Public Services and Procurement Canada
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Provision of the personal information is required pursuant to the Department of Public Works and Government Services Act, para. 7(1)(d) and s.13, for the following purposes: certify eligibility to the PSHCP Relief Provision and authorize deductions from your pension. Refusal to provide the requested information or the provision of incorrect information may result in loss of benefits and / or delays in processing your PSHCP Relief Provision Application. The personal information is protected and only used in accordance with the Privacy Act and as described in Personal Information Bank PWGSC PCU 703 Federal Government Employees, Pensioners and Survivors-Insurance Information. Under the Act, individuals have rights to request access to, and correction of their personal information, if erroneous or incomplete, and to make a complaint to the Privacy Commissioner of Canada.
I, the undersigned, have read the above Privacy Notice and consent to the collection and use and disclosure of my personal information, as described therein.
Retired members' percentage of contributions for Supplementary Coverage is currently 25% of the plan costs, excluding hospital coverage. The changes to the PSHCP cost sharing for retired members are:
The rate will be adjusted annually after that date to maintain a 50:50 cost sharing ratio. Retired members who elect for coverage at levels 2 or 3 will continue to be responsible for 100% of the additional cost for the hospital coverage.
Retired members of the federal public service who are entitled to the PSHCP Relief Provision are eligible to retain the existing retired member / employer cost sharing ratio (25:75) for as long as they meet the
criteria for the provision.
To be eligible for the PSHCP Relief Provision you must be a retired member of the PSHCP with
Supplementary coverage (or have applied for PSHCP coverage) on or before March 31, 2015, and either:
The survivor of an eligible retired member who meets one of the above criteria is eligible to receive the PSHCP Relief Provision provided there is no break in PSHCP plan participation.
Complete and sign the PSHCP Relief Provision Application Form and return it to your pension office. Please contact your pension office if you require assistance completing your application.
Approved applicants will be contacted next year and asked to again complete the new application form. That
application form will provide your pension office with the authority to contact CRA and/or ESDC to obtain the necessary information to validate your continued participation in the PSHCP Relief Provision for both, next year and each year thereafter.
In the event you are no longer found to be eligible for the PSHCP Relief Provision through the annual
validation process, your PSHCP contribution rate will be adjusted to reflect the standard PSHCP retired
member cost sharing ratio for the Supplementary coverage in the second month following your income
Yes, however, you will require to submit a new PSHCP Relief Provision Application Form.
No. PSHCP Relief Provision for those who meet the income thresholds of the program or who declare they are in receipt of GIS will only be effective the second month following your pension office's receipt of an application form.
PWGSC-TPSGC 481 E (2014-10)