Choosing and managing your PSHCP coverage
June 13, 2017
The Public Service Health Care Plan (PSHCP) provides coverage for a wide variety of health-related products and services. Ensure you and your dependants are receiving the appropriate benefits by selecting the right coverage that meets your needs.
There are two types of coverage available to you under the PSHCP:
1) Supplementary coverage is intended for members and their dependants residing in Canada who are covered under a provincial/territorial health insurance plan, or;
2) Comprehensive coverage is intended for members and their dependants residing outside Canada who are not covered under a provincial/territorial health insurance plan or under a non-government hospital insurance plan. This type of coverage is only necessary for Plan members living outside Canada and not for those traveling abroad. Members with Supplementary coverage are protected while traveling for up to 40 days from their date of departure.
Within the Supplementary and Comprehensive categories, you may select either Single or Family coverage depending on your familial situation.
Following certain life events such as the birth of a child or divorce, you may need to modify your PSHCP coverage from Single to Family or vice versa. Updates to your Plan are not processed automatically and, under the PSHCP, a retroactive cancellation of coverage is not permitted. Each year, the PSHCP Administration Authority receives an increasing number of appeals from members asking to be reimbursed for an overpayment of contributions as a result of having forgotten to modify their coverage from Family to Single. All too often, members realize that their coverage level no longer reflects their current situation and that they have been paying for coverage they do not require. For example, a member may realize that he or she is still paying for Family coverage, yet they no longer have a spouse or eligible children under the Plan. Unfortunately, this omission results in an overpayment of contributions that may not be refunded.
As a PSHCP member, you are responsible for amending your level of coverage. To modify your file, complete and submit either an electronic application form using the secure online Compensation Web Application (CWA) (please note that CWA is accessible only from the Government of Canada network) or submit a paper Employee Application Form to your compensation office.
If you are a retired member wishing to amend your coverage, you must fill out a Pensioner Application Form and mail it to the address below:
Public Works and Government Services Canada
Government of Canada Pension Centre Mail Facility
150 Dion Blvd.
PO Box 8000
Matane, QC G4W 4T6
Please note that simply advising your compensation or pension office of a life event or a change of address status will not automatically adjust your level of coverage. In order to successfully amend your coverage, submit your request in writing along with the appropriate form. Neither your compensation office nor the pension office can modify your coverage without your written consent.
Lastly, any change made to your coverage will also require a modification to your Positive Enrolment information. You can update your Positive Enrolment information online through the Sun Life Plan Member Services website at www.sunlife.ca/pshcp or by submitting a Positive Enrolment Change Form to Sun Life by mail.
For more information on coverage under the PSHCP, click here.