Protecting the ARTA Retiree Benefits Plan
To prevent the misuse and abuse of benefits, ARTA’s plan administrator, the Alberta School Employee Benefit Plan (ASEBP), routinely reviews claims for accuracy and has measures in place designed to prevent and detect inappropriate and unusual claiming practices (UCP). This includes working directly with ARTA plan members in the investigation of all areas of suspected UCP.
The vast majority of claims are submitted in good faith but sometimes plan members and service providers take advantage of benefit coverage for their personal gain. Some examples are:
- Service providers telling plan members that services or products are covered by their ARTA benefits when they aren’t.
- Plan members submitting claims for services that are not covered as items that are eligible (e.g. receiving a spa treatment and claiming it as a therapeutic massage).
- Service providers claiming for services that are not medically necessary or were not provided.
The misuse and abuse of benefits has lasting impacts, including higher premiums, a reduction in benefit coverage or even loss of benefit coverage.
The good news is, you can help! There are things you can do to help protect your benefits:
- Be cautious of aggressive sales tactics to persuade you to buy unnecessary products or services. Only purchase products or services that are medically necessary.
- Never sign blank claim forms. Only sign claim forms once you have confirmed they are complete and accurate.
- Only share your ARTA Benefits ID number with your health care providers.
- Regularly check your ARTA Members Health Care Account to make sure all claim details are correct. If you notice anything wrong, report it!
How to Report Unusual Claims
If you become aware of any misuse of benefits or unusual claims, please contact ASEBP with the details through our confidential hotline.
Toll-free: 1-833-821-ARTA (2782)