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Introduction

Eligibility is determined by the Benefits Office and they also adjudicate and pay short term disability benefits. Drug, health and dental claims are adjudicated and paid by Medavie Blue Cross whereas Great- West Life adjudicates the long term disability benefits and our life insurance coverage. The Local 46 Health Benefits Trust Fund assumes all financial liability of the Plan.

Because our Plan is self-insured, every claim you make directly affects the cost of the Plan. If claims go up dramatically, it eventually leads to higher contribution rates. On the other hand, if the Plan is used wisely, we all benefit. Factors driving the cost of the Plan include new, more expensive drugs, an aging population and cost-shifting from the public health care system to private plans like ours. What can you do to help? There is not a lot we can do about getting older or the rising cost of prescription drugs and health care, but there are a few steps that we can all take to help control rising costs, which in turn will allow the Trustees to continue to offer comprehensive benefits.

  • Use the Plan wisely: The purpose of the Health Benefits Plan is to ensure that you and your family have access to good and affordable healthcare, so use the Plan wisely. The Plan belongs to all of us.
  • Shop around and get the best price: Spend the Plan’s money as if it were your own. When possible, take the time to get the best price before buying health care items or services, or prescription drugs covered by the Plan.
  • Use generic drugs: Ask your doctor to prescribe generic equivalents; they have been shown to be as effective as their brand name equivalents.
  • Coordinate your coverage: If you or your spouse are covered by another plan, tell us. That way we can make sure both plans pay their fair share. More information on how this works can be found under the heading Coordination of Benefits.