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Report
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Report To: General Government Committee
Date of Meeting: May 6, 2019
Report Number: COD -006-19 Resolution: GG -296-19
File Number: By-law Number:
Report Subject: Benefit Increase Cha
Recommendation:
That Report COD -006-19 be received for information.
Municipality of Clarington Page 2
Report COD -006-19
Report Overview
Information report responding to the question raised about the types of benefit coverage
which is causing increases, and the measures that can be taken to control benefit costs.
1. Background
Resolution #GG -187-19 and Current Renewal Increases
1.1 At the Council meeting of April 8, 2019 the General Government resolution #GG -187-19
was approved as follows:
That Staff report back on the types of benefit coverage which is causing
increases, and what measures can be taken to control the costs, with the Report
to be put before the meeting of General Government Committee of May 6, 2019.
1.2 As mentioned at the April 8 meeting, the recent approval of the Health Benefit Program
at the January 14, 2019 Council meeting through Resolution #C-019-19, provided for a
change in the renewal date to a fall timeframe, with the next renewal details including
the ASO consideration expected in September 2019. This report is for general
information.
1.3 The questions asked at the GGC meeting related to the general increases which were
identified in the renewal report covering February 1, 2018 to January 31, 2019.
Attachment #1 is a copy of the table provided by Mosey & Mosey that identified the
individual benefit category increases faced in the most recent renewal (totalling 9.8%
overall). It also notes the increase of 14.3% that would have been experienced had the
Local Authority Services (LAS) option not been explored.
1.4 The renewal increases on the chart in Attachment 1 per category and the percent they
represent in the total premium value are as follows:
Premium Increase % of Premium
Life Insurance 0% 7.0 %
Long Term Disability 32.1% 19.8%
Extended Health Care 7.6% 50.0%
Dental 2.6% 23.2%
1.5 Mosey & Mosey acquired the specific detailed breakdown of the claims history for each
of the categories and for each of the Divisions; CUPE Inside and Outside, Non -
Affiliated, Firefighters, Library and Museum (Attachment #2).
Municipality of Clarington Page 3
Report COD -006-19
2. Potential Increase Factors
2.1 The increases in the benefit categories can vary year over year based on the plan's
experience, primarily driven by plan member overall health and wellbeing.
2.2 The LTD category in the renewal values above is the largest increase. The LTD
category is one area that generally has low utilization as it includes individuals on
extended leaves for significant illnesses. As a result, a modest increase in numbers of
employees in the benefit group may trigger an increase in the rates. A rate guarantee
was obtained with the market placement of the benefit program in 2016 which protected
this category from an increase until 2019, thereby aiding in overall cost containment
over those years. The total value of the LTD category in the overall premium is
approximately 19.8%.
2.3 The Extended Health Care category includes a number of different services including
drugs, hospital care, vision, and paramedical coverages such as physiotherapy and
chiropractor. The premium increase was 7.6% on the renewal, and this category
represents 50% of the total premium value. The usage of benefits by division of
employees is detailed in Attachment 2, represented in both dollar value tables and in
bar charts for a further breakdown of paramedical services. In reviewing the data, it is
important to note that the bar charts appear to be the same in each division, however
there are differences in the representation of dollar values for each group. For instance
the highest use paramedical for the CUPE Inside group on page 4 is "massage" valued
at $17,565, whereas the highest used paramedical in the Firefighter Group is
"physiotherapy" totaling $45,728. The large use in physiotherapy for the Fire group is a
result of the arbitration decision to award "unlimited" use of this benefit. Although that
appears to be unusual in comparison to the CUPE and Management groups of
employees, it is fairly common in the Durham Region Fire sector to see an "unlimited"
physiotherapy benefit.
2.4 The dental category increase on the renewal was 2.6%. Attached are two articles that
speak to dental fee increases. The Dental Fee Guide Increases chart (Attachment #3)
shows a steady adjustment of approximately 2% annually over an eight year period from
2010 to 2018, and then an increase of 4% in 2019. The higher than average expected
increase is partly attributed to an industry requirement to accommodate technology and
equipment upgrades that were not being covered with the modest annual increases to
date. Attachment #4 is an article from Benefits Canada identifying the expected increase
of dental fees in 2019 of 4.19%.
Municipality of Clarington
Resort COD -006-19
3. Cost Containment Measures
Page 4
3.1 Mosey & Mosey noted that some control measures might include consortium buying,
market placement at reasonable intervals, employee education, prevention and wellness
initiatives and plan design. The Municipality has taken advantage of these categories by
the actions set out below.
3.2 Local Authority Services (LAS) as a Division of AMO offers a consortium approach to
acquiring benefit programs. Mosey & Mosey was engaged through the renewal with Sun
Life to provide this advantage to the Municipality which resulted in a reduction in the
renewal rate increase that would have been applicable at 14.3% to a renewal rate
increase of 9.8%.
3.3 Market placement on a five year basis has been the practice of the Municipality, and it
has been noted by Mosey & Mosey that this is a reasonable timeframe to maintain
interest in bidding on the Municipal book of business which is considered as a medium
value in the market. To go to market on less than a five year cycle is not recommended
as it creates an impression of "benefit provider shopping" and providers do not look to
invest in a program that jumps from one provider to another on a frequent basis.
3.4 Plan design and modifications are reviewed regularly through negotiations. There is little
control in some areas that are subject to interest arbitration awards that achieve parity,
however there have been successes in reducing some categories of benefits through
negotiations, such as the reduction in the dental units on cleaning/scaling from 16 units to
8 units, mandatory generic drugs, prescription requirement for some paramedicals,
reduction of orthotics to one pair annually for one group and changes to the qualifying
criteria overall.
3.5 The Municipality supports wellness initiatives through an employee driven wellness group
that offered new and interesting opportunities over a number of years. In addition the
Municipality has sponsored a number of mental health awareness and certification
programs to bring awareness to/and support of mental health. Post -Traumatic Stress
Disorder (PTSD) for First Responders and mental health issues have a significant impact
on workplace performance, and focus on these initiatives are an investment in employee
wellbeing and health with the intention of reducing the demand on benefit programs.
3.6 The Municipality also encourages wellness through the provision of an Employee
Assistance Program (EAP) which is recognized as supporting a healthy workforce.
Municipality of Clarington Page 5
Resort COD -006-19
4. Concurrence
Not Applicable
5. Conclusion
The next benefit program renewal will be November 1, 2019. A report to Council outlining
the implications of renewing under an Administrative Services Only (ASO) program, or
maintaining the funded program, will be brought to Council as soon as the renewal rates
are available, which is expected to be September 2019.
It is respectfully recommended that Report COD -006-19 be received for information.
6. Strategic Plan Application
Not applicable.
a �—
Submitted by:
Marie Marano, H.B. Sc., C.M.O.,
Director of Corporate Services
Reviewed by:
Andrew C
CAO
Allison, B. Comm, LL.B
Staff Contact: Kerri McMullen, Compensation & Benefits Supervisor, 905-623-3379, ext., 2206
or kmcmullen@clarington.net
There are no interested parties to be notified of Council's decision.
Attachment 1 — Mosey & Mosey Report - LAS Renewal Rates
Attachment 2 — Mosey & Mosey Report - Historical Extended Health Care and Dental
Experience Report
Attachment 3 — Mosey & Mosey Report - Dental Fee Guide Increases 2010 — 2019
Attachment 4 — Article Benefits Canada — Ontario dental fees to increase by 4.19% on average
in 2019
$WWDFRH01WR5HSRUW&2'
Benefit
Current Cost
Sun Life Proposed
Stand Alone Renewal
Effective February
Cost
1, 2019
Mosey& Mosey Revised
Cost Within the LAS
Effective February
Negotiated
Consortium
1, 2019
Monthly
Monthly
Monthly
Volume
Premium
Premium
Adjustment
Premium
Adjustment
Life Insurance
79,168,000
$ 17,143.75
$ 17,143.75
0.0%
$ 17,143.75
0.0%
Dependent Life Insurance
325
2,389.12
2,389.12
0.0%
2,389.12
0.0%
Long Term Disability
1,566,925
41,734.64
59,262.28
42.0%
55,136.15
32.1%
Extended Health Care
Single
46
6,775.19
7,588.18
12.0%
7,287.44
7.6%
Couple
122
37,002.20
41,442.21
12.0%
39,799.91
7.6%
Family
218
85,483.27
95,741.43
12.0%
91,947.05
7.6%
Dental
Single
44
2,845.71
2,988.10
5.0%
2,920.56
2.6%
Couple
122
15,861.14
16,654.03
5.0%
16,279.52
2.6%
Family
218
44,024.62
46,226.32
5.0%
45,185.44
2.6%
TOTAL MONTHLY PREMIUM
$ 253,259.64
$ 289,435.42
$ 278,088.94
TOTAL ANNUAL COST -ALL
BENEFITS
$ 3,039,115.68
$ 3,473,225.04
$ 3,337,067.28
Variance To Current Cost
$ 434,109.36
14.3%
$ 297,951.60
9.8%
Without LAS - Mosey&Mosey Using LAS - Mosey&Mosey
$WWDFRHO]WR5HSRUW
HISTORICAL EXTENDED HEALTH CARE (EHC) AND DENTAL EXPERIENCE
Below is the premium and claims experience for the past two years. Where size allows, this information is
provided by group (active and retiree information combined). Any groups that were too small to illustrate on their
own are grouped together with others of a similar nature, wherever possible. Therefore, the union and non-union
Museum are combined, as well as union and non-union Library. The remaining divisions (i.e., Arena, Council and
Contract employees) though not of a similar nature, are simply grouped together due to their size.
Further to this illustration, HDF:]Ql9ZSLCV[ffRIlD-NSPZG-A +&[D❑O1EHEk0Cj)aid claims have been broken down by
the internal service categories, as shown on the following pages. For the larger groupings in particular, we note
that overall paid claims are trending within the expected levels. For the smaller groupings, their claiming
variances are less predictable from year to year, which is typical.
Total Outside Union ❑ EHC
Paramedical Claim Amounts Paid
$12,000
Prescription Drugs
$132,261.12
64.0%
$116,983.9357.4%
•',
Vision
$34,588.30
16.7%
$32,882.16
16.1% •'
Paramedical
$19,558.40
9.5%
$26,208.77
12.8% - '' 1111111
All Other Services & Supplies
$6,016.22
2.9%
$11,591.91
5.7%
Footwear
$8,969.00
4.3%
$9,505.00
4.7%
Eye Exams
$4,793.00
2.3%
$4,213.00
2.1%
Hospital
$600.00
0.3%
$1,620.00
0.8%
Emergency Out -of -Canada
$0.00
0.0%
$887.14
0.4%
9. . I
i
Average Number of Subscribers
Wz�.-
89
Physiotherapist
90
+1.1%
Paramedical Claim Amounts Paid
$12,000
■ 2017/2018
$10,000
■ 2018/2019
$8,000
$6,000
$4,000
$2,000
$0
Massage
Physiotherapist
Psychologist Naturopath Chiropractor
Podiatrist/
Chiropodist
Other
Osteopath practitioners
2017/2018
$7,470.40 $3,826.00
$580.00
$85.00
$6,856.00
$741.00
$0.00 $0.00
2018/2019
$9,884.07 $5,463.50
$468.00
$2,181.60
$6,972.60
$729.00
$140.00 $370.00
Total Outside Union ❑ Dental
Dental Care Procedure
Periodontics
Total Paid
Claims
2017/2018
Percent of
Total Paid
Claims
Total Paid
Claims
2018/2019
Percent of
Total Paid
Claims
% Change
Year
Over Year
-4.9%
Basic Restorative -
:.' .
,, ..
1 •
+7.1%
10.3%
+60.6%
Exams & Diagnostic
Major Restorative •
Orthodontics
-0.5%
ServicesSurgical
11
•'
..
•1
• ••• :•
$166,367.21
•'
1'.
-44.6%
+33.5%
-1.3%
+3.7%
Endodontics1
Preventative Services• • :•
LL, 60,372.381
Average Number of Subscribers
$1,848.52
rp
+2.6%
Average Claims Per Subscriber C4 AQ��
Total Inside Union F EHC
Paramedical Claim Amounts Paid
$20,000
$18,000
Total Paid
Percent of
Total Paid
Percent of
% Change
$16,000
Claims
Total Paid
Claims
Total Paid
Year
Health Service Category
2017/2018
Claims
2018/2019
Claims
Over Year
Prescription .
1
I
-2.3%
-.
1 .�: �•
$11,618.00 $2,662.50 $660.00 $1,170.00 $12,065.95 $737.00 $575.00 $1,160.00
•. I
+21.2%
•
. •
.:.
•'
-12.3%
••
,
•'11
Fmmm
-46.8%
• •
: 11
1 •'
1 • 11
I
+400.0%
All Other ServicesSupplies
1 •
1'.
• 1 5 :•
•'.
+80.2%
• 11
:'
• 1
•'
+4.0%
Emergency Out -of -Canada
+0.3%
Mal EHC Claims Pa
$252,885.87
100.10/6
$253,712.87
li"+0.3%
Average Number of Subscribers
Average Claims Per Subscriber
$2,661.96
j J
$2,615.60
i
-1.7%
Paramedical Claim Amounts Paid
$20,000
$18,000
■ 2017/2018
02018/2019
$16,000
$14,000
$12,000
$10,000
$8,000
$6,000
$4,000
$2,000
$0
Podiatrist/ Other
Massage Physiotherapist Psychologist Naturopath Chiropractor Chiropodist Osteopath Practitioners
2017/2018
$11,618.00 $2,662.50 $660.00 $1,170.00 $12,065.95 $737.00 $575.00 $1,160.00
12018/20191
$17,565.58 $4,798.00 $240.00 $1,745.00 $10,889.95 $805.00 $460.00 $640.00
Total Inside Union 5 Dental
,-
Periodontics
$49,207.57
725.0%$42,480.55
$45,315.50
32.1% •'
Basic Restorative Services
$36,031.50
30.1%Exams
& Diagnostic
$19,428.95
$20,557.10
14.6%
Major Restorative
$16,077.54
11.2%
$14,367.19
10.2% .'
Preventative Services
$7,161.72
5.0%
$7,563.98
5.4% •'.
Orthodontics
$4,226.50
2.9%
$5,905.03
4.2% '
Surgical Services
$6,574.78
4.6%
$3,698.40
2.6%
Endodontics
$5,340.60
ihL
3.7%
$1,094.00
i
0.8% '
Average Number of Subscribers
Average Claims Per Subscriber
95
$1,516.31
97
$1,453.42
+2.1%
-4.1%
Illustration of Historical Health & Dental
Experience and Claims Breakdown
Total Non -Affiliated (Non -Union) ❑ EHC
6 ❑❑d 11HVJR❑QD H❑ULiSRIVt❑❑I iC❑C❑❑[ID❑❑❑CSHLff Qa =O IGEFC P V -SD a:R 1111❑❑C❑❑❑EVM11 MCCEH /❑
:D LVFH®J-R❑1NL11LSun Life has confirmed that these amounts were for rehabilitation hospital (substance abuse).
Therefore, we have allocated this amount within the All Other Services and Supplies category for 2018/2019
period below.
MWF-
Total Paid
Percent of
Total Paid
Percent of
% Change
Claims
Total Paid
Claims
Total Paid
Year
Health Service Category
2017/2018
Claims
2018/2019
Claims
Over Year
Prescription .s
-5.0%
-.
. .:,.
+33.1%
All Other Services & Supplies1
E, •
•
•'
+285.1%
1
-6.5%
..
1 . •
+21.9%
1 • 11
.'
-16.8%
• •
1 1 11
1',
11
1
-52.0%
Emergency Out -of -Canada
•.
•'
1
1
-81.9%
Total EHC Claims Paid
$314,971.
=41,977.24IM100.0%
+8.6%
Average Number of Subscribers
Average ClalflMPer Subscriber
$3,350.76
$3,454.32
+3.1%
Working towards better solutions.._
Total Non -Affiliated (Non -Union) []Dental
Periodontics
$51,124.20
30.0%
$47,817.07
29.3%
,-
'
Basic Restorative Services
$42,578.90
25.0%
$34,655.35
21.2%
: •' ,
•'
Exams & Diagnostic $22,056.05 12.9% $22,689.15 13.9%
Major Restorative $12,623.36 7.4% $17,075.82 10.5%
Orthodontics
$4,811.00
2.8%
$15,920.32
9.8%
•'.
Surgical Services
$17,075.85
10.0%
$9,556.40
5.9%
Endodontics
$13,633.95
8.0%
$8,128.20
5.0%
'
Preventative Services
$6,616.00
3.9%
$7,235.15
4.4%
'
Average Number of Subscribers
Average Claims Per Subscriber
94
99
$1,647 A
+5.3%
Illustration of Historical Health & Dental
Experience and Claims Breakdown
Total Firefighters C EHC
6 ❑❑d 11HVJ;U H❑W-ISRIVt❑❑I i❑❑❑❑❑IIII❑❑❑❑SHLff Ga =O IGEFC P V-SaG:R ❑❑❑❑1111❑❑❑ M11 MCCEH /E
:D LVFH®J-Rd1/❑E1[Sun Life has confirmed that these amounts were for rehabilitation hospital (substance abuse).
Therefore, we have allocated this amount within the All Other Services and Supplies category for 2018/2019
period below.
Health Service Category
Prescription.
Total Paid
Claims
2017/2018
1 1:.• •
Percent of
Total Paid
Claims
Total Paid
Claims
2018/2019
Percent of
Total Paid
Claims
% Change
Year
Over Year
+15.3%
-. M
$45,000
-5.7%
All Other Services & • •
•
• • •
:'
+292.8%
• • : •
. 1
-17.2%
■ 2017/2018
o2018/2019
$40,000
$35,000
-11.9%
• • 1 11
1 11
+26.8%
Emergency • .•.
• 1 :
1
-77.6%
• • -
Total EHC Claims Paid
: 11
$264,
1
11
1
MO.0%
+294.7%
+10.0%
Average Number of Subscribers
Average Clai er Subscriber
$3,886.33�WMEW
$4,094.04
+5.3%
$50,000
Paramedical Claim Amounts Paid
$45,000
■ 2017/2018
o2018/2019
$40,000
$35,000
$30,000
$25,000
$20,000
$15,000
$10,000
$5,000
$0
EEL—
$15,849.85
Massage
Physiotherapist
Psychologist
Naturopath
Chiropractor
Podiatrist/
Chiropodist
Osteopath
Other
Practitioners
2017/2018
$16,538.42
$45,728.00
$1,340.00
$2,202.76
$6,229.00
$5,560.00
$550.00
$0.00
2018/2019
$15,849.85
$42,235.00
$400.00
$657.08
$8,548.00
$3,949.00
$610.00
$1,410.00
Total Firefighters ❑ Dental
Dental Care Procedure
Periodontics11
Total Paid
Claims
2017/2018
Percent of
Total Paid
Claims
Total Paid
Claims
2018/2019
1
Percent of
Total Paid
Claims
% Change
Year
Over Year
+3.4%
Basic Restorative -
: • . 1
1 1
+40.5%
Exams & Diagnostic
4.9%
Services
+11.9%
SurgicalPreventative
11
•
. 11
-34.9%
Major- • -
1 1
-40.4%
Orthodontics
111 11
:'
• 1 :1
1',
-14.1%
Endodontics1
11
L,120,370.9j�
'
• 11
$119,349.96
-70.9%
-0.8%
Average Number of Subscribers
$1,680.99
]w
-5.0%
Average Claims Per Subscriber $1,770.'.1
Total Museum (Union & Non -Union) F1 EHC
$800
MTotal Paid
Percent of
Total Paid
Percent of % Change
Claims
Total Paid
Claims
Total Paid Year
Health Service Category
2017/2018
Claims
2018/2019
Claims Over Year
Prescription.
$300
+397.3%
$200
+524.8%
$100
.' .
I U
+3900.0%
-•
��
Massage Physiotherapist Psychologist Naturopath Chiropractor
�� ��
•' -63.2%
• .
.�� ��
•'.
��
�'. -100.0%
2018/2019
$300.00 $0.00 $0.00 $0.0 $$0.00
$0.00
$0.00
All Other Services & Supplies
++
Emergency Out -of -Canada
++
Mal EHC Claims Pa
$1,721.46
$2,327.24
100.0% +35.2%
Average Number of Subscribers
Average Claims Per Subscriber
$860.73]
$775.75
-9.9%
$800
Paramedical Claim Amounts Paid
$700
$600
■ 2017/2018
0 201 8/201 9
$500
$400
$300
$200
$100
I U
$0 __
Massage Physiotherapist Psychologist Naturopath Chiropractor
Podiatrist/
Chiropodist
Other
Osteopath Practitioners
2017/2018
$675.00 $0.00 $0.00 $0.00 $140.00
$0.00
$0.00 $0.00
2018/2019
$300.00 $0.00 $0.00 $0.0 $$0.00
$0.00
$0.00
Working towards better solutions.._ EE
10
Total Museum (Union & Non -Union) ❑ Dental
Yz
11
Total Paid
Percent of
Total Paid
Percent of % Change
Claims
Total Paid
Claims
Total Paid Year
Dental Care Procedure
2017/2018
Claims
2018/2019
Claims Over Year
Exams & Diagnostic
+79.9%
Periodontics
-0.8%
Preventative Services•
11
•
11
+93.5%
RestorativeBasic
11
1
1 11
1 1' . -100.0%
Surgical1
11
1 1'.
1 11
1 1'. ++
Endodontics1
11
1 1'.
1 11
1 1'. ++
Major Restorative
++
Orthodontics
++
$1,486.00
$1,042.00
-29.9%
Average •- of • •-
Average Claims Per Subscriber
$74A
1
$347.33
1 1'.
]w -53.3%
Yz
11
Total Library (Union & Non -Union) F -I EHC
Paramedical Claim Amounts Paid
$3,000
■ 2017/2018
MTotal Paid
Percent of
Total Paid
Percent of
% Change
Claims
Total Paid
Claims
Total Paid
Year
Health Service Category
2017/2018
Claims
2018/2019
Claims
Over Year
Prescription .
. •
.1 •'
1
12018/20191
+11.7%
• : 1
1
+64.6%
+2.6%
••
1 1 1 1
1 1 0
• F=+130.8%
•1 11
1 •',
1•� 11
.'. I
+195.6%
All Other Services..
• • •
1
-59.6%
• •
11 11
:
1 11
1 1' .
-100.0%
Emergency Out -of -Canada
++
Mal EHC Claims Pa
$38,394.31
-�
$41,292.90
100.0%
+7.5%
Average •- of • •e
•
1
Average Claims Per Subscriber
$2,020.75
' I
$2,064.65
+2.2%
Paramedical Claim Amounts Paid
$3,000
■ 2017/2018
$2,500
132018/2019
$2,000
$1,500
$1,000
$500
$0
Podiatrist/ Other
Massage Physiotherapist Psychologist Naturopath Chiropractor Chiropodist Osteopath Practitioners
2017/2018
$2,131.12 $490.00 $0.00 $156.00 $910.00 $0.00 $0.00 $40.00
12018/20191
$2,446.49 $388.00 $0.00 $0.00 $690.00 $100.00 $0.00 $200.00
Working towards better solutions.._
12
Total Library (Union & Non -Union) ❑ Dental
Dental Care Procedure
Periodontics•
Total Paid
Claims
2017/2018
• 1 1
Percent of
Total Paid
Claims
Total Paid
Claims
2018/2019
1
Percent of
Total Paid
Claims
1'
% Change
Year
Over Year
+15.6%
Basic Restorative -s
EMT.T.•1 11
.'
+33.0%
Surgical Services
+357.5%
Exams & .• •
•1 1
1'.
•• 1
-2.8%
Major- . -
.1
1'
: • .1
•'
+105.7%
Preventative Services
4.5%
Orthodontics
1 1
1',
1 11
-77.6%
Endodontics•
1
LIL$28,796.201�
•'
1 11
$34,655.70
1 1'.
-100.0%
+20.3%
Average •- of • •-
•
1
$1,732.79
]w
+14.3%
Average Claims Per Subscriber $1,515.zi
Yz
13
Total for All Others (Arena, Council, Contract) '1 EHC
Paramedical Claim Amounts Paid
$1,000
$900 ■ 2017/2018
■2018/2019
Total Paid
Percent of
Total Paid
Percent of % Change
$700
$600
Claims
Total Paid
Claims
Total Paid Year
Health Service Category
2017/2018
Claims
2018/2019
Claims Over Year
Prescription .
11 •
: 1'
. .
. +1.6%
11 11
1
. 11
• -59.6%
-.
11
: •
-33.4%
.•
1 11
1 1',
11
•' ++
All Other Services & Supplies11
$327.89 $40.00 $0.00 $0.00 $85.00 $60.00 $0.00 $900.00
1 •'
• 11 11
• +496.6%
• 11
11
+231.9%
•
',1 11
1 1'.
',1 11
1 1'. ++
Emergency Out -of -Canada
++
Mal EHC Claims Pa
$11,042.06
$9,216.53
100.0% -16.5%
Average•- of • •-
1 1'
Average Claims Per Subscriber
$1,380.26
'I
$1,152.07
-16.5%
Paramedical Claim Amounts Paid
$1,000
$900 ■ 2017/2018
■2018/2019
$800
$700
$600
$500
$400
$300
$200
$100
$0Podiatrist/
Other
Massage Physiotherapist Psychologist Naturopath Chiropractor Chiropodist Osteopath Practitioners
2017/2018
$822.00 $500.00 $360.00 $0.00 $140.00 $0.00 $0.00 $300.00
12018/20191
$327.89 $40.00 $0.00 $0.00 $85.00 $60.00 $0.00 $900.00
Yl
14
Total for All Others (Arena, Council, Contract) -1 Dental
■
Dental Care Procedure
Periodontics11
Total Paid
Claims
2017/2018
Percent of ,
Total Paid
Claims
1 . '
Total Paid
Claims
2018/2019
Percent of
Total Paid
Claims
% Change
Year
Over Year
-20.9%
Basic Restorative -
11
•'
• .1
-36.5%
Exams & Diagnostic
-49.9%
Endodontics1
11
1
+19.6%
Preventative Services
-14.4%
ServicesSurgical
11
1' .
-93.9%
Major Restorative.
1
1 11
1 1' .
-100.0%
Orthodontics
L$7,304.94
$3,166.05
++
-56.7%
Average Number of • •-
Average Claims Per Subscriber
$913.11
Jw
$395.76
]w
1 1'
-56.7%
Yz
15
LIFE AND LTD CLAIMS EXPERIENCE AND RATING
Below are the Life and LTD claims paid for the past 30 months by Sun Life. At the February 1, 2019 renewal, the
/ UH:F-H-H N9i ❑GiJDEUM mLDEXh -Iiiii ELBiVVH7 7 ❑ =❑❑Q❑ ❑FRP SDL HG LWi6 ❑❑7 LLHVL
original proposal of +42%). This negotiated increase was softened on the basis of the Municipality of Clarington
being included within the Local Authority Services (LAS) Group Benefits Program.
Period
PAID CLAIMS
Life
LTD
2016/2017 (9 months)
$0
$0
2017/2018
$0
$70,762
2018/2019 (9 months)
$0
$0
Future renewals will be effective each November 1St (starting in 2019). Mosey & Mosey is in the process of
L HAN❑ L❑❑A1ViEHEk HC/ $ 6 LRE IDP "ESHL EFH, VREGI-PoILP L HANH SLS?b9 VdW LLH:DEGd 7 ❑ A1:L_FU 1VW 1 RJVV:i
upcoming renewal. Once that review has been completed, your projected rate adjustments will be communicated
for all benefits. However, we note that although the manual rate did have an impact on the February 1, 2019
renewal rate adjustment for LTD, it ceases to be a factor within the LAS Program (for both Life and LTD), since
the overall plan is large enough as a whole to be fully experience -rated. This fact alone will have a significant
benefit to your upcoming renewal projections for Life and LTD.
Y'
16
Dental Fee Guide Increases 9�
11HIEW,41
37.24%
° 31.19% 33.05
24.02 °la
° 27.56% 29.24.02%26.Q31a _
21.88°la
19.34%
16.80%
9°1a
% 5°la 6%
o la °la
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
IAnnual Adjustment I Cumulative Adjustment
40%
35%
30%
25%
20%
15%
10%
5%
0%
Source: ESI Canada
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