Health Benefits
Gary Sawatzky | Chief Operating Officer , ARTA ( Luna | Chief Eating Officer , ARTA )
Self-Administration of the ARTA Retiree Benefits Plan
As you have likely read in the last edition of news & views and in the most recent ARTAfacts newsletter , ARTA is moving administration of its Retiree Benefits Plan to provide these services in-house .
Our plan has been administered by a third-party administrator ( TPA ) since its inception in 1995 . It is currently administered by the Alberta School Employee Benefit Plan ( ASEBP ), which has been a wonderful partner for ARTA .
Unfortunately , because of legislation changes affecting the definition of Health Trusts , ASEBP is unable to provide TPA services for ARTA members going forward . This means ARTA had a choice to make : find a new TPA or bring administration of the plan in-house . Both options were reviewed and , based on the financial benefits that could be realized by ARTA and the plan ’ s covered members , ARTA ’ s Board of Directors elected to move administration in-house .
Prior to now , ARTA ’ s membership was simply not large enough to self-administer our plan . But over the past eight years we have reached a critical mass , thanks to our phenomenal growth rate . When we first moved to ASEBP in 2012 , we had 8,200 covered members . Now , our membership is almost triple that number .
To accommodate this exciting change , new administration systems were developed to make operation of the plan as efficient as possible . This is good news , as ARTA is now a “ one-stop shop ” for managing ARTA membership and administering our Retiree Benefits Plan . All your calls , emails , and mail will go to one location and be responded to by one team of ARTA staff . Communications and processes will be streamlined , as you will no longer need to contact ASEBP regarding your benefits matters .
To accommodate the additional volume of calls and inquiries , we have hired five new Member Services front-line staff members , a team manager and a trainer / quality control expert , as well as a new human resource representative , communications personnel , systems management personnel , and a new accounting resource . With the sizable growth in staff count ( more than doubling since this time last year ), we outgrew our office space and moved into a new move-in-ready office , which is still located in northwest Edmonton .
Next , we needed a new claims adjudicator to pay the claims submitted by our members . We found a new partner in HBM +, a division of Greenshield Canada ( GSC ). We worked closely with GSC to ensure the same plan design currently in place will continue when they begin to pay claims , with only very minor changes ( such as the drugs subject to Enhanced Special Authorization and Therapeutic Alternative Reference-based Pricing ).
We have also been able to leverage services already developed by GSC , including online claims capabilities and a smartphone app that will help you quickly and easily access your health and dental benefits information . You can check your drug coverage , find a nearby health provider , submit a claim , access your electronic ID card , and more .
Finally , you will be able to access online claims submissions and other self-help services from the new member web portal .
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