Sixteen months after Canada Life Insurance Company took over management of the Public Service Health Plan (PSHCP), hundreds of thousands of federal retirees will now have their dental insurance plans with the same provider. , I would like to avoid a similar problem.
“I have dental work coming up, so I have to do it, and I’ve seen the history. [with the PSHCP]I’ve seen how these claims are handled,” said Debbie Myers, who retired from the federal civil service in 2020 after working in the government for 15 years.
On July 1, 2023, 1.7 million federal civil servants, retirees, and their dependents switched their health insurance coverage from Sun Life to Canada Life under a $514 million deal. Dozens of changes to the plan itself also went into effect at the same time, impacting coverage for some members.
What followed was months of frustration for many members, including being unable to reach call center representatives and suddenly being denied medication they had been taking for years because of changes in plans.
In one case, Myers said, MSH, which is contracted by Canada Life to provide supplemental insurance for retirees traveling abroad, took three months to reimburse a $175 doctor’s visit abroad. It took more than that, and even more. Canada Life will take five months to reimburse you for $54 of prescriptions related to the same claim.
“It’s really scary,” Myers said of switching dental plans. “I really hope they do it in their favor this time.”
Ralph Landry, who worked at International Affairs Canada for nearly 40 years before retiring in 2000, shares that concern.
“Because of what we saw, [health] We’re making plans, but we’re not too enthusiastic about what’s going to happen in the near future in terms of dental planning,” Landry said.
Dental plan switched on November 1st
Current federal employees already have a Canada Life dental plan, but 325,000 federal retirees switched their dental plan to the insurer on Nov. 1.
The new contract for the Pensioner Dental Service Plan (PDSP) is valid until 2032. CBC has not been able to determine how much money is being paid to Canada Life to take over the dental plan.
In a statement to the CBC, the Treasury Board Secretariat [TBS] It said it has learned from the challenges experienced during the PSHCP transition and will “use the lessons learned to support a positive experience.” [PDSP] members. ”
“In our first week of service, we paid more than 75,000 claims and responded to more than 15,000 calls with an average wait time of 7 seconds. [for both dental plans]. We remain committed to supporting our members to ensure the smooth continuation of their dental benefits,” Canada Life wrote in an email to CBC.
Retirement groups lobbied for a delay.
But groups representing some federal retirees, veterans and RCMP officers also said they were concerned about the switch.
Pensioners’ dental plans were scheduled to transition to Canada Life on July 1, but that was delayed by four months at the request of the National Association of Federal Retirees, which heard from members concerned about the switch.
“I think everyone learned from that. [the PSHCP transition] We want Canada Life to have the capacity to support its members…with a seamless dental claims process without delay,” said Hélène Nadeau, vice-president of the association.
To some extent, I use the word poppy, but I have received a lot of limited information.– Ralph Landry, Federal Retired
Improvements noted by TBS include automatically enrolling more than 99% of dental plan members and adding Canada Life agents to handle more calls.
TBS also said it has taken steps to ensure that claims are not denied if a dentist or plan member accidentally uses an old plan number or ID.
But Landry said there was once again a lack of communication.
“The information we received was limited and contained a lot of information…I use the word poppycock,” he said.
Landry said he doesn’t expect the changes to make a big difference in terms of reimbursement.
“Time will tell,” he said. “I just hope that Canada Life Insurance will be more careful than they were when I switched my health plan from Sun Life Insurance to Canada Life Insurance.”
