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Learning About Health Benefits

HEALTH BENEFITS 101 BCNU members learned about benefits administration and financing at province-wide education meetings held this fall.
Education meetings give members a comprehensive overview of their health plan

The province-wide series of full-day education meetings the union held this fall included a detailed presentation on the design of BCNU's current health benefits plan.

"We believe that benefits education and consultation with members is especially important because health benefits help form nurses' total compensation under the provincial collective agreement," says BCNU President Christine Sorensen.

"Just like wages and pension benefits, health benefits are a vital part of nurses' overall compensation package. So it makes sense that nurses have a say in determining the future of their health benefits plan."

Sorensen says it's also important that nurses understand how health benefit costs are determined and paid. The education sessions were touted as the start of the consultation process on benefits that will help determine any recommended changes to the nurses' health benefits package.

Those who attended the education sessions also learned about the single most important benefit plan feature they enjoy – 100 percent employer-paid benefits – and how BCNU is committed to maintaining this for the health and well-being of all nurses. 

Members were also invited to provide input on their health benefits priorities and asked what they'd like to see improved (see sidebar).


The rising cost of extended health benefits has been raised as a serious issue by health employers for nearly a decade. However, many members may wonder why employers do not just buy health insurance from a benefit provider that's less expensive than Pacific Blue Cross. This question was the subject of much discussion during the regional education sessions.

"It makes sense that nurses have a say in determining the future of their health benefits plan."

- BCNU President
Christine Sorensen

When most people think of a benefits plan, they think of what is called an insured plan, where an employer purchases benefit plan insurance from an insurer, such as Pacific Blue Cross or Manulife.  When purchasing insurance, an employer is charged an informed estimate of what the benefits will cost, a charge for administration, and an additional amount (called a risk surcharge) in case of unexpected benefits costs.

If health employers were purchasing insurance for a nurses' health benefits plan, they might save money by finding another insurer that charges a lower risk surcharge. But health employers do not purchase insurance for nurses' health benefits.

Instead, health employers self-insure the health benefits plan, taking on all the risk of unexpected health benefits costs. Instead of purchasing extended health benefits insurance from the benefits provider, they contract Pacific Blue Cross only to administer, or provide, the benefits to the member. This means that employers pay Pacific Blue Cross only for the cost of the benefits used by plan members, plus a small amount for administration. As a self-insured benefit plan, expenses are largely limited to the costs of those benefits claimed by members, and nothing else.

This is an important distinction. It means that, with a well administered plan, the only savings that could be found by switching benefit providers would be in the small cost of administration. Conversely, if a self-insured plan were administered poorly, switching plan administrators could save a lot of money.


As a self-insured plan, nurses' benefits are managed by a not-for-profit health benefits trust responsible for providing the benefits agreed to in the Nurses' Bargaining Association (NBA) collective agreement. Under this contract, the employer pays the bill for the benefits plan, no matter the cost. This arrangement protects nurses against escalating costs and safeguards the benefits offered. Regardless of the cost of the benefits plan, the employer can only make changes to nurses' benefits through collective bargaining.

Maintaining a 100 percent employer-paid benefits plan is a key achievement for the BCNU. All other health union members in BC are now forced to share the responsibility for funding their benefits plan through a Joint Benefits Trust (JBT) agreement. Under a JBT, funding for the benefits plan, including extended health, dental, and long-term disability (LTD) benefits is negotiated in advance and capped. If the benefits plan costs more than the negotiated amount, plan members and the employer share responsibility for financing the extra cost.

Under the 2019-2022 NBA provincial collective agreement, BCNU negotiated the opportunity for members to have a voice in the development of their future health benefits coverage while also securing 100 percent employer-paid funding.

Sorensen says it's a deal to be proud of. "BCNU remains committed to improving the value of nurses' benefits while protecting those members who rely on them the most." •

UPDATE (Dec 2019 / Jan 2020)
Updated: 12/23/2019 3:48 PM


The Nurses' Bargaining Association is currently exploring benefits plan redesign options. What would you like to see in your benefits plan?


I think vision care is huge and I’d like to see laser eye surgery added. These are things that people are really asking for. I’d like our nurses to be more aware of what their benefits are. I feel like there is a big gap – where there are so many people who are unaware of what their benefits cover. I’d like to see some changes but nothing drastic. I’m concerned about the backlash to BCNU if there are drastic changes.

NICOLE SHERLOCK, Richmond Vancouver

Improved vision care would be nice. I’m considering getting new glasses and my husband needs new glasses. It would be nice if they covered the actual eye exam. I didn’t realize that although we are covered for the eyeglasses up to $350, we still have to pay out-of-pocket for the exam. My husband needs strong lenses. He has astigmatism and he’s paying $500 just for lenses.


With kids, the cost of things like the learning assessments, therapy and all that kind of stuff is absolutely atrocious. There are kids who have a lot of needs, and I don't think our benefit package adequately supports our children.

ALEXANDRA HANSEN, Coastal Mountain

I do want to see more flexibility with the benefits package. I use chiro, massage, and acupuncture therapy for musculoskeletal pain. I have now used up all of my chiropractic coverage and for me [paramedical benefits] are all medically necessary. At this point I’m paying 100 percent out-of-pocket for chiropractic benefits because I still need them over and above what’s covered under our current benefits plan. Massage is fantastic, but it doesn’t always cure everything. I think flexibility would make benefits more accessible because my care isn’t accessible to me at this point.

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