By Robert Green
Mention ‘health insurance’ to any group of teachers within Quebec’s English school system and one is likely to hear complaints. There seems to be a widespread perception that this is an expensive plan for the coverage received. Some who have investigated the cost and coverage of individual health insurance plans offered by various companies have even claimed that they would be better off with such a plan rather than remaining with the Quebec Provincial Association of Teachers’ (QPAT’s) group insurance.
For these reasons, whenever the subject of health insurance has come up at the Montreal Teachers Association (MTA) reps assembly, a heated discussion has usually followed as reps attempt to express some of the frustration they hear from their members. Some of this frustration has been directed at Industrial Alliance and at the consulting company Mercer that recommends the use of Industrial Alliance to QPAT. Attempts by the MTA executive and professional staff to explain the role of these two organizations and the technical side of how the plan works seem to have been lost in the din of members expressing their frustrations about the plan.
In order to address this problem so that a more informed debate could take place, MTA Executive Assistant John Winrow invited many of those who had expressed concern about the plan to a meeting at the MTA office with a representative from QPAT.
Our Plan
The first thing that was explained at this meeting, that is important for the members of QPAT to understand, is that we the members of QPAT are the owners of this plan. This plan is not controlled by Industrial Alliance. We the members, through our association, QPAT, have determined what the coverage will be and how much it will cost. The role of Industrial Alliance is merely to administer the plan that we have created. Mercer, which was presented as one of the most knowledgeable and reputable insurance consultants in the province, is hired to ensure that the fees Industrial Alliance charges for this service are competitive.
The fact that this plan is owned and controlled by our own provincial association should mean that this is a plan that most teachers feel good about. As the meeting progressed several pieces of information came to light which could help explain why this is not the case.
The Only Province Without a School Board Contribution
This is ‘our plan’ both in the sense that we control its costs and benefits (which is not the case with an individual insurance plan whose premiums can quickly increase from their initially advertised rates) and in the sense that we the members pay the costs entirely. Quebec’s unions are the only teachers unions in Canada that have never succeeded in winning a board contribution to group insurance plans for their members. In every other province school boards pay part of the cost of teachers’ group insurance. This explains the intense dissatisfaction of teachers who have come to Quebec from other provinces, who are used to having far greater benefits at a far a far lower cost.
QPAT’s “Administration” Fee
The other important dimension of this plan being “our plan” is that the members must live with their own claims experience. In other words, if claims go up dramatically that could result in either increased fees or reduced benefits in subsequent years. Conversely, if claims go down this can result in a surplus and a “fee vacation”, as has recently occurred. What this also means is that if money is removed from the plan, it is the members who ultimately have to pay for it.
The members of QPAT might be surprised to learn that this is exactly what happens every year as Industrial Alliance transfers between $250,000 and $310,000 annually into QPAT’s operating budget. According to QPAT this transfer is done to help it defer the costs of “administrating” the plan. However, as QPAT’s budget indicates this amount is listed as a general revenue to its overall operating budget. Despite members raising concern that this amount is exorbitant on several occasions, QPAT has never provided its members with a formal breakdown of how this large amount of money is spent. Without such a formal breakdown members have no way of knowing whether this amount is actually justified or in fact represents a kind of additional back-door fee being paid to pad QPAT’s annual operating budget.
School Board Mismanagement?
Another reason that teachers may feel that they have not been getting their money’s worth out of this plan is that some years ago Industrial Alliance began noticing discrepancies between their own records and those of the school boards. A process was begun to look into the extent of these discrepancies. In addition, moves were made to switch to a digital system that would reduce such errors in the future. According to QPAT President Serge Laurendeau a discrepancy of $250,000 over ten years was discovered at just one school board, Riverside. According to Laurendeau discrepancies also possibly existed at the English Montreal School Board (EMSB) but were not investigated due to “time constraints” related to the implementation of the new digital system.
What this means is that beyond the $250,000 worth of errors at Riverside the members of QPAT will never know the full extent to which they have been paying, through their group insurance fees, for school board errors.
More disturbing is the fact that since these errors were discovered, no efforts were made by QPAT’s leadership to inform its members that such errors had taken place. This in itself is utterly outrageous given that it is the members of QPAT that ultimately had to make up for these lost amounts either through the premiums they paid, the benefits they received, or through lost surpluses to the plan as a whole.
Even more disturbing is that members of QPAT’s own executive committee seem to have been kept in the dark about this possible mismanagement. At a recent meeting of the MTA reps assembly, MTA President and QPAT executive committee member Ruth Rosenfield claimed to have no knowledge whatsoever of the fact that QPAT had been considering investigating her own school board (the EMSB) for the sorts of discrepancies that were discovered at Riverside.
In an email of February 24, Mr. Laurendeau was posed the following two questions: “Given that the members must ultimately pay for this mismanagement why has QPAT not informed its members that a quarter million dollars has gone missing from their plan? Further how is it possible that a member of QPAT’s own executive seems to have no knowledge of this important matter whatsoever?”
In his response of February 24 Mr Laurendeau opted not to respond to either question.
No Consultation on Benefits
A final reason that members may be dissatisfied with the plan is that at no time since the plan’s inception have members been formally consulted about the plan’s benefits. In theory the advantage of this being “our plan” is that we could consult our members and perhaps better cater this plan to their needs. However in the absence of political will by QPAT’s executive to take such an initiative, this ‘advantage’ remains theoretical.
