Saskatchewan Teachers Federation

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Guiding Principles - Members’ Health Plan

1. That the most comprehensive health benefits plan possible be provided through the resources available.
   • Base funding for the Plan is set at a fixed percentage of teachers’ gross payroll in accordance with the Department of Finance payroll report as of January 1 of each year.
   • The Board of Trustees may recommend that a premium be considered, payable by the members of the Plan to maintain or increase current benefit levels.
2. That the STF Portaplan and Members’ Health Plan Board of Trustees accept fiduciary responsibility to work within its given administrative and financial resources.
   • The Board of Trustees will maintain adequate policies and procedures to fulfill their fiduciary responsibility.
   • The Board of Trustees will invest funds in the best interest of members and maintain a proper balance between investment returns and risk.
   • The Board of Trustees will review its funding annually, including studies of projections that calculate the level of benefits in relation to the funding provided.
     • The rates for the travel assistance benefit reflect the actual experience and projected costs of the benefit. The annual review of rates is done prior to Plan renewal and determines the premium rates required to maintain the benefit.
     • The estimated monthly payments for prescription drugs, extended health care and vision care services and supplies are reviewed to determine whether an increase is warranted and to adjust projections to ensure reserve targets are met and claims are paid.
   • Decisions to enhance or decrease benefits will be based on current and relevant information attained through:
     • Current and projected financial position of the Plan
     • Member feedback
     • Council resolutions
     • Consultant reports and recommendations
     • Any other sources deemed appropriate by the Board
3. That the STF Portaplan and Members’ Health Plan Board of Trustees set funding policies and review them periodically.
   • There are six (6) reserves in place:
     • Prescription Drug Claims Fluctuation Reserve (CFR)
     • Vision Care Claims Fluctuation Reserve (CFR)
     • Extended Health Care Claims Fluctuation Reserve (CFR)
     • Prescription Drug Incurred But Not Reported Reserve (IBNR)
     • Vision Care Incurred But Not Reported Reserve (IBNR)
     • Extended Health Care Incurred But Not Reported Reserve (IBNR)
4. That the STF Members’ Health Plan establishes regular communications to keep members informed about the Health Plan.
   • Information is disseminated to the membership via:
     • Member Booklet
     • Website
     • FAQs (Frequently Asked Questions)
     • Information Sessions, Workshops and Conferences
     • Regular Bulletins
5. That Plan members have the right to have claims adjudicated and personal information handled efficiently and confidentially, and according to Plan provisions, in a respectful, courteous and appropriate manner.
6. That Plan members have the right to appeal, through the process as outlined in the Appeals Policy, a decision regarding their entitlement to benefits from the Plan.