DID YOU KNOW? The Top 10 Prescription Drugs used by members of the UNB Health Plan represented 21.2% of total prescription drug costs for 2011 as compared to 18.5% the previous year. The Top 10 Drugs by cost for 2011 are as follows:

Don’t forget to notify Human Resources if your eligibility changes. For instance, if you get married or have a baby, you must apply for coverage within 31 days. Please do not delay submit-ting your request, as late requests can affect your in-surability. Also, if you are currently not enrolled in the Health and/or Dental Plans because you have other coverage, don’t forget to notify Human Re-sources if you lose that cov-erage. You must notify HR within 31 days.

ELIGIBILITY CHANGES

Benefits NEWSLETTER Human Resources & Organizational Development

November 2012

If your child is between 19 and 24 years of age and will be attending school as a full-time student at an educational institution this fall, you are able to continue coverage for him/her under your family Health and/or Dental Plan.

But, you must register your “over-age” de-pendents each year by the end of August for each academic year. You can also access the form on our Website at unb.ca/hr/_resources/forms/overagedependent11.pdf.

HAVE YOU REGISTERED YOUR OVER-AGE DEPENDENT?

Name of Drug Paid Amount

2011 Paid Amount

2010 Class of Drug

1. Enbrel $127,739 $87,703 Rheumatoid Arthritis/Spondylitis

2. Crestor 90,301 80,208 Cholesterol

3. Remicade 54,742 56,374 Rheumatoid Arthritis/Crohn’s

4. Copaxone 50,544 42,943 Multiple Sclerosis

5. Sutent 46,964 32,426 Tumor Treatment/Cancer

6. Nexium 41,807 43,028 Gastro-intestinal

7. Advair 38,428 38,667 Asthma

8. Lyrica 36,250 27,164 Neuropathic Pain Reliever

9. Tecta 36,087 28,822 Gastro-Intestinal

10. Losec 33,074 36,405 Gastro-Intestinal

Total of Top 10 $555,936 $473,740

UNB Health Plan

The FBRC is pleased to advise that services from Certi-fied Acupuncturists and Certified Athletic Therapists (when prescribed by a physician) have been approved for coverage under the UNB Health Plan. The annual treatment and financial limits will be combined with the current Physiotherapy benefit.

UNB Dental Plan

The FBRC is pleased to advise that our plan will be amended to partially cover implants, up to the amount that would have been permitted if the member had cho-sen a lower cost alternative procedure that is an eligible expense under the UNB Dental Plan. For a more com-plete explanation, please contact the HR&OD depart-ment, preferably before you decide on a treatment plan.

Also, effective July 1, 2012, benefits will be paid based on the 2012 New Brunswick Dental Fee Guide.

Monthly Rates (Family):

Effective July 1, 2012

Plan Changes

Plan 2012 2011 2010

Health $240.09 $225.52 $222.35

Dental $104.08 $90.35 $82.14

Group Life & Family Protection Benefit (per

$1,000 of annual salary) $0.6155 $0.4730 $0.4730

Long Term Disability Insurance (per $100 of

monthly salary) $2.063 $2.028 $2.028

C.O.B Coordination of Benefits (COB) is a process where individuals, couples or families with more than one benefits plan combine their ben-efits coverage. This allows a plan participant to have coverage for up to 100 per cent of the dollar value for eligible prescription drug, dental or health services benefits.

To take advantage of COB, you submit claims to your benefits carrier for adjudication first. Once you have received an explanation of ben-efits or statement from your benefits carrier, you can submit a claim for the eligible out-standing amount to your spouse’s or your own second plan.

In accordance with an industry-wide protocol, for families with dependent children, the parent whose birth month falls earlier in the calendar year is considered holder of the primary plan for the dependent children. If both parents’ birthdays are in the same month, then the par-ent whose day of birth is earlier is primary. The year of birth does not matter. If the parents are separated or divorced, claims for dependents should be submitted first to the plan of the par-ent who has custody of the children – the pri-mary plan.

UNB Prescription Drug Maximum Reimbursement program UNB has agreements in place with some local pharmacies whereby they have agreed that if you fill your prescriptions at their pharmacies, they will do so, at no cost to you. Typically, drugs covered un-der the Plan are subject to a co-pay to the maximum of the dispensing fee less $5 plus the mark-up less 9.5%. The following pharmacies are participants:

Fredericton / New Maryland / Oromocto

Smythe Street Atlantic Superstore

Pharmasave – Fredericton North

Pharmasave – Fredericton South

Ross Drug – Queen & Smythe St., Rookwood Ave.

Southside Walmart

New Maryland Pharmacy

Oromocto PharmaChoice

Medicine Shoppe (Fredericton Direct Charge Coop)

Moncton Area

Trinity Drive Atlantic Superstore

Champlain Place Walmart

Saint John Area

Atlantic Superstore – Millidgeville & Rothesay

Supervalue – Lancaster Mall

Westmorland Road Walmart

Bathurst Area

St. Peters Avenue Atlantic Superstore

Chaleur Centre Walmart

War Zone Restrictions SSQ Financial Group publishes a monthly list that indi-cates areas where possible limitations or exclusions may affect coverage should you need to file a claim. The list is available from UNB Human Resources. Many exclu-sion zones might not be immediately top-of-mind (eg. Egypt, Fiji, Thailand, India, Qatar) so we encourage you to review the listing regularly. Additionally, Foreign Af-fairs and International Trade Canada posts updates on countries around the world. The listing is posted on the web at voyage.gc.ca/countries_pays/menu-eng.asp. These updates indicate whether Canadians should:

Exercise normal security precautions – there is no

significant security concerns

Exercise a high degree of caution – there are identi-

fiable security concerns, and travelers should be

alert and vigilant to their surroundings

Avoid non-essential travel – there is a specific secu-

rity concern, and travelers should reconsider their

need to travel at this time

Avoid all travel – there is an extreme risk to personal

safety, and Canadians should not travel at this time

If you are going to be travelling abroad and the country you will be visiting is a war-zone risk, you must contact with UNB HR. You may be able to apply for an endorse-ment that indicates that you will be covered (may be an additional fee). When contacting, you need to provide a list of full names of the insured member(s), length of travel time, and the countries to which you will be travel-ling.

Group Travel Plan On April 1, 2010, UNB switched its provider of Group Travel Insurance from Medavie Blue Cross to AXA Assurances Inc. In January, 2012, UNB’s Travel Insurance provider, AXA Assurances Inc., was acquired by the SSQ Financial Group. With one exception, coverage under the Group Travel Insurance provider remains unchanged by the acquisition. The card and phone number is the same. The exception is for Plan Members mak-ing claims for Out-of-Province Referrals. Out-of-Province referrals are claims for travel expenses while accessing health care services not available in New Brunswick. Those claims are made di-rectly to SSQ Financial.

I have a common-law spouse, would they be eli-gible for benefits under UNB’s Fringe Benefits Plans?

Yes, common-law relationships are recognized under your group fringe benefits package, and should be added to your group coverage as a dependent. If this spouse has health or dental coverage elsewhere and opts out of your Plan, you should provide HR with their policy number and insurance carrier. Should their coverage end, they should be added to your Plan within 31 days. Otherwise, coverage could be affected.

My dentist currently charges above the “current” New Brunswick fee guide. Will this affect my pocketbook?

The UNB Dental Plan covers a fixed percentage of the regular and customary fees associated with den-tal care claims. These are decided by the provincial dental association. The insurance community uses these fees to decide claim payment. If your dentist charges above the fee guide, Medavie Blue Cross will ONLY pay the amount prescribed by the NB Dental Fee Guide. As a consumer, you will be re-sponsible for anything over and above this amount.

I am a new employee and new to New Brunswick, my family has not yet joined me, are they eligible for coverage?

Yes. So long as they are Canadian citizens, residing in Canada, they are eligible for coverage on your group plan.

FAQ’s

Spotlight on the Health Plan The chart below breaks down Health Claims for 2011:

The University of New Brunswick

Major Medical 26.8% Prescription Drugs 65.5%

Vision Care 6.5% Semi-Private hospital 1.2%

Medavie Blue Cross - Medication Advisory Panel (MAP)

NAME Indication Pharmaceutical Decision

Toctino Severe chronic hand eczema Recommended with exception status

Revolade Chronic immune thrombocytopenia purpura Declined

Zanhale Asthma (inhaler) Regular Benefit

Daxas Chronic Obstructive Pulmonary Disease Recommended with exception status

Mezavant Ulcerative colitis Regular Benefit

Vyvanse Attention Deficit Hyperactivity Disorder Regular benefit

Targin Opioid-induced constipation Declined

Kuvan Phenylketonuria Declined

To help Plan Sponsors like UNB meet the challenge of rising health care costs and insure efficacy of medications, Medavie Blue Cross has a Medication Advisory Panel (MAP). The MAP is a panel of external and internal experts that make recommen-dations concerning new medications. Its mandate is to provide a comprehensive review of medications to ensure their use is proven effective, medically necessary and cost affordable with respect to health outcomes. Who is the MAP?

The panel consists of:

Five pharmacists (one hospital, one retail and three internal)

Two physicians (GP and cardiologist)

Ph.D. in Pharmacy Health Care Administration

Two registered nurses (one internal and one external)

Actuarial pricing specialist

Director of Group Product Management (chairperson) What happens when a new drug comes to market?

The first step in introducing a new drug to the Canadian market is for the drug to receive a Notice of Compliance (NOC). A No-tice of Compliance is a notification indicating that a manufacturer has complied with relevant sections of the Food and Drug Reg-ulations.

Once a new drug receives its NOC, it becomes available to Canadian Consumers; however, an NOC doesn’t automatically mean your plan will cover the cost of the new drug. In fact, MBC requires submissions from the drug manufacturer before it considers a drug as a potential benefit.

Submissions to MBC require a focus on pharmacy and economic data, impact on short and long-term disability, drug efficacy, statistical significance of the drug research, off-label use, safety and patent expiration.

Once the MAP completes its review of a new drug, six outcomes are possible:

The drug is recommended as a full benefit.

The drug is recommended as a full benefit with maximum amount.

The drug is recommended with exception status (special authorization).

The drug becomes supplemental to government funding.

It is recommended that the drug be declined.

Decision postponed until further information has been obtained.

In 2011, the MAP reviewed the following recently introduced medications:

If you would like more information on the MAP process or on a particular drug decision, please contact Kevin Ring, Secretary of the Fringe Benefits Review Committee at the UNB HR department.

©University of New Brunswick 2012