Important News on Your PSHCP: Electronic Claims and New Pensioner Rates

February 26, 2018

 

The National Association of Federal Retirees is pleased to announce better electronic claims supports for the Public Service Health Care Plan (PSHCP) – a much-anticipated plan feature that the Association’s PSHCP pensioner representative, Jean-Guy Soulière, has been pushing to have implemented for plan members.

This is a real win for PSHCP plan members, including retirees,” notes Soulière. “It means many pensioners can now carry their entire plan on their mobile phone in their pocket, and these new resources will speed up claims reimbursements – which is so important when you’re a pensioner on a fixed income.

The Treasury Board has also announced the new PSHCP monthly contribution rates for pensioner members, which are explained in detail below.

 

New web and mobile claims submission

Pensioner plan members of the Public Service Health Care Plan will have an easier time filing their health claims thanks to new web and mobile claims submission. The new services and my Sun Life Mobile app will launch on April 1, 2018.

Members residing in Canada will be able to submit claims for paramedical services and vision care benefits electronically, from both the Sun Life Plan Member Services website at www.sunlife.ca/pshcp and the my Sun Life Mobile app.

In addition to electronic claims submissions, plan members can use the mobile app to review recent claims, find out what the plan covers, lookup drugs, search for providers and access the benefit card.

The app will also allow you to submit photos of receipts and documents to accompany your claims, and Apple users will be able to add their PSHCP benefit card to their Apple Wallet and enable TouchID to log in to the app securely without a password.

New web services include the ability to submit coordination of benefits claims between two Sun Life plans. Plan members can also complete and update positive enrollment information, and sign up for direct deposit.

Getting ready to access these services on April 1, 2018 is easy.

First, register today on Sun Life’s Plan Member Services website at www.sunlife.ca/pshcp. Sun Life will require your email address and banking details so that you may submit claims electronically. If you are already registered, you must also provide banking information to benefit from these services.

Then, download the free my Sun Life Mobile app for iPhone and Android devices from the App Store and Google Play.

For more information on the new web and mobile features available to PSHCP members, contact Sun Life at 1-888-757-7427 (or 613-247-5100 if you’re in the National Capital Region).

 

New PSHCP pensioner contribution rates

The Treasury Board has announced the new PSHCP monthly contribution rates that will come into effect April 1, 2018.

The contribution rates for retired members of the PSHCP with Supplementary coverage will be adjusted on April 1, 2018, to meet this year’s 50% : 50% (retired member : employer) cost-sharing ratio. PSHCP contribution rates are based on pensioner costs under the Plan over the preceding year.

The following tables break down the contribution rates by the Extended Health Provision (EHP) and Hospital Provision (HP) with a total amount paid by the pensioner each month. The tables compare 2017 rates (left) with the new rates for 2018 (right).

 

Single rate

 

2017

2018

Type of Coverage

EHP

HP

Total

EHP

HP

Total

Hospital Level I

$50.44

$0.00

$50.44

$58.31

$0.00

$58.31

Hospital Level II

$50.44

$16.56

$67.00

$58.31

$16.56

$74.87

Hospital Level III

$50.44

$45.41

$95.85

$58.31

$45.41

$103.72

 

Family Rate

 

2017

2018

Type of Coverage

EH

HP

Total

EHP

HP

Total

Hospital Level I

$97.24

$0.00

$97.24

$115.06

$0.00

$115.06

Hospital Level II

$97.24

$16.56

$113.80

$115.06

$16.56

$131.62

Hospital Level III

$97.24

$45.41

$142.65

$115.06

$45.41

$160.47

 

Relief Provision for Pensioners

If you joined the PSHCP as a retired member on or before March 31, 2015, relief from increasing PSHCP rates may be available if you are or become a recipient of a Guaranteed Income Supplement (GIS), or if your net or joint net income is lower than the GIS thresholds. The PSHCP Relief Provision can allow you to retain the 25:75 (retiree: employer) monthly contribution cost-sharing model. Find out who can and how to apply.

 

Single Rate 2017

Single Rate 2018

Type of Coverage

EHP

HP

Total

EHP

HP

Total

Hospital Level I

$28.82

$0.00

$28.82

$29.16

$0.00

$29.61

Hospital Level II

$28.82

$16.56

$45.38

$29.16

$16.56

$45.72

Hospital Level III

$28.82

$45.41

$74.23

$29.16

$45.41

$74.57

 

Family Rate 2017

Family Rate 2018

Type of Coverage

EHP

HP

Total

EHP

HP

Total

Hospital Level I

$55.57

$0.00

$55.57

$57.53

$0.00

$57.53

Hospital Level II

$55.57

$16.56

$72.13

$57.53

$16.56

$74.09

Hospital Level III

$55.57

$45.41

$100.98

$57.53

$45.41

$102.94

The new contribution rates will begin to be taken from the March 27, 2018 pension cheques. This is the final year for contributions to increase to meet the 50:50 cost-sharing ratio, though contribution rates may change in future years as plan costs can vary.

Federal Retirees is continuing its legal action to have the courts declare the government’s actions on the PSHCP unlawful. We had our say in Federal Court in April 2017, and an unfavourable decision from the Court in August 2017 – but we’re not done yet. The National Association of Federal Retirees is appealing the Court’s decision, though it could be several months before our appeal is heard. Learn more about the background on the Association’s PSHCP legal action now.

In the meantime, be sure to spread the word about membership with Federal Retirees. As a not-for-profit advocacy organization, we have strength in numbers and your membership matters. The larger our Association becomes, the stronger our voice – and the more effectively we can speak on behalf of federal retirees. Tell your federal retiree friends to enroll today.