ARCHIVED CD 2009-002
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February 12, 2009
SUBJECT: Administration of the Public Service Group Insurance and Other Benefit Programs
1.1. The purpose of this directive is to reinforce the insurance plan administration responsibilities of compensation advisors (CAs) and the insurance services staff in the Public Service Pension Centre (PSPC), formerly known as the Superannuation, Pension Transition and Client Services Sector (SPTCSS), at Public Works and Government Services Canada (PWGSC).
1.2. The directive impacts the administration of the following insurance plans: the Public Service Health Care Plan (PSHCP), the Disability Insurance (DI) Plan, the Long-term Disability (LTD) Plan and the Public Service Management Insurance Plan (PSMIP).
2.1. PWGSC has been undergoing a review of its authorities and Treasury Board Secretariat (TBS) policies to ensure that insurance administrative activities and resources are aligned with PWGSC's mandate and the TBS policy framework. Until recently, the insurance staff at PSPC was modifying invalid information on the insurance application forms received by departmental CAs. In addition to returning the forms to the CAs specifying the changes, the insurance administrators were also notified of these changes to avoid delays in the processing of employee benefit claims.
2.2. It has been concluded that this practice is not consistent with PWGSC's mandate. Departmental CAs are responsible for the accuracy, integrity, verification and timeliness of pay and benefits transactions. Furthermore, departments and agencies are liable and responsible for paying expenses incurred or benefits lost due to an administrative error that resulted in having an eligible expense or benefit under one of the group insurance or benefit programs not being reimbursed or paid to the member. For more information on the consequences for failing to fulfill these responsibilities, refer to section 8 of the TBS Policy of the Administration of the Public Service Pension Plan and Group Insurance and Other Benefit Programs at: Policy on the Administration of the Public Service Pension Plan and Group Insurance and Other Benefit Programs.
3.1. In line with PWGSC's mandate, the insurance staff at PSPC will no longer modify insurance application forms containing invalid information. In order to allow departmental compensation staff time to establish controls to ensure that information on the insurance application forms is accurate and verified, this procedural change will be phased in as follows:
Effective immediately, all insurance application forms containing invalid information that could result in a financial impact or liability will be returned to departmental CAs. The CAs will be responsible for correcting the information on the form, entering the appropriate information in the Regional Pay System (RPS), and returning the corrected form to PSPC. The following table provides the information on the insurance application forms that has a financial impact.
Insurance Type Key fields on insurance application forms where errors could result in a financial impact Public Service Health Care Plan (PSHCP)
- Deduction start date
- Effective date of coverage
- Eligibility date
- Level of coverage
- Single or family coverage
Disability Insurance (DI) and Long-term Disability (LTD)
- Acting salary
- Adjusted salary
- Last day of work
- End of elimination period
- Effective date of coverage
- Sick leave hours
- Excluded or non-excluded
Public Service Management Insurance Plan (PSMIP)
- Exclusion date
Note: PSPC Insurance Services will continue to correct the information on the Post Retirement Life Insurance Plan and Pensioners' Dental Services Plan forms because the member is a pensioner by the time the documentation is received in Shediac.
- Until March 31, 2010, insurance staff at PSPC will continue to support the CAs by modifying invalid non-financial information (i.e. certificate number, member name, date of birth, pay office/pay list). A copy of the insurance application form, with a covering note specifying the revised information, will be sent to both the insurance administrator and the department. The CAs will be responsible for entering the correct information in the Regional Pay System, where required, modifying the form and returning it to insurance services in the PSPC.
- As of April 1, 2010, CAs will be solely responsible for the accuracy of all information - financial and non-financial - on insurance forms and in the RPS.
3.2. Accuracy of Information
The CAs play a key role in ensuring that employees' receive the insurance benefits to which they are entitled. As invalid information could impact the benefit claim of the employees and cause undue hardship, it is critical that the information entered in the RPS and on insurance application forms is accurate and verified. Should a correction be required, it is essential that they are made in a timely manner. When data is accurate, it avoids delays in receipt of insurance benefits, enquiries and complaints from clients, as well as workload for compensation advisors in the correction of data.
As part of its responsibility, PWGSC will provide indicators to the TBS to allow them to monitor departmental progress on the integrity of insurance information.
PWGSC provides insurance courses that are tailored to meet the needs of the CAs. These courses are beneficial not only to new employees, but also serve as a refresher for the seasoned employees. The schedule of the courses is available on the PWGSC Compensation Sector Web site at the following link: Welcome to Compensation Training.
4.1. Any inquiries on the information contained in this document should be addressed to your (PWGSC) Compensation Services Office.
Original Signed by
Accounting, Banking and Compensation
Reference(s): CJA 3060-1
- Date modified: