Frequently asked questions

The Teachers’ Pension Board of Trustees reviews the plan’s retirement health coverage periodically to ensure the coverage and premiums provide the best value for members, meet the needs of members and are sustainable over the long term. Retirement health coverage is optional and funded by members.

If the board chooses to make changes to retirement health coverage, they would be implemented in January 2025.

The board will review the results of the survey as well as other factors like plan usage, cost, sustainability and market trends to decide whether changes to retirement health coverage are needed.

Information about the results of the survey will be shared with members in early 2024.

The board will consider member feedback, along with other factors, in its decision making. Phase one of the engagement was launched in fall 2022. Retired members who are enrolled in retirement health coverage were invited to participate in focus groups to provide feedback on the current plan, including what is working well and what might be improved.

Phase two of the engagement sought wider member input through an online survey.

In phase two of the engagement process, all retired members and active members within five years of retirement were invited to provide their input through an online survey.

Members were eligible to take part in the engagement if they were either:

• An active member contributing to the Teachers’ Pension Plan and within five years of retirement
• A retired member collecting a pension from the Teachers' Pension Plan

If you are unsure whether you are a member of the Teachers' Pension Plan, contact your school district.

If the board decides to move ahead with changes to coverage, the changes will apply to all members enrolled in coverage, regardless of retirement date.

The survey ran from September 18, 2023, to October 13, 2023.

Thank you to everyone who participated in the retirement health coverage survey. The survey is now closed.

Watch the plan website and the Pension Life retired member newsletter for updates about what we learned.

• Learn more about what is currently covered under the plan by reading the GreenShield My Benefit Plan booklet.
• Watch a recorded webinar about the current extended health coverage and this engagement project.
• Watch a short animated video about current extended health coverage.

The extended health care plan is set up to supplement services and supplies available through public programs (e.g., PharmaCare and Medical Services Plan). To make sure premium costs are manageable and sustainable, some services, such as vaccines, are not covered.

The Essential dental plan offers coverage on basic services (e.g., recall visits, fillings, simple extractions) and basic comprehensive services (e.g., root canal, periodontal scaling) up to an annual limit of $1,000. The Enhanced plan offers coverage on basic and basic comprehensive services plus major services (e.g., crowns and dentures) to an annual maximum of $2,000.

For more information about what is considered a basic, basic comprehensive or major service, read the GreenShield My Benefit Plan booklet.

Any improvement to one area of coverage will increase the cost of the extended health plan. That means either premiums would need to be increased or another area of coverage would need to be decreased or made more cost-efficient.

The extended health and dental plans do not include travel coverage. However, GreenShield does offer optional medical travel coverage at an added cost. Contact GreenShield for more information.

For more information about limits on drug coverage, watch the recorded webinar or read the GreenShield My Benefit Plan booklet.

For more information about the Special Authority program, including which drugs require Special Authority, see the BC PharmaCare website.

Most doctors and pharmacists are familiar with drugs listed by BC PharmaCare, so you can ask your health professional. In fact, you can save money if you tell your doctor you prefer to be prescribed a drug covered by BC PharmaCare.

You can also use BC PharmaCare’s online formulary search tool to learn if your drug is covered by PharmaCare. Visit the BC PharmaCare website. If your drug is not listed, or it displays “$0.00” or shows no value under the Maximum PharmaCare Covers column, it means it is not covered by PharmaCare. Click the highlighted DIN/PIN/NPN number to see details for the product. The result may indicate the drug is a “non-benefit,” which means it is a non-PharmaCare drug.

A premium is the monthly amount a member pays for their coverage. Premium rates are based on the level of coverage and member use of the plan. A plan with more coverage and higher overall member usage requires a higher premium to cover expenses.

Premium rates are reviewed and negotiated annually with GreenShield.

Learn more about current premiums members pay for the extended health plan and the dental plan by reading Retirement health coverage premiums. Premium rates are subject to change February 1 of each year.

The board reviews and sets premium rates each year. Premiums may be increased, be decreased or stay the same depending on factors such as plan usage, new drugs available on the market, PharmaCare policy changes and inflation.

Updated premium rates are announced January each year in Pension Life (the retired member newsletter) and on the plan website, and are effective February 1 of that year.

Premium rates are set every year and are based on usage. Rates are reviewed and negotiated with GreenShield every year to make sure they are in line with expected usage and inflationary adjustments in the coming year.

The premiums you pay for retirement health coverage are automatically deducted from your monthly pension payment. If your pension payment cannot cover the extended health care and dental premiums, you must pay GreenShield directly through pre-authorized debit.

A deductible is the amount that must be paid by you or on behalf of you and your dependant each calendar year before an eligible expense will be reimbursed.

The current annual deductible is $200. The deductible does not apply to hearing care, vision care and emergency in-province expenses.

The deductible is applied per person, not per family.

Health plans include a deductible to share the costs with the member. This is done by requiring members to pay a certain amount before the health plan begins to pay claims. The deductible helps keep premiums lower for the plan. It is possible to remove the deductible completely, but that would increase premiums significantly or require other trade-offs.

Co-insurance is the percentage of the eligible cost of an extended health or dental expense that is paid by the plan after the annual deductible has been paid.

The current co-insurance is 80 per cent for extended health coverage until $1,000 of paid claims has been reached per person per calendar year. After that, it increases to 100 per cent for the remainder of the year.

Note that hearing care, vision care and emergency in-province expenses are covered at 100 per cent. Also, the co-insurance is 90 per cent for prescription drugs filled at Costco.

Some areas of coverage do not have annual maximums (e.g., prescription drugs); other areas of coverage do have dollar limits applied over a certain period (e.g., vision care, orthotics, massage therapy). See the GreenShield My Benefit Plan booklet for the applicable maximums. Maximums are per person, not per family, and usually apply to the calendar year.

The plan has a $200,000 lifetime maximum per person. If you reach that lifetime maximum, you will no longer be covered, but your dependants will continue to be covered and your premium rates will be adjusted to pay only for that dependant coverage.

GreenShield will notify you if you are approaching your lifetime maximum. You may be able to preserve your lifetime maximum by asking your physician to help you apply to a public drug program such as BC PharmaCare for Special Authority approval, which will coordinate drug costs with the province. If you are taking a high-cost drug and are concerned about reaching the lifetime maximum, talk to your physician or the drug manufacturer’s patient support program for more information.

If you are currently retired, you can learn how to enrol in the program by reading Apply for or cancel coverage on the plan website.

If you are nearing retirement, you can learn more about retirement health coverage and how to enrol by reading Retirement health coverage and you on the plan website.

See Retirement health coverage and you on the plan website for more information about eligibility.

To be eligible for coverage, your unmarried dependent child must be under age 19. The rules are different for full-time students and disabled children who are considered your dependant under the Income Tax Act. For full eligibility information for dependent children, see the GreenShield My Benefit Plan booklet.

Retirement health coverage under the Teachers' Pension Plan is optional. However, it is important to note that if you choose not to enrol when you retire, you will need to meet specific requirements if you want to enrol later. See the GreenShield My Benefit Plan booklet for more information.

No. Once you retire, you are no longer eligible for coverage through your employer.

Retirement health coverage under the Teachers’ Pension Plan is optional. Depending on your situation, you may have access to group coverage through another provider, such as your spouse’s employer.

We recommend you carefully review coverage details such as co-insurance, premium rates and annual maximums, and assess the current and future health needs for you and your family.

You may be eligible for dual coverage. The GreenShield plan is set up to coordinate with other plans that may be available to you (e.g., your spouse’s plan). Contact the plan for more information.