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

Public Service Health Care Plan (PSHCP)

1. All waiting periods are waived
   1. Unless retroactivity is requested, the effective date of all PSHCP applications or request for coverage changes will take effect the first of the month, following receipt by the Pay Centre or designated compensation office of a completed self-service electronic application in Phoenix or Employee application form (PDF document – 94.65 KB) (TBS-006491).
   2. Applicants should first 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. 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. 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;
   2. A retroactive coverage date request cannot be established further back than September 1, 2015.

Example: An employee hired on January 21, 2019, who has already applied or is just now applying for coverage, can request a retroactive coverage effective date of February 1, 2019.

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.

3. Members who began a period of Leave Without Pay (LWOP) on or after September 1, 2015, 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 designated compensation office; 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. Members on LWOP who lost PSDCP coverage on or after September 1, 2015, because contributions were not remitted in advance, can have coverage reinstated without first returning to work, provided:
   1. A request for reinstatement is received by the Pay Centre or designated compensation office; and,
   2. Cheque(s) for all missed and future contributions are included with the request to the Pay Centre or their compensation office.
2. New employees who have not been informed of their plan 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 on or after September 1, 2015, provided:
   1. The employee was and continues to be eligible to apply in accordance with the Plan rules;
   2. The employee’s application 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.

An employee who was eligible for Basic or Dependant Life insurance before September 1, 2015, 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.

2. When an employee returns to work, the Pay Centre, or designated compensation office, is authorized to recover missed premiums from a period of LWOP, which began on or after September 1, 2015, if premiums were not remitted to the insurer in accordance with I.A.M. 4.17.1 and I.A.M. 4.17.3.