On Monday, July 21, you will have received an email from ONE-T, your benefits provider. In the email and related blog on the ONE-T website, members were given the unwelcome news that some of the benefits in the plan are being reduced. The reductions are occurring due to increased plan usage by members, increased supplier costs on claims, and some demographic changes. These increases in costs have not been offset by funding improvements leaving the plan in a position where costs are exceeding plan revenues. These pressures are not unique to the CAEAS-ECAB ONE-T plan as they are being experienced in a number of other Employee Life and Health Trusts in our sector
When benefits moved to the ELHT model, they changed the way that benefits are funded. Prior to 2018, benefits were a defined benefit model where benefits were paid by individual school boards based on a certain benefit level. The ELHT model moved benefits to a defined contribution plan where funding is set, and benefits are paid out of that pot of money. When expenditures were less than plan revenues, members experienced enhancements to coverages. Now that expenditures are exceeding revenues the opposite is occurring.
The changes are as follows:
- A maximum annual coverage of $2,000 for anti-obesity drugs per person. Note that this maximum does not apply to those taking medications for the treatment of diabetes.
- The introduction of prior authorization formal approval for Plan Members who did not need to go through this process previously for the use of Ozempic, Rybelsus, Contrave, and Xenical. Those affected members will be contacted by Canada Life this summer and will have until October 31, 2025 to submit the required materials. We have asked that the notifications be sent as soon as possible.
- Reduction in coverage for paramedical practitioners from 100% to 90%.
- Reduction in the annual Health Care Spending Account allocation from $850 per year to $500 per year. The roll over of unused amounts from the current year (year ending August 31, 2025) will continue to be the unused portion of the $850 allocation for the year.
For more details, please review the email sent from ONE-T and the links to the blog contained therein. The website can be accessed directly at one-t.ca. There is a ONE-T contact email included for your questions.
If you have further difficulties, questions that do not get explained, or could use more assistance, please contact info@caeas-ecab.ca for assistance.
