Association of Ontario Midwives. Benefits Trust. Practice Administrative Staff. Your benefits plan. Presented by: AOMBT and Equitable Life

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1 Association of Ontario Midwives Benefits Trust Practice Administrative Staff Presented by: AOMBT and Equitable Life Your benefits plan

2 Presentation Objectives Overview Introductions Benefits plan overview and May 1 st changes Claims submission made easy EquitableHealth.ca Questions

3 What we do Established in 2008 through formal Trust Agreement with AOM Governed by 9 Trustees Manage and administer benefits program for midwives, AOM and AOMBT employees and practice administrative staff Provide additional investment management options and financial education resources to support midwives 3

4 AOMBT Trustees Chair Karin Terpstra, RM (on leave) Elected Trustees Diana Doe, RM (Born Midwives) Debbie Doiron, RM (New Life Midwives) Kelly Gascoigne, RM (Community Midwifes of Brantford) Andrea Mills, RM (Barrie Midwives) Melinda Soares, RM(Sages-Femmes Rouge Valley Midwives) AOM Board-appointed Kelly Graff, RM (Kenora Midwives) Esther Willms, RM (Midwives Clinic of East York-Don Mills) AOM Executive Director Kelly Stadelbauer 4

5 AOMBT Staff & Consultants Staff - Management Nicole Mellin, Director Janice Fuller, Manager, Benefits Operations & Administration Staff - Administration Chona Layson, Senior Benefits Administrator Marlene Mahadeo, Benefits Administrator Allison Jack, Executive Assistant & Communications Officer Indira Thomas, Finance Coordinator (part-time) Consultants Morneau Shepell, Benefits Consulting & Group RSP KPMG, Auditors Pape, Salter & Teillet, Legal Counsel 5

6 Our vision and strategic directions 6

7 AOMBT s mission The AOMBT supports the financial, physical and mental well-being of plan members and their families throughout their lives. We provide an exemplary, responsive, internally equitable and externally competitive benefits program. 7

8 Benefits plan redesign overview May 1, 2013: changeover to Equitable Life Selection criteria included: Exemplary customer service Improved disability case management Competitive pricing Improved claims processing Leader in technology and innovations Practice administrative staff benefits plan unchanged with the move to new carrier 8

9 Practice partner consultation process Summer 2013 information gathering (roughly half of practices provide benefits for staff, most are practice-paid) October 2013 webinar for practice partners followed by 1 st survey Results gave some information (interest in eyewear coverage, desire to add Short-Term Disability and enhancements to dental and paramedical) but were inconclusive on benefits plan changes March 2014 second survey asked partners to vote on one of 3 options (one vote per practice; majority vote needed for changes) Second survey results: majority in favour of Option 3 9

10 Benefits plan changes effective May 1, 2014 $500 per discipline/year, to a max of $1,500/year Paramedical $2,500 combined max/annually; no max per discipline Eye exams only Vision Exams plus eyewear $200/24 months Covered at 80% Basic dental Covered at 100% Covered at 50% Major dental Covered at 50% $2,000/year combined for basic and major No coverage No coverage Employer-paid coverage at 60% of monthly earnings, max $3,500/month, payments are subject to income tax. Previous plan Dental maximum Orthodontics Short-term disability Long-term disability $2,000/year each for basic and major Covered at 50%, max of $2,500/lifetime % of weekly earnings, max $1,385/week. Employee-paid coverage at 60% of monthly earnings, max $3,500/month, payments not subject to income tax. Approx. premium $47/month ($40,000 salary). New plan

11 Eligibility Actively employed for 3 consecutive months (waiting period) Be actively at work Work a minimum 16 hours per week Be under the age of 65 Dependents may be covered if two-party or family coverage selected: Legal spouse or common law partner (12 months) Dependent children under the age of 21; 25 if the dependent is a full time student or permanently incapacitated (if they became so under 21 or while an eligible student) 11

12 Extended health care Prescriptions Hospital Paramedical services Medical supplies Vision Out of province emergency services Covered at 80%. 100% after $1,200 annual maximum out-of-pocket reached. 100% coverage for a semi-private room. Covered at 100%, up to $2,500 combined annually. Covered services: Acupuncturist, Chiropractor, Physiotherapist, Massage Therapist, Psychologist, Osteopath, Naturopath, Speech Therapist, Chiropodist/Podiatrist, Athletic Therapist, Audiologist, Dietician, Social Worker/Counsellor. Covered at 100%. Maximums vary - $500 per plan member per 60 months for hearing aids; $450 per 3 calendar years for custom-made orthotics; 2 pairs surgical stockings or support hose per 4 month period Eye exams performed by a licensed optometrist, ophthalmologist or physician are covered at 100% once every 24 months (age 21+) or once every 12 months (under 21). Eyewear coverage at $200 every 24 months. Coverage for a maximum of 180 days, up to $5,000,000 per lifetime for eligible emergency medical expenses as a result of illness or injuries that occur while travelling outside of Ontario. 12

13 Dental care Basic services Major services Covered at 100%, to a maximum of $2,000 per calendar year. Recall exams once every 5 months. Basic services include diagnostic, preventive, routine restorative (such as fillings), routine surgical, endodontic (such as root canals) and periodontal (such as gum scaling). Major services are covered at 50%, to a maximum of $2,000 per calendar year. Major services include dentures, bridges, crowns, inlays and onlays. Orthodontics Orthodontic services are covered at 50%, to a maximum of $2,500 per lifetime. All services, including dental and paramedical, are subject to reasonable and customary maximums. Reasonable and customary maximums are the amount an insurance carrier will cover for each service, and are determined based on the general prevailing amounts charged within a geographic region or province. Every insurance company has different maximums, though they tend to be quite similar. Equitable Life will not reimburse claims for more than this predetermined amount. 13

14 Insurances Basic life insurance Optional life insurance Accidental death & dismemberment Optional accidental death & dismemberment Basic critical illness Optional critical illness Short-Term Disability Long-Term Disability Two times annual earnings to a maximum of $250,000. At age 65, the coverage reduces by 50%. Coverage terminates at age 70. Plan members have the option of purchasing additional life insurance in units of $10,000, to a maximum of $250,000, for either themselves and/or their eligible spouse. Two times annual earnings to a maximum of $250,000 following a loss or severe injury caused by accidental means. Coverage terminates at age 70. Plan members have the option of purchasing additional AD&D coverage for themselves, their eligible spouse/partner and/or child(ren). Coverage provides a lump payment of $10,000 to a plan member after confirmed diagnosis of a critical condition covered under the plan. Coverage terminates at age 65. Plan members have the option of purchasing additional critical illness coverage for themselves, their spouse and child(ren). Plan members are eligible for short-term disability after 14 days: 66.67% of weekly earnings, max $1,385/week. Practices may be eligible for EI premium reduction; visit to learn more Plan members are eligible for long-term disability with coverage of 60% of monthly earnings to a maximum of $3,500 per month. Payments are not taxed; premiums paid by employee. 14

15 Long-term disability (LTD) example Employer-paid premium Annual salary: $50,000 Gross monthly earnings prior to disability leave: $4,167 Pre-disability net monthly earnings (less federal and provincial taxes, CPP and EI premium): $3,190 Estimated payroll deductions: $977 LTD payment 60% of monthly gross earnings: $2,500 (Taxable) Income Tax payable by employee: $310 Monthly benefit received: $2,043 Employee-paid premium Annual salary: $50,000 Gross monthly earnings prior to disability leave: $4,167 Pre-disability net monthly earnings (less federal and provincial taxes, CPP and EI premium, LTD premium): $3,190 Estimated payroll deductions: $977 LTD payment 60% of monthly gross earnings: $2,500 (Non-taxable) Income Tax payable by employee: $0 Monthly benefit received: $2,500 15

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18 Plan Member Web Demo

19 Thank you! Questions?

20 AOMBT Tel: (416) or Ext Website: midwivesbenefits.ca Equitable Life Policy # Tel: Website: equitablehealth.ca