auxiliary status or from an excluded to a bargaining unit position. Group life and AD&D insurance Coverage is cancelled at the end of the month: When your employment ends. When you turn 65. The last day of the month in which you change from regular to auxiliary status or from an excluded to a bargaining unit position. When you retire under the provisions of the Pension (Public Service) Act, except if you elect to continue coverage to age 65 (details are provided at the date of retirement). After the month in which a premium is not received by you or by your employer on your behalf. The date the policy terminates, whichever comes first. Coverage for eligible dependents Coverage ends on one of the following: The same date that your insurance terminates. The date you request coverage end. The date he/she/they cease to qualify as an eligible dependent. In the event of the employee s death, extended health and dental plan coverage for dependents is maintained until the end of the month following the month of the employee s death. However, MSP coverage for dependents terminates at the end of the month of the employee s death. Important If you end your employment or if you reach age 65 and are no longer eligible for group life insurance, you may convert your coverage to an individual policy, limited in both amount and plan, without a medical examination. See next section for important timelines. 10

12 EFFECTIVE DATES OF COVERAGE Converting to individual benefits plans The conversion policy enables you to convert to individual extended health, dental and life insurance plans when your group coverage ends. You can apply to convert to some or all of these plans within 60 days of the end of the month in which your group coverage ends. This conversion cannot be made retroactive. If you miss this deadline, you are no longer eligible for conversion. Individual extended health and dental plans If your employment ends, you may convert to individual extended health and dental plans without providing evidence of good health. Note: An individual plan will be different than the group plan. The waiting period for extended health and dental is waived. Individual group life insurance plans If your employment ends or you reach age 65 (and are no longer eligible for group life insurance), you may convert your coverage to an individual policy, limited in both amount and plan, without a medical examination. You must do so within 60 days of the end of the month in which your group coverage ends. Or, you may take a medical examination (paid for by the carrier) and choose any insurance plan offered by the company. If you do not meet the medical requirements, you still have the opportunity to convert your coverage to an individual policy, limited in both amount and plan. The amount of the individual policy where no medical examination is taken may be any amount up to the amount of coverage (maximum $200,000) in force at the time your group coverage ends. The premium for the individual policy will depend on your age and on the type of policy you select. It is not the same rate as paid while covered under the group plan. Converting your spouse s optional life insurance Provided your spouse is under age 65, you may also convert his or her optional life insurance to an individual plan at the same time as you are converting your own coverage. The same application deadline applies. If your spouse is older than you when you turns 65, your spouse is ineligible for conversion to an individual plan. To start the conversion process For extended health and/or dental, contact Pacific Blue Cross. For life insurance, contact the Benefits Service Centre (see Contacts and resources on page 55). Important Converting to an individual plan may benefit you if you do not qualify for other insurance due to an existing medical condition. 11

13 INITIAL ENROLMENT Enrolling for the first time How to enrol 1. Read this document. Gather all the information and forms you need on the MyHR website. Flexible Benefits guide Your Choices at a Glance document Your Enrolment/Change form Beneficiary Designation form Evidence of Insurability form Medical Services Plan of B.C. Application for Group Enrolment form 2. Do your homework: check records of your medical and dental expenses over the past year and review your spouse s benefit coverage (if applicable). 3. If you have questions, contact the Benefits Service Centre. (See Contacts and resources on page 55.) 4. Complete the Enrolment/Change form. Complete other forms (Evidence of Insurability, Beneficiary Designation, and Medical Services Plan of B.C. Application for Group Enrolment forms) if required. Make copies of all completed forms for your records. 5. Be sure your enrolment is received by the Benefits Service Centre within 30 days of your date of eligibility. Choosing life insurance coverage Maintaining employee basic life insurance coverage is a condition of employment and cannot be waived. The minimum coverage required is $25,000, and there are two other options available. The rules around when you need to provide evidence of insurability (good health) are outlined below. When you first enrol, you can choose any option of basic employee life insurance without having to provide evidence of good health. You can also elect up to $50,000 of optional life insurance coverage for yourself and/or your spouse without having to provide evidence of insurability. If you elect more than $50,000 of optional life insurance for yourself and/or your spouse in your initial enrolment, you will be required to provide evidence of good health. Evidence of good health is not required for child optional life insurance, Optional Accidental Death & Dismemberment Insurance or the Family Funeral Benefit. If required, complete an Evidence of Insurability form and mail it to the address noted on the form. Don t miss out Your benefits enrolment forms must be received by the Benefits Service Centre no later than 30 calendar days from your date of hire (or date of eligibility). If you miss the deadline, you will receive the default benefits package. (See page 13 for information). If you are mailing your enrolment forms, allow plenty of time for them to reach the Benefits Service Centre within 30 calendar days of your date of hire or eligibility. 12

14 INITIAL ENROLMENT Remember to list your dependents and select them for the benefit on the enrolment form In order to have dependents covered under MSP, extended health and dental, you must ensure that your dependents are listed on the enrolment form and that you select the dependents you wish to cover under each benefit plan (MSP, extended health and dental). So, take the time to ensure that your dependent information is correct and that you have selected the right dependents for coverage in each plan. Be sure to designate beneficiaries for your employee basic and optional life insurance Complete and sign a beneficiary designation form. If you do not designate your beneficiary by submitting the signed form, benefits will be paid to your estate. Beneficiary designations are not effective until the completed and signed original form has been received by the Benefits Service Centre. If you do not enrol on time, you ll receive a default package of benefits Don t miss out on the opportunity to tailor your benefits package. Take the time to review your benefits and actively enrol. The following default package may not meet your needs and you will not be able to change your benefits until the annual Open Enrolment period unless you have an eligible life event. Benefit General flex credits MSP Extended health Dental Employee basic life insurance Health Spending Account Unallocated flex credits Default You will receive the $200 in general flex credits Waive Option 3 coverage for yourself only Option 4 coverage for yourself only Option 3 (3 x annual salary, $80,000 minimum) Waive Paid out as taxable cash Note: if you are transferring in to the Flexible Benefits Program from the Bargaining Unit Benefits Program, you will be enrolled in the benefit plans (and plan options) that most closely match the coverage you had while participating in the Bargaining Unit Benefits Program. Eligible dependents covered under the Bargaining Unit Benefits Program will also be covered under the Flexible Benefits Program. 13

15 UPDATING BENEFITS COVERAGE Open Enrolment Each fall, during Open Enrolment, you are able to change benefits coverage for you and your dependents for the next benefit plan year, which starts on January 1. The only exception to this is if you selected the top option for extended health (Option 5) and/or dental (Option 6). You are locked into these options for two plan years. You will receive $200 in general flex credits to spend however you choose. (See Your costs and flex credits on page 5). It is recommended that you review your recent claims experience and look at the changes to the plans (See What s new in 2014 to the right), and then either confirm your current choice or select a better option for you and your family through Employee Self Service. If you don t make choices during Open Enrolment, your benefits will remain the same as the previous year, and you waive the opportunity to have a Health Spending Account. You will not be able to change your benefits until the next Open Enrolment or eligible life event. What if I m away during Open Enrolment? If you are away during Open Enrolment, and wish to make changes to your options, contact the Benefits Service Centre before you leave (see Contacts and resources on page 55). You may be able to access Employee Self Service from home, or you can request enrolment forms to be sent to you. Simply complete the forms and mail them to the Benefits Service Centre. What s new for 2014? Costs and credits for MSP have changed to reflect the increase in MSP premiums effective January 1, There is no additional cost to you. The annual premium for the Family Funeral Benefit has increased from $24 annually to $25.20 annually effective January 1, Don t miss out! Open Enrolment is your annual chance to update your coverage for the next calendar year. Plan members will receive reminders about Open Enrolment. 14

16 UPDATING BENEFITS COVERAGE Eligible life event During the year, you may change your benefit options after you experience an eligible life event. Eligible life events allow you to make changes to your benefit options within 60 days of the event. They include: Marriage or entering a common-law relationship. Divorce, separation or end of a common-law relationship. Birth or adoption of a child. Loss of a child s status as a dependent (marriage, age limit, school status, etc.). Your spouse gains or loses a benefit coverage. Death of a spouse or child. Increasing life insurance coverage There are some limitations on increasing life insurance. You or your spouse will be asked to complete an evidence of insurability form (a medical questionnaire) if you: increase your employee basic or optional life insurance from the previous year; or increase your spouse optional life insurance. The insurance company must review your information and approve your request before increased coverage can take effect. Effective dates of coverage Changes will be effective on the appropriate date based on the timing of Open Enrolment, an eligible life event or the approval of evidence of good health for life insurance. Changes made during Open Enrolment will be effective at the start of the subsequent plan year. Changes made as a result of an eligible life event will be effective on the date of the event. If a life event is reported more than 60 days after the event, changes will not be permitted. Exceptions, back-dating and retroactive adjustments will not be made. Be sure to review your coverage and make changes during the Open Enrolment period or as soon as possible after the eligible life event to ensure that the Benefits Service Centre receives your benefits change forms no later than 60 days from the date of the event. Note: If you are mailing your change forms, allow plenty of time for them to reach the Benefits Service Centre within 60 calendar days from the date of the eligible life event. Important Your benefits change forms must be received by the Benefits Service Centre no later than 60 calendar days from the date of the eligible life event (e.g. birth of your child). If you miss the deadline, you will have to wait until the next Open Enrolment or eligible life event to make choices. After the deadline passes, you can add (or subtract) your dependent from your coverage but you cannot update your choices (i.e. select different plan options). 15

17 WORK STATUS CHANGES Effects of work status changes on benefits coverage What happens if: I transfer from a regular to an auxiliary position? I am on a temporary assignment to an excluded position from my base position which is a bargaining unit position? I transfer to a bargaining unit position? Your benefits coverage ends at the end of the month of your date of transfer and you must re-qualify for benefits. Any balances remaining in your Health Spending Account or taxable cash are forfeited. You are eligible for flexible benefits effective the first of the month following your temporary assignment to the excluded position. Your temporary assignment must be 21 days or greater for the Flexible Benefits Program to apply. When you return to your bargaining unit position, you return to the bargaining unit benefit plans. Your Health Spending Account or taxable cash terminates at the end of the month. Any balances remaining are forfeited. Your extended health and dental claims history (e.g. payment towards your deductible, eligibility periods for things like vision care) will remain with you throughout your employment. As such, you should always confirm your eligibility for reimbursement of a product or service prior to purchasing it. When you transfer to your bargaining unit position, you are covered under the bargaining unit benefit plans. Your flexible benefits coverage terminates at the end of the month of your transfer. Your Health Spending Account or taxable cash terminates at the end of the month. Any balances remaining are forfeited. Your extended health and dental claims history (e.g. payment towards your deductible, eligibility periods for things like vision care) will remain with you throughout your employment. As such, you should always confirm your eligibility for reimbursement of a product or service prior to purchasing it. Note about transfering the Family Funeral Benefit: The Family Funeral Benefit under the Flexible Benefits Program is the same coverage as Optional Spouse and Dependent Life Insurance Plan under the bargaining unit benefit program (with the exception that there is an evidence of insurability requirement under the bargaining unit plan). You can transfer to the bargaining unit optional spouse and dependent life insurance product, evidence free, by completing an Optional Spouse and Dependent Life Insurance Election Form and submitting it to the Benefits Service Centre within 90 days of your date of transfer into the bargaining unit. If you miss this deadline, you will be required to submit evidence of insurability along with the election form, and coverage will be subject to approval by the insurance carrier. 16

18 WORK STATUS CHANGES I transfer from a bargaining unit position to an excluded position and do not enrol in the Flexible Benefits Program? When you transfer into an excluded position, you have 30 days to enrol in the Flexible Benefits Program. We recommend that you complete your enrolment forms. It s your opportunity to choose the best options available to you and any eligible dependents. If you do not enrol, you will be enrolled in the corresponding benefit plans you had under the Bargaining Unit Benefits Program with the options that most closely match your coverage under the bargaining unit plan. Any dependents covered under the bargaining unit plans will also be covered under the Flexible Benefits Program. Any unused flex credits will be paid out in monthly instalments as taxable cash. You will have to wait until the next Open Enrolment period (or until you experience an eligible life event) to make any changes. Your extended health and dental claims history (e.g. payment towards your deductible, eligibility periods for things like vision care) will remain with you throughout your employment. As such, you should always confirm your eligibility for reimbursement of a product or service prior to purchasing it. I am away during Open Enrolment period? I am on Short Term Illness and Injury Plan (STIIP)? I am approved for Long Term Disability (LTD)? I commence a rehabilitation trial? I return to work from Long Term Disability? I am on a leave with pay? If you will be on a short-term leave with pay or on vacation during the Open Enrolment period, you must contact the Benefits Service Centre before you leave (see Contacts and resources on page 55). You may be able to access Employee Self Service from home, or you can find the change forms on MyHR. You are eligible to continue in the flexible benefit options you have at the time you commence STIIP. You can participate in Open Enrolment and make changes if you have an eligible life event. Benefits in place prior to being approved for LTD will remain in place during the LTD period. If you return to work on a rehabilitation trial after being on LTD, your LTD claim continues to be active and there are no changes to your benefits coverage. If you return to work during the same plan year (calendar year), you are reinstated in the options you selected within the Flexible Benefits Program and are eligible to make changes at the next Open Enrolment or eligible life event windows. If you return to work in a different plan year (calendar year), you will have the opportunity to make new selections in the Flexible Benefits Program at that time. During these leaves, you may participate in Open Enrolment and make changes after eligible life events. Contact the Benefits Service Centre for information (see Contacts and resources on page 55). 17

19 WORK STATUS CHANGES I am on a leave without pay? You cannot make changes to your options while you are on a leave without pay. You may continue in the benefit plan options that you have at the time you commence your leave by paying the benefit premiums, otherwise coverage will terminate until you return to work. If you return to work during the same plan year (calendar year), you will be reinstated in the options you selected within the Flexible Benefits Program and would be eligible to make changes at the next Open Enrolment or eligible life event windows. If you return to work in a different plan year (calendar year), you will be able to make your new selections in the Flexible Benefit Program at that time. If you choose not to continue your employee or spouse optional life insurance during your leave, and your leave extends beyond 90 days, you will be required to provide evidence of insurability if you wish to reinstate these benefits. I am on a Maternity/Parental/ Pre-placement Adoption Leave? You may participate in Open Enrolment during your leave. Benefits in place prior to your leave will remain in place during this leave. The birth of a child is an eligible life event. As such, you have 60 days from the birth of your child to update your benefits coverage (except for changes related to the optional Health Spending Account, which can only be made during Open Enrolment). After 60 days, you can still add your child to your coverage, but you cannot change your options. If you chose, you may waive MSP and/or extended health and dental plan coverage during your leave. Employees often consider this if they have coverage under their spouse s plan or if they want to minimize repayment of benefits if they are unsure about returning to work after their leave. Maintenance of group life insurance and long term disability coverage is mandatory during your leave. If you do not satisfy the return to work requirements after your leave, you will be required to pay for these and any other benefit premiums paid on your behalf during your leave. For more information, visit MyHR. I travel out of province? Your coverage depends on a number of factors, including whether you are on government business, on vacation or on a leave of absence. Contact the Benefits Service Centre at Note: The Medical Services Plan strongly advises B.C. residents to purchase additional health insurance when traveling out-of-province to cover the cost of services not included in the plan. Detailed information is available on MyHR. My employment terminates and I m rehired within 90 days to an excluded position that is eligible for flexible benefits? When your flexible benefits are reinstated, you will receive the same coverage you had prior to termination. You cannot make changes until the next Open Enrolment period or eligible life event windows.. 18

20 WORK STATUS CHANGES I am actively working and I reach the age of 65? I retire from the BC Public Service? Coverage for MSP, extended health and dental does not change when you turn 65. However, you are no longer eligible for employee basic life insurance or for any of the optional life insurance or optional accidental death and dismemberment insurance products. To learn more about converting to individual benefits plans, see page 11. Your flexible benefits coverage terminates at the end of the month in which you retire. Any balances remaining in your Health Spending Account or taxable cash are forfeited. Retirement benefits are administered through the BC Public Service Pension Plan. The benefits coverage available under the Public Service Pension Plan is different from this program. Review retirement benefits criteria at the BC Pension Corporation website. I terminate from the BC Public Service? I die? Your extended health and dental coverage terminates on your last day of work. All other flexible benefits terminate on the last day of the month of your date of termination. Any balances remaining in your Health Spending Account or taxable cash are forfeited. Employee Flexible benefits coverage will terminate at the end of the month in which the death occurs. Funds in the employee s Health Spending Account and/or taxable cash will terminate at the end of that month and any balances will be forfeited. A life insurance claim will be initiated. Medical Services Plan (MSP) coverage for dependents Dependent coverage for MSP will terminate at the end of the month in which the death occurs. Cancellation of the dependent coverage will generate an individual account for any covered dependents. Dependents are advised to contact MSP at to confirm coverage and contact information so there is no lapse in coverage. Extended health and dental plan coverage for dependents Extended health and dental plan coverage terminates at the end of the month following the month in which the employee dies (e.g. extended health and dental plan coverage terminates on April 30 when the employee s death occurs in March). Under the conversion policy, dependents can purchase individual extended health and dental plan coverage, evidence free and with no waiting period, within 60 days of the end of the month in which the group coverage ends. Of course, family members are free to purchase coverage from any health insurance carrier they choose. Optional life and optional AD&D coverage for dependents Coverage ends at the end of the month in which the death occurs. Covered dependents have the opportunity to apply for individual coverage. See Converting to individual benefits on page 11 for further information. 19

21 BENEFIT CHOICES AT A GLANCE Your choices at a glance Everyone is unique and has different needs for benefits. There are plenty of choices in the Flexible Benefits Program to enable you to create a benefits package to meet your needs. For each benefit, you will either select the option that best meets your needs or you will waive that coverage. The exception is with group life insurance you must maintain a minimum ($25,000) level of coverage. The following tables summarize the coverage in each option of each benefit plan, starting with the Medical Services Plan of B.C. For your convenience, we ve included annual net pricing information with each table. See sidebar for full details. Note that the fully funded option is shaded in blue in each benefit plan. MEDICAL SERVICES PLAN Waive Option 1 (fully funded) MSP coverage No coverage Coverage Annual price (all family sizes) $117 CR $0 Important If the cost of the option you choose is less than the fully funded option, you will have left-over flex credits. The annual price, in green, will show a dollar amount credit (e.g. $117 CR). If the cost of the option you choose is $0, this is the fully funded option. It is shaded in blue for ease of reference. If the cost of the option you choose is greater than the fully funded option you will have to partially pay for that option. The annual price, in red, will show a dollar amount cost (e.g. $108). 20

22 BENEFIT CHOICES AT A GLANCE EXTENDED HEALTH PLAN Waive Option 1 Option 2 Option 3 (fully funded) Option 4 Option 5 (two year lock-in) Annual deductible No coverage $80 $200 $80 $0 $0 Reimbursement (includes prescription drugs) No coverage 20% 80% 1 80% 1 80% 1 100% Vision No coverage $250/2 years None $250/2 years $500/2 years $500/2 years Paramedical services (acupuncture, chiropractor, massage therapy, naturopathic physician, physiotherapy, podiatry) Hearing aids (Adult: 4 years/ Child: 2 years) Annual price No coverage $300/year/person combined (all services) $800/year/person combined (all providers) $200/year/person ($500/ family)/service except: massage therapy ($750/person/year) physiotherapy (no annual maximum) $500/year/person/ service $500/year/person/ service No coverage $700 per ear $700 per ear $1,500 per ear $1,500 per ear $1,500 per ear Employee only $300 CR $198 CR $135 CR $0 $108 $309 Employee + 1 dependent $216 $417 Employee + 2 or more dependents $324 $525 DENTAL PLAN Waive Option 1 Option 2 Option 3 Basic services recall exams every 6 months for dependent children and every 9 for adults, unless otherwise stated. No coverage 20% 80% 100% Recall for adults: 6 months Option 4 (fully funded) Option 5 Option 6 (two year lock-in) 100% 100% 100% Recall for adults: 6 months Major services No coverage 50% 65% No coverage 65% 75% 85% Orthodontic services (Note: LTM = lifetime maximum) No coverage 50% with LTM of $2,000 No coverage No coverage 55% with LTM of $3,500 No coverage 55% with LTM of $5,000 Annual price Employee only $300 CR $195 CR $96 CR $75 CR $0 $42 $213 Employee + 1 dependent $84 $426 Employee + 2 or more dependents $120 $633 1 Reimbursement at 80% for the first $1,000, then at 100% for the balance of the year. Cost to you Left-over flex credits 21

23 BENEFIT CHOICES AT A GLANCE EMPLOYEE BASIC LIFE INSURANCE Option 1 Option 2 (fully funded) Option 3 Coverage $25,000 $80,000 3x annual salary (minimum $80,000) Annual price (Employee s portion) $112 CR $0 ( x annual salary) - $163* Note: A minimum amount of life insurance is required. Evidence of insurability is not required on first enrolment, but it is required for future increases. OPTIONAL LIFE INSURANCE Waive Option 1 Employee You must choose Option 3 of employee basic life insurance to apply for this coverage. Spouse Child No coverage No coverage No coverage Units of $25,000 to $1 million maximum Units of $25,000 to $500,000 maximum $11.28 per unit of $5,000 to a maximum of $20,000 ANNUAL RATE PER UNIT ($25,000) OF COVERAGE FOR OPTIONAL LIFE INSURANCE (NS=NON-SMOKER; S=SMOKER) Gender\Age (yrs) Under Female (NS) $9 $12 $18 $30 $48 $78 $105 Female (S) $12 $18 $30 $54 $87 $132 $183 Male (NS) $15 $15 $21 $45 $84 $138 $183 Male (S) $30 $33 $54 $99 $168 $285 $381 Note: During initial enrolment, you and your spouse are eligible for up to $50,000 of optional life insurance evidence free. Evidence of insurability is required for all future increases. OPTIONAL ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE Employee Spouse Child Waive Option 1 Rates for Option 1 No coverage No coverage No coverage Units of $25,000 to $500,000 maximum Units of $25,000 to $500,000 maximum Units of $10,000 to $250,000 $9.60 per unit of $25,000 $9.60 per unit of $25,000 $3.30 per unit of $10,000 (single rate covers all listed children) OPTIONAL FAMILY FUNERAL BENEFIT HEALTH SPENDING ACCOUNT (HSA) Waive Option 1 No coverage $10,000 spouse $5,000 per child Annual price $0 $25.20 Waive No HSA Option 1 Elect HSA and allocate a minimum of $100 flex credits to it. Note: You may only allocate funds to an HSA during initial enrolment and Open Enrolment. Cost to you Left-over flex credits 22

24 MEDICAL SERVICES PLAN Medical Services Plan of B.C. The Medical Services Plan of B.C. (MSP), insures medically-required services provided by physicians and supplementary health care practitioners to all eligible British Columbians. This includes services like your doctor s visits, lab services and diagnostic procedures, like X-rays. For more detailed information on MSP benefits, visit the Ministry of Health website. All British Columbia residents must be covered under MSP. Eligibility To be eligible for MSP coverage, employees and their dependents must: Be residents of British Columbia. Be Canadian citizens, permanent residents or temporary document holders. Employees must also meet the eligibility requirements for regular and auxiliary employees outlined earlier. If you and/or your dependents recently moved to B.C., MSP requires a waiting period of the remainder of the month in which your residence in B.C. is established, plus two months. First Nations and Inuit Residents Status Native and Inuit residents usually enrol in MSP through Health Canada s First Nations and Inuit Health Branch. For further information about MSP coverage for status Native and Inuit peoples, visit Ministry of Health website. Your MSP options Waive If you waive MSP coverage under the Flexible Benefits Program: you must have MSP coverage elsewhere or a selfadministered account will automatically be set up for you and you will be billed directly by Health Insurance BC, and you will receive flex credits that you can use elsewhere. Note: All employees, regardless of family status, will receive the same number of flex credits upon waiving a benefit plan. Option 1 You can select coverage for: employee only; or employee plus one dependent; or employee plus two or more dependents. Note: You must list any dependents you wish to cover for MSP. Option 1 is fully funded so your annual price is $0. Things to consider If you have coverage elsewhere, (e.g. under a spouse s plan), you may not need to enrol under your group plan. (Only one person needs to enrol for MSP coverage for the entire family.) If you have an individual account and are paying premiums directly to MSP, it is beneficial for you to be enrolled in the employers group plan. Important If you have waived MSP under the Flexible Benefits Program, you are responsible for paying your premiums directly to Health Insurance BC and for any collection activity due to non-payment. Don t miss out MSP coverage is not automatic. You must enrol and list any eligible dependents. You are responsible for any MSP premiums you incur for any periods during which you were eligible for coverage but were not enrolled in the group plan. 23

25 EXTENDED HEALTH PLAN Extended health plan The extended health plan is designed to partially reimburse you for a specific group of medical expenses which are not covered by MSP (e.g. prescription drugs, medical equipment, paramedical services and vision care). Overview Pacific Blue Cross administers your extended health plan on behalf of your employer. Detailed descriptions of expenses eligible for reimbursement under this plan are provided on the next page. There is a lifetime maximum of $250,000 per covered person. This lifetime maximum may be reinstated after paying for any one serious illness on the basis of satisfactory evidence provided by the employee to the carrier of complete recovery and return to good health. CARESnet CARESnet is an online system that allows you to view your extended health benefit information and claims history online, submit claims and arrange to have extended health and dental claim reimbursements deposited directly into your bank account. Register for access on the Pacific Blue Cross website. PharmaCare The PharmaCare program helps B.C. residents with the cost of eligible prescription drugs and designated medical supplies. The plan provides financial assistance for individuals and families, based on their income, and requires a one-time registration. Once you are eligible for coverage, PharmaCare will pay a portion of your prescription. This reduces your extended health care claim, which protects your lifetime maximum (less of your lifetime maximum is used up by each claim). Extended health plan members must be registered for PharmaCare. You can register by phone at or online at the Ministry of Health website. Special Authority Effective April 2013, Pacific Blue Cross plan members will be required to apply to PharmaCare Special Authority for certain high-cost drugs before they can claim these drugs under their extended health plan. For a current list of drugs, visit CARESnet. Important It is your responsibility to verify that an item or service is covered prior to purchase. It is recommended that you get an expense pre-approved if the cost is over $1,000. You must submit a request for pre-approval for any medical aid or supply expenses greater than $5,000. Don t miss out Extended health coverage is not automatic. You must enrol and list any eligible dependents. 24