2025 Welcome Package

Getting to Know ASEBP

Elected School Trustees

About the Alberta School Employee Benefit Plan

Our Mission

The Alberta School Employee Benefit Plan (ASEBP) provides sustainable, holistic health benefits, programs, and services to support education workers from the first year of their careers through to their well-deserved retirement. Established more than 55 years ago, ASEBP was created specifically to serve the needs of the education sector and has continuously evolved to align with this mission.

ASEBP is governed by 10 Trustees who are appointed by ASEBP’s two parent bodies, the Alberta School Boards Association (ASBA) and the Alberta Teachers’ Association (ATA). Trustees set ASEBP’s mission, values, and strategic direction, create and make changes to benefit plans, set premium rates, establish adequate reserves, and invest the funds of the Trust.

ASEBP benefit plans and services cover the full spectrum of the health and wellness journey, including general health, employee and family assistance, and loss of life and disability benefits.

As an employee life and health trust, ASEBP is different from traditional insurance providers and operates as a not-for-profit organization. Any profits gained from premiums or investment funds are reinvested into the Plan to benefit covered members. ASEBP’s trust structure provides flexibility to subsidize premium rates while ensuring Plan sustainability.

ASEBP is proud to be the tailored, comprehensive option for the more than 68,000 covered members and 84,000 dependants supported by our services.

As the recognized leader in providing comprehensive health benefits and services specifically designed to meet the needs of Alberta’s public education sector, ASEBP is a committed partner in promoting, protecting, improving, and sustaining the health of our covered members and their dependants.

Governance

All decisions require a two-thirds majority of voting Trustees. This requires seven Trustees to vote in favour of motions, so Trustees appointed by both the ASBA and the ATA must agree.

ASEBP is not accountable to shareholders or driven by corporate profits, so our Trustees can focus their attention and ASEBP’s efforts on the needs of Alberta’s school employees and employers.

ASEBP’s chief executive officer, who is appointed by the Trustees, along with the rest of ASEBP’s executive team, operationalize these decisions and create health initiatives, products, and services.

Journey to 2030 ASEBP’s strategic plan, the Journey to 2030, builds on past successes and providing a clear focus for the future.

ASEBP will look to: • Continue meaningful communication and engagement with covered members and stakeholders.

• Expand access and enhance prevention strategies to improve the health and quality of life of covered members.

• Increase the plan’s sustainability through administrative efficiencies and look for strategic ways to reduce plan and system costs.

• Deepen ASEBP’s reputation as a highperformance not-for-profit organization.

ASEBP is continually refining its approach to improve, maintain, and protect our covered members’ overall wellness. The strategic plan represents a commitment to consistently adapt and add value to Alberta’s public education sector and our stakeholders.

Benefits and Services Overview

Extended Health Care Extended Health Care includes coverage for drugs, travel emergencies, and other medical services and supplies (e.g., massage therapy, physiotherapy, psychology, and more).

Dental Care ASEBP’s Dental Care coverage helps proactively manage oral health through basic preventative and restorative treatments. Select ASEBP plans also cover major restorative dental work (e.g. bridges and crowns, etc.) and orthodontic treatments (e.g. braces and appliances, etc.)

Vision Care Vision Care benefits cover a variety of products and services designed to help maintain healthy eyesight. In order to qualify for coverage, products or services must be prescribed or provided by: • registered ophthalmologist, • registered optometrist, or • registered optician.

Life and Accidental Death and Dismemberment (Under 70 years of age)

The Life Insurance plan provides a lump sum payable to the designated beneficiary or the estate.

AD&D plans provide coverage in the event a death is accidental and include various coverage levels if an accident leads to dismemberment or loss of use of a body part or function.

Employee and Family Assistance Program (EFAP) EFAP is included in ASEBP benefits at no additional cost to employers, and accessible through a third-party provider, GreenShield. EFAP can be used in conjunction with Extended Health Care to help covered members get the most out of their ASEBP benefits throughout the year.

MyRetiree Plan The MyRetiree Plan is available to present or former employees of an eligible Alberta public or catholic school board, ages 50 and over, which provides covered members continuity with the same carrier as they transition into retirement. ASEBP’s MyRetiree Plan is tailored to the needs of Alberta’s retired educations workers and represents ASEBP’s intentional approach to scaling up our membership.

Information about ASEBP benefits and more details on coverage is available at asebp.ca Covered members and dependants can register for the My ASEBP desktop and mobile app, which provides easy access to coverage information, view claims history, and submit claims quickly.

Premium Rates ASEBP is committed to ensuring that the Plan is competitive and is continually seeking ways to ensure a fair balance between premiums collected and the cost of providing benefits.

As a not-for-profit employee life and health trust all excess funds, which are gained from prudent investment policies and positive plan experience, are reinvested in the Plan. Other benefits of this status include: • No commissions or profit charges are included in premiums.

• ASEBP’s investment gains are earned tax free.

• Premium rate flexibility (ASEBP can subsidize future rates or amortize losses over a longer period)

Rate Setting Process At ASEBP, months of analysis and preparation go into the rate setting process.

ASEBP enlists a third-party actuarial service to perform premium rate calculations, including: • Analysis of historical experience and emerging trends.

• Review of prior premium rate subsidies.

• External environment analysis.

ASEBP then estimates the claims costs for the upcoming year, based on historical data, and compares it against current premium rates to determine a breakeven rate. When doing this, ASEBP determines: • The premium rate required to fund actual claims costs.

• Loss ratios, which include paid loss ratio (what was paid out in claims divided by premiums) and incurred loss ratio (what was paid out plus how the reserves change and divided by premiums).

ASEBP values transparency, sharing with employers the key drivers of premium rate increases (e.g., inflation and plan utilization) along with our third-party actuary valuation and benchmarking, which helps employers prepare budgets by eliminating unknowns.

ASEBP does not take premium rate increases lightly and understands the impact they have on employers and covered members.

Sustainability ASEBP and its’ Trustees remains deeply committed to the long-term sustainability of the Plan and continues to buffer against external factors such as rising drug costs and higher Extended Health Care utilization. In addition to working with partners, monitoring trends, and managing costs through administrative efficiencies and diversified investments, the Trustees have directed ASEBP to implement cost containment strategies such as:

Rate Management: ASEBP collects and pools premiums from participating employers, which spreads risk across a large group, thereby lessening the impact of claims. In addition, pooling rates reflects the impact of an individual employer’s experience under the Experience Adjustment System (EAS).

Experience Adjustment System (EAS): The EAS

approach to rate setting preserves the advantages of pooling while providing participating employers with appropriate annual rate adjustments to address inequities in employers’ claims experiences (i.e., consistently above or below average utilization possibly resulting in higher or lower premiums), Employers new to the plan are not initially eligible for this program.

Sick Leave Support Program (SLS): ASEBP’s SLS

program provides administrative and case management services for sick leave absences greater than 14 days but less than 90 days. The program launched to all employers on January 1, 2025, and is showing promising signs of limiting durations of Extended Disability claims.

Employee and Family Assistance Program (EFAP): The EFAP is included at no additional cost to

employers. EFAP provides proactive health and wellness support to employees and their dependants, who can access pre-determined yearly support allotments, free of charge. Employees can continue with their chosen provider at below market rates for psychological services.

Therapeutic Alternative Reference Pricing (TARP): ASEBP’s TARP program encourages cost-effective prescribing, identifying preferred drugs for four common medical conditions (stomach acidity, high blood pressure, non-narcotic pain/inflammation management, migraines). The identified preferred alternatives medications are proven to be as safe and effective as their brand or generic counterparts.

Generic Substitutions: The coverage level for many

prescription drugs is based on the generic alternative (based on brand name drug patent expiry)—the lowest cost brand or generic drug alternative to what is prescribed by health care providers.

This standard helps maintain lower drug costs within the Plan, while continuing to meet covered member needs.

Managed Formulary: ASEBP works in close partnership with Alberta Blue Cross (ASEBP’s third-party adjudicator) to manage drug expenditures through its managed drug formulary, including drug special authorizations and generic substitutions.

Benefits Assurance: Claims are reviewed for accuracy while implementing measures to prevent and detect inappropriate and unusual claims to prevent fraud and abuse of benefits.

Dental Limitations: In 2019, ASEBP developed an evidence-

based, comprehensive Oral Health Strategy, that included numerous changes, such as frequency and age restrictions for fluoride treatment and polishing. ASEBP dental fees follow the Alberta Dental Association's previous year's Dental Fee Guide.

By using the previous year’s Dental Fee Guide, ASEBP protects premiums and avoids unanticipated dental fee increases throughout the calendar year.

Contact Us If you have questions about anything in this package, please contact ASEBP’s chief stakeholder relations officer, Dr. Carlyn Volume-Smith, by email at carlynvs@asebp.ca.

If you have questions about your ASEBP benefits, please contact a benefit specialist toll free at 1-877-431-4786 or email benefits@asebp.ca.

You can also book a virtual meeting or call back by scanning this QR Code.

@AlbertaSchoolEmployeeBenefitPlan @asebp_benefits