Health Benefits
Gary Sawatzky | Chief Operating Officer , ARTA
Making a Benefit Plan
A lot of thought goes into making the ARTA Benefit Plans . They are reviewed by ARTA staff , the Health Benefits Committee , and the Board of Directors to ensure they continue to meet our members ’ needs , both in terms of their coverage and the financial realities of the plans ’ incurred costs .
Formulating Rates
We review premium rates annually to ensure they are appropriate to cover claims and overhead costs for the upcoming year . ARTA ’ s health and dental benefits are self-insured , meaning ARTA is responsible for calculating and setting the monthly rates paid by covered members for each plan . We do this by comparing the annual premiums paid into the plan with the amounts paid as claims over the past twelve months . We also include an inflationary factor because — as we know too well — costs always seem to go up , but never down . This calculation is done for each benefit and for each of the Education and Public / Private sectors covered under ARTA ’ s plans . There is no cross-subsidization between the two sectors ; each one pays monthly rates based on the claims experience for their specific sector .
Each year , the Health Benefits Committee considers two or three scenarios for potential rate changes , which often depend on the experience of the past year . For example , for the 2021 renewal year , the premiums paid into the plan exceeded ( by a fair margin ) the amount that was paid out through claims and overhead . This meant a rate reduction could be implemented , which was the option selected by the committee . The opposite was true for the Dental Care plan , and the committee chose a modest rate increase for the Education sector and no change to rates in the Public / Private sector .
The Emergency Travel rate component is renewed differently . This benefit is fully insured , which means the monthly rates need to be negotiated with the insurance underwriter . The negotiated monthly rates are then included in the appropriate Extended Health Care monthly rates . Once all rates have been reviewed , and the suggestions have been put forward , the Board of Directors considers the suggestions at their summer meeting . The new rates are implemented on November 1 of the same year .
Plan Design
When the Health Benefits Committee sets rates each year , plan design changes also need to be considered . Plan design includes adding or removing coverage for specific medications or services , based on member needs .
All suggestions for plan design changes are gathered from members themselves . The committee evaluates each suggestion to determine if it would be appropriate for coverage under the plans . The committee also considers any legislative or public plan changes made over the past year that could affect the ARTA plans .
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