ARCHIVED CD 1996-028

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June 12, 1996

Ottawa, Canada
K1A 0S5

SUBJECT: Public Service Health Care Plan - New Plan Administrator

1. PURPOSE

1.1 The purpose of this directive is to provide you with instructions regarding the new administrator of the Public Service Health Care Plan (Public Service Health Care Plan (PSHCP)).

2. BACKGROUND

2.1 In December 1995, the Treasury Board agreed to award the contract to provide administrative services for the Public Service Health Care Plan to Sun Life of Canada.

3. POLICY

3.1 Effective July 1, 1996, Sun Life of Canada becomes the new administrator of the Public Service Health Care Plan.

3.2 The PSHCP policy and benefits are the same. If members have already paid their annual deductibles this year through claims made to Mutual Life, they will have met the deductible requirement with Sun Life. Co-payment procedures will also remain the same.

4. PROCEDURES/INSTRUCTIONS

4.1 Pay input procedures which apply to PSHCP contribution deductions on the Regional Pay System remain the same.

4.2 The PSHCP claim form has been revised. The headquarters of client departments and agencies will be provided with an initial supply of the new standard form. If personnel offices require additional forms, they may contact the Treasury Board Secretariat at the following address:

Distribution Centre
Treasury Board Secretariat
Level P1, West Tower
300 Laurier Avenue West
Ottawa, Ontario
K1A 0G5 Telephone: 613-995-2855
Fax: 613-996-0518

Personnel offices are reminded that, upon claim reimbursement, Sun Life will provide the member with a personalized claim form. Personnel offices should encourage members to use the new Sun Life claim form to ensure the efficient processing of claims. Sun Life will, however, continue to accept remaining Mutual Life forms.

Effective July 1, 1996, the PSHCP - Application for Designation of Additional Dependant for Comprehensive Coverage, form Public Works and Government Services Canada (PWGSC) 2028-8, should be forwarded to Sun Life instead of Mutual Life at the following address:

Sun Life of Canada
Health Claims Office
240 - 1730 St. Laurent Blvd.
Ottawa, Ontario
K1G 5L1

The form is being amended to reflect Sun Life's mailing address. The procedures to be followed for the completion and distribution of this form are contained in Section 2.7.1 of the Insurance Administration Manual.

4.4 Commencing a few days before July 1, 1996, personnel offices should remind PSHCP members to start mailing their claim forms to:

Sun Life of Canada
Health Insurance Claims
P.O. Box 9601 CSC-T
Ottawa, Ontario
K1G 6A1

4.5 If Mutual Life receives a member's claim after July 1, 1996, it will automatically be forwarded to Sun Life. After July 1, 1996, members should call the Sun Life Service Centre for any questions they have about medical benefits or claims status. The toll-free number is 1-888-757-7427. If they are calling from the Ottawa/Hull area, they can make a local call to 247-5100.

4.6 If a member's benefit card is lost or stolen, personnel offices should contact the Sun Life Service Centre at 613-247-5100 for a replacement. When a new benefit card is required because the member's name is changing, the personnel office should forward a written request to Sun Life (at St. Laurent Blvd. Ottawa) and provide a copy to the Superannuation Directorate.

4.7 An amendment to the Insurance Administration Manual will be issued shortly to reflect these changes.

5. INQUIRIES

5.1 Any request for information regarding the foregoing should be addressed to your PWGSC Client Services Centre as per Compensation Directive 1994-039 dated October 6, 1994.

Original Signed by
P. Charko

P. Charko
Director General
Compensation Sector
Government Operational Service

Reference: CJA 9006-5-1, 9242-1