Your “Savvy Retiree” Newsletter for December 2023
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As of 1 January 2023, the health insurance schemes for retired managers and retired judges have been harmonized. The premium rates for these two groups are now identical.
In 2022, we presented to Conseil du trésor officials a proposal to improve the reimbursement criteria for eligible care provided by health professionals in the enriched plan. There are two reasons why we were unable to proceed with this enhancement in 2023. The increase in the cost of living, since an increase in the eligible costs per treatment resulted in an increase in the premium for the enriched plan. The second reason is that the consultation process with members of the collective plan must be carried out in accordance with Bill 25, which specifies the new provisions protecting the privacy of Quebeckers. Non-compliance with Act 25 can lead to legal consequences. We therefore consulted lawyers who specialize in data privacy law. They analyzed the dossier taking into account all the parties involved: the policyholder, the insurer, the ACR and the members. We have presented to Conseil du trésor officials a legal analysis and a solution adapted to the new legislation. We hope to be able to consult you in 2024, but we hope that the government will quickly make a decision on the sustainability of the plan, because this inaction could still lead to additional delays.
When we analyzed the results for 2023, we found that the pandemic is behind us. Indeed, we note that the benefits paid for travel insurance and travel cancellation insurance in the past year are at the average level observed before the pandemic. Benefits paid were $3.6M, which is higher than the $3.0M projected last year using assumptions made by consulting actuaries. Last year it was about $2.0 million. The return to normalcy and the increase in the cost of travel can largely justify the premium increases for the enriched diet.
According to the latest news, the COVID-19 positivity rate is still high among Quebeckers. Let’s continue to be cautious and take advantage of the vaccination program.
I would have liked to inform you that a settlement had been reached between the government and the insurer. Unfortunately, that is not the case. However, I recognize the courage of the insurer Beneva who decided to take the case to court. Indeed, Beneva is suing the government for $13M. For our plan, the amount is approximately $1M in Beneva’s portfolio. We have to anticipate that the matter will not be resolved quickly.
Work continues at a rate of one meeting every 6-8 weeks. There's no shortage of files. Thanks to the hard work of our coordinator, Mrs. Line St-Cyr, several insured persons were able to recover amounts of money that had been denied them when they filed their claim.
We continued to ask Secrétariat du Conseil du trésor officials if a decision would be made on this matter. At this point, the government is not prepared to make a decision. Negotiations with government employees appear to be the priority.
For our part, we continue to remind them that more than 18,000 retired executives over the age of 65 remain insured with the plan when they may decide to opt out. If the government decided to terminate the plan, more than 24,000 retired executives would be left without insurance overnight. This is a situation that we consider irresponsible. We remind you that this benefit was part of the overall compensation when we were active. On the asset side, their position does not change. They want the obligation to join the pension plan to end when they retire. We'll let you know as soon as we know what the government's decision is.
On August 30, Beneva (formerly SSQ Financial Group) tabled the conditions of renewal on January 1, 2024, of the group insurance plan for retirees of the Government of Quebec’s public and parapublic management personnel to representatives of the Conseil du trésor (SCT) and to representatives of retirees. According to our actuary council, our plan is in excellent health with a stabilization fund of $6,883,006.00 as of December 31, 2022, its maximum level equivalent to 15% of premiums.
It should be noted, however, that according to the statistics for the first six months of 2023, the 2023 financial year is expected to generate a significant deficit in health insurance. Indeed, a deficit of 4% of the participating premiums is estimated for the first 6 months of 2023. Generally, since claims paid are higher in the last 6 months of a year, this deficit is expected to increase by the end of the year.
For the health accident insurance scheme, the increase in benefits for the medicine Ozempic (type 2 diabetes) was significant for retired managers under 65 years of age in the basic and the enriched schemes.
We held two (2) meetings in September with the consulting actuary, the spokesperson, the spokesperson’s substitute, a committee member and the coordinator to prepare a proposal to the insurer Beneva. As usual, a document was prepared by SAI Actuarial Services to SCT officials. SCT officials agreed with the contents of the report, which provided a basis for our discussions with the insurer.
On October 11, a first meeting was held with two representatives of retirees, representatives of SCT and representatives of the insurer. Since the latter had to validate certain figures in order to respond to our requests, a new meeting was held on October 13 in the morning. We finally reached an agreement that was satisfactory to the insured.
The objective was to minimize the increase requested by the insurer, i.e. 17,2 %. We finally reduced the demand for a raise to 7.7%. We were also successful in adding kinesiologist coverage to the list of professionals eligible for a zero-cost claim.
Accident and health insurance plan
The rate change for each of the categories is shown in the table below.
As the health of the plan is good, we have been able to grant premium leave of 7.5% to insured persons under 65 who must maintain their participation in the drug insurance.
For insured persons who are registered for the premium premium (not registered for the RAMQ), the rate remains unchanged.
These changes include any variation in pooling fees and the addition of the kinesiologist.
Drug pooling fees continue to increase each year and this has a great influence on premium increases. We remind you that pooling was introduced to protect us against the costs of the more common "expensive drugs" on the market. The risk is now shared between the members and the insurer.
We have found that our experience is still very favorable, no cases above $135,000 since this measure was introduced. For this year, we increased our risk share to $1 million, which allowed us to reduce the premium rate to 0.90% per 12-month period per certificate. In 2024, we will have to do a lot of thinking before we decide whether to keep this measure in our system.
Life insurance plan
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Pricing is maintained at its current level for the life insurance of the retired member and the additional life insurance of the spouse of the retired member.
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The rate is maintained at its current level for life insurance for the spouse and dependent children of the retired member.
Contractual amendments
The kinesiologist's coverage is added to the same grouping and reimbursement parameters as the physiotherapist's.
To find out the actual pricing applicable to your situation, we suggest you consult the new brochure produced by the insurer. Link to the leaflet “Your plan at a glance on January 1, 2024”
During the holiday season, your representatives wish you festive meetings, rewarding trips in a safe environment.
