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Administration Authority

Plan details

• How the Plan works


• Key players
• Administration Authority
• Financial management
• Administrator of the PSHCP


• Joining the Plan
• Who is eligible to join?
• Is membership optional?
• How do I join?
• What do I do if I need a replacement benefit card?
• When does coverage begin?
• Can I change from single to family coverage or vice versa?
• Can I increase or decrease my hospital coverage?
• Can I cancel coverage?
• Where do I call if I have a question about eligibility?



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• Cost
• How do I pay for my part of the cost?
• What happens if the cost changes?
• How do I pay if I'm not getting a paycheque?
• Where do I call if I have a question about my costs?



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• Coverage
• What coverage am I entitled to?
• Do I have to pay a deductible before I can receive benefits?
• Does the Plan pay all my expenses?
• How much does the Plan pay for…
• How can I check whether an expense is covered?
• Where do I call for emergency travel assistance?



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• Claims
• How do I claim eligible expenses?
• What can I do if I disagree with a claims decision made by the Administrator?
• What happens if my spouse also has health care coverage under another plan?
• What is the deadline for submitting claims?
• What is the group policy number?
• Where do I call if I have a question about a claim?



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• What the Plan does not cover
• General exclusions and limitations
• Drug benefit exclusions and limitations
• Vision care benefit exclusions and limitations
• Medical practitioner benefit exclusions and limitations
• Miscellaneous expense benefit exclusions and limitations
• Dental benefit exclusions and limitations
• Out-of-province benefit exclusions and limitations
• Hospital benefit exclusions and limitations
• Comprehensive coverage exclusions and limitations



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• Termination of coverage
• When does my coverage end?
• When does coverage for my dependants end?



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• Other administrative details
• Plan Document
• Plan booklet
• Overpayments
• Pension offices
• Public Service pensioners
• Canadian Forces pensioners
• RCMP pensioners
• Judges Act pensioners

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