Group insurance benefit plans administration for the Public Service Pay Centre

To: The Public Service Pay Centre

Subject: Temporary change in process: Group insurance benefit plans administration ( to ) for the Pay Centre

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) has 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 new 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, of a completed electronic or paper Employee application form (PDF document – 94.65 KB) (TBS-006491).
    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, a scanned copy of the paper Employee application form (TBS-006491) can be emailed to: TPSGC.RSSFP-PSHCP.PWGSC@tpsgc-pwgsc.gc.ca.
  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 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 .

In the event the Sun Life system rejects a reported retroactive coverage effective date, error code UPE567 on the Weekly Eligibility Error Report, the Pay Centre will contact the Sun Life coverage team at 1-613-560-7512 and request the date be manually amended in the Sun Life system.

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 (TBS-006491) to the Pay Centre 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 before ; and,
    2. Cheque(s) for all missed and future contributions are supplied with the request, to the Pay Centre.
  2. New employees who have not been informed of their policy or certificate number should contact the Pay Centre 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 the Industrial Alliance; and,
    3. The employee submits a completed application form PWGSC-TPSGC 2028 or PWGSC-TPSGC 2028-5 to the Pay Centre 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 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 pay system issues.

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

Caroline Curran
Assistant Deputy Minister
Pensions and Benefits Sector

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