(Update) Temporary change in process: Group insurance benefit plans administration

To: The Public Service Pay Centre, Compensation Managers, Heads of Human Resources and Pay/Pension System administrators of organizations paid by Phoenix

Subject: Temporary change in process: Group insurance benefit plans administration ( to )

Update: Due to ongoing operational delays, all temporary process changes are extended until .

Purpose

The purpose of this notice is to provide information regarding temporary process changes which took effect in October 2016, for the administration of the group insurance benefit plans which have been impacted by the implementation of the Phoenix pay system.

Background

In collaboration with Public Services and Procurement Canada (PSPC) and the Plan administrators, the Treasury Board of Canada Secretariat (TBS) put in place temporary process changes to address some undue hardship affecting group insurance plan members, in .

The following authorized temporary process changes are for employees of the public service who are paid by the Phoenix pay system. These processes will be in effect retroactively from to .

Public Service Health Care Plan (PSHCP)

  1. All waiting periods are waived.
    1. Until , and unless retroactivity is requested, the effective date of all applications or coverage changes are to be effective the first of the month, following receipt by the Pay Centre, or designated compensation office, of a completed Employee application form (PDF document – 94.65 KB) (TBS-006491) or the self-service electronic application in Phoenix.
    2. Applicants should first attempt to apply to the PSHCP or make changes to their coverage using the self-service electronic application in Phoenix. If this is not possible, employees should contact the Pay Centre by submitting a Phoenix feedback form or by phone. Please note this is a new process. For those paid by Phoenix but not serviced by the Pay Centre, the Employee application form (PDF document – 94.65 KB) (TBS-006491) should be sent to their compensation office.
  2. Retroactivity
    1. Until , a member can request a retroactive amendment to their coverage start date. Such requests must be provided in writing to the Pay Centre, or their compensation office, and will be effective the first of the month following the date that an employee first became eligible for the change in coverage requested; and,
    2. A retroactive coverage date request cannot be established further back than .

Example: An employee hired on , and who has already applied or is just now applying for coverage can, until , request a retroactive coverage effective date of .

Note: A benefit claim must be received by Sun Life within 12 months following the calendar year in which the expense is incurred. Claims will not be accepted after the 12 month deadline, unless the late claim is the result of unavoidable circumstances such as medical or psychological incapacity. If a member's claim is denied due to late submission, an appeal can be submitted to the PSHCP Administration Authority.

  1. Members who begin a period of Leave Without Pay (LWOP) between and , can request an amendment to their coverage without first returning to work provided they:
    1. Submit a completed Employee application form (PDF document – 94.65 KB) (TBS-006491) to the Pay Centre, or their compensation office, before ; and
    2. Acknowledge that any retroactive employee contributions will be taken from their pay upon their return to work.

Public Service Dental Care Plan (PSDCP)

  1. Until , members on LWOP who lost PSDCP coverage on or after , because contributions were not remitted in advance, can have coverage reinstated without first returning to work, provided:
    1. The request for reinstatement is received by the Pay Centre, or compensation office, before ; and,
    2. Cheque(s) for all missed and future contributions are supplied with the request, to the Pay Centre, or compensation office.
  2. New employees who have not been informed of their policy or certificate number should contact the Pay Centre, or their compensation office, for a status update.

Public Service Management Insurance Plan (PSMIP) – Basic Life Insurance

  1. The requirement for a Declaration of Health (DOH) form will be waived for an employee who first became eligible for Basic and/or Dependant Life insurance coverage after , and until , provided:
    1. The employee was and continues to be eligible to apply in accordance with the Plan rules;
    2. The employee was not already denied by Industrial Alliance; and,
    3. The employee submits a completed application form PWGSC-TPSGC 2028 or PWGSC-TPSGC 2028-5 to the Pay Centre, or their compensation office, before .

An employee who was eligible for Basic or Dependant Life insurance before , and who continues to be eligible but is not currently enrolled, must still complete a DOH form.

Note: This waiver of a DOH for Basic Life insurance does not extend to Supplementary Life insurance coverage which has always required a DOH form.

  1. When an employee returns to work, the Pay Centre, or compensation office, is authorized to recover missed premiums from a period of LWOP, which began between and , if premiums were not remitted to the insurer, in accordance with I.A.M. 4.17.1, I.A.M. 4.17.3.

Additional information available

For more information regarding measures being taken to address the various pay service issues, please visit Phoenix news and updates.

Additional information for employees can be found on the New to the public service page.

Marie-Chantal Girard
Assistant Deputy Minister
Pensions and Benefits Sector

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