Changes to the ARTA Retiree Benefits Plan Effective November 1, 2020
Each year the ARTA Health Benefits Committee reviews the long-term vision of and proposed changes to the ARTA Retiree Benefits Plan. Plan changes are determined by responses to legislative changes and suggestions made by covered members. This process ensures that the plan provides ARTA members with the best retiree benefits available.
Once a potential change is approved by the Health Benefits Committee, the committee makes a recommendation to the ARTA Board of Directors, which then reviews and votes for the potential changes they think are most beneficial to plan members.
The following changes become effective November 1, 2020, for all members covered by the ARTA Retiree Benefits Plan’s Extended Health Care Plan:
- Statin medications (used to treat high cholesterol) will be subject to Therapeutic Alternative Reference-based Pricing (TARP) due to the addition of a number of drug categories subject to similar policies implemented by the Government of Alberta in December. These new drug categories added by the government’s policy changes largely duplicate the drug categories that are subject to TARP under the ARTA Drug Benefit List, except for statins. This should have a minimal effect on covered members since the reference medications subject to TARP pricing (rosuvastatin and atorvastatin, the generic equivalents for Crestor and Losec, respectively) are those already used most frequently by ARTA’s covered members.
- Walker repairs are added to the list of extended medical benefits under the current maximum for walkers.
- Prolotherapy is now covered when provided by a licensed health care practitioner, to a maximum of $250 per year, included under the annual paramedical practitioners’ coverage maximum.
- Access to the Home Care benefit now only requires that an invasive procedure is completed, with prior approval from the plan administrator and the physician. Currently, a covered member must be hospitalized for twenty-four hours to access Home Care; however, many procedures, including invasive procedures, are now being done on an outpatient basis.
- Frequency limits associated with crowns on the same tooth are removed. Currently, a crown cannot be replaced within three years; however, a person’s body could reject the crown before this.
- The purchase of pessaries is covered to a maximum of $100 every 36 months.
- Members who have cancelled EHC coverage will not be allowed to re-join for one year. In extenuating circumstances, an appeal process will determine if a member can re-join.
- Usual and Customary charges are being updated to reflect the marketplace charges for certain medical aids, devices, and services claims submitted over the past year.
As a result of the COVID-19 pandemic, ARTA’s emergency travel plan saw many trip cancellation and interruption claims. However, these costs were largely offset by the reduction in health and dental claims paid. This means overall health care and dental rates can be reduced for one year starting November 1, 2020. More detailed information will be included in your annual renewal statements in October.
Detailed information on these coverage changes will be reflected in the updated plan booklets available online.
ARTA will continue to review potential plan enhancements while keeping the plan affordable for our covered members. Please continue to submit plan change suggestions for the Health Benefits Committee’s consideration. Suggestions may be mailed to the ARTA office or emailed to firstname.lastname@example.org.