NBA Benefits
The current Nurses’ Bargaining Association (NBA) benefits package is one of the best in Canadian health care, and one of the only nurses' contracts where the employer pays 100 percent of the cost.
But in the upcoming round of negotiations, NBA benefits could change.
What Are the Options in this Round?
The current NBA contract requires nurses and health employers to implement one of the following two options by Jan. 1, 2026:
Option 1: Capping Massage Therapy Reimbursement
- The cap would apply to a monetary amount and could include a sliding scale dependent on the number of visits.
- Previous employer proposals would significantly reduce access for most nurses.
Option 2: Enhanced Flex Benefit Account
- Nurses would be provided with annual allowance for paramedical services (massage, physio, etc.) with a choice of how the money is spent.
- This flex account would be considered a taxable benefit.
- The amount of such an account would be negotiated based on a percentage of straight time payroll.
- Unused funds may roll over, but the amount proposed by the employer previously was less than all of the paramedical limits combined.
In either case, any benefit increases could mean higher out-of-pocket expenses for individual members or require additional negotiation to raise the reimbursement limit.
Learn more about your current benefits and what's at stake
Bargaining and Your Benefits - Part 1: Understanding Your Current BenefitsExplore the design of your current 100% employer paid extended health care benefits and remind yourself of what benefits are included along with their respective limits. |
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Bargaining and Your Benefits - Part 2: The Fight to Protect ThemBC's nurses enjoy some of the best benefits in Canada, but holding on to these benefits hasn't been easy. Dive into the history of NBA bargaining and discover how we reached where we are today. |
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Bargaining and Your Benefits - Part 3: What's Next for Your Coverage?Learn what the future of NBA bargaining may hold, what contractual obligations the NBA is under, and what alternative benefit plan designs look like. |
Current Benefits
Current NBA benefits include employer-paid LTD, dental, prescription coverage, medical aids and equipment, vision care, medical travel insurance, capped paramedical, and unlimited massage and physiotherapy.
These benefits are secure until January 2026, but the upcoming bargaining round will determine their future.
What’s at stake?
Previous bargaining rounds have committed the NBA to agree to either:
- Capping massage therapy reimbursement, or
- An enhanced flex benefit account
We also expect employers to pressure nurses to agree to a joint benefits trust (JBT) cost-sharing arrangement which would shift the financial risk and liability of rising costs from health employers to the NBA.
Why this matters
Employers currently pay 100 percent of the cost of benefits. But a JBT could make benefits less secure, tying coverage to funding levels and any changes could reduce coverage or increase out-of-pocket costs.
What’s a Joint Benefits Trust - and why should you care?
A JBT would:
- Force nurses to share costs (LTD, prescriptions, paramedical services, etc.)
- Tie benefits to funding - if the trust runs low, coverage could be cut
- Make benefits vulnerable to inflation and usage spikes
How Did We Get Here?
Health employer negotiators have consistently told nurses that benefits make up an ever-growing share of total compensation costs. For over 10 years, they have come to the bargaining table with the message that rising benefits costs are a serious issue.
2014 – 2019
- HEABC proposed moving nurses into a joint benefits trust (JBT) arrangement that would share the risk of increased benefits costs 50/50 between health employers and the union
- BCNU did not agree to a JBT, and instead negotiated Appendix U, which established a joint committee to explore cost savings without sacrificing our acquired gains.
- Other health sector unions did enter into JBT arrangements during this round of bargaining
2019 – 2022
- HEABC once again proposed a JBT and, again, BCNU did not agree.
- Instead, the parties agreed to Appendix U.1 which set out two potential options to contain rising benefit costs:
- capping massage therapy reimbursement, or
- the creation of an enhanced flex benefit account
2022 – 2025
- The parties agreed to extend the implementation deadline of Appendix U.1 to Jan. 1, 2026, with no changes to our current benefits
- In addition, a one-time, $60-million fund was successfully negotiated with the Ministry of Health in April 2023 to support nurses’ mental health and wellness