It’s time for better EHC for retirees.
Group benefit plans harness the strength of thousands to provide security and benefits to individuals in the plan. As a teacher you enjoyed better benefits than most, with up to 80% of the costs paid by your employer.
EHC coverage changes in retirement. Everyone in the group is older, sometimes with higher claims, and there is no employer to share the cost. So EHC plans for retirees tend to offer lower benefit levels. But it is still better to be in an EHC group plan than to sign up for an individual plan directly with the insurance company – costs in such plans are often much higher.
EHC coverage should be clear, easy to use, reliable, fair, and treat subscribers with respect and compassion. A bad EHC experience might include confusing or conflicting guidelines, needless disputes, excessive paperwork and indifference toward you as a person.
POSSIBILITIES OF CHOICE
The right choice in EHC plans is very important for peace of mind and security. The points at which you rely on coverage are often the most stressful times of your life. A caring, responsive insurer will make for much happier outcomes. You may realize just how bad your coverage is at your moment of greatest need.
Many retirees do not realize they have a choice of plans. For BC’s retired teachers, a “default” plan is the Green Shield coverage publicized by the TPP. The TPP does not own or run the plan, but contracts with Green Shield the right to be the default choice for new retirees. All residual funds of the Green Shield EHC plan stay with GSC. Many teachers are not aware of other options when they sign up. A common misunderstanding is that BCRTA is connected to the Green Shield plan. That is not the case.
For over 20 years, BCRTA has grown an alternative benefits plan, crafted in response to member needs. Our partner is Johnson Insurance, who bring a focus on personal service and “Best Friend Advice.” A portion of the Johnson Prestige EHC premiums paid by BCRTA members goes back into supporting the work of our association. We think of it as a “virtuous circle”: our members benefit from the bargaining power of our group, in a plan that builds the strength of our association to serve retirees.
ADVOCACY AND COMPLAINTS
BCRTA’s mission is the well-being of our members. That means we spend a lot of time listening to and advocating for retirees. What we have been hearing for some time is great frustration with EHC coverage. When the TPP switched providers from Blue Cross to Green Shield there was a marked increase in dissatisfaction. Members told us of difficulty in making claims, changing interpretations of coverage, and unresponsive or unsympathetic service agents. We heard it in person at branch meetings, in conversation, and by mail.
To gauge the size of the problem, over fifteen months we tracked every interaction our service desk had with members, making a note of the character of each of those conversations. We recorded dozens of complaints about EHC plans. Just 10.7% of those were about the BCRTA-Johnson EHC plan. A whopping 89.3% of complaints were about the Green Shield plan. Also note: this time period was well after the initial deluge of complaints about Green Shield coverage.
We expect to hear about any issues with the Johnson plan – after all, they are our partner, and we can follow up to resolve issues because we have direct access to the plan partners, and thousands of BCRTA members use it.
It is no small irony that the vast majority of complaints BCRTA receives are for the plan we do not sponsor. We provide information and any support we can regarding complaints about Green Shield EHC. People contact us because they have exhausted all other routes, or sometimes do not understand who offered the plan.
A BETTER FUTURE FOR EHC
It is time to get this situation fixed. Our EHC survey will give us a statistically significant profile of how YOU feel about your EHC coverage. This confidential information will help BCRTA ensure that our EHC plan is the best it can be. The survey will also display for all retirees just what their peers think about each of the EHC plans.
We think the best approach to caring for people is to have open, informed conversation about facts. So here is your chance to share your stories, good or bad, and register your voice. We are listening to YOU.
