At Canada Life, we are dedicated to ensuring you have reliable access to your health and wellness benefits when you need them.
We know that during the recent transition of the Public Service Health Care Plan (PSHCP), some plan members' experience has not met that standard. We are committed to getting things right.
From speaking with you, we heard what needs to be fixed:
- Reducing call centre wait times
- Improving claims processing times
- Ensuring compassionate care is available quickly for those with urgent needs
To help accelerate improvements in your member experience, we are implementing a Customer Service Action Plan. This plan focuses on the above 3 core priorities:
1. Reducing PSHCP Member Contact Centre wait times
- Dedicated support for PSHCP members
Our PSHCP Member Contact Centre will be temporarily open 7 days a week from November 1 through December 17, 2023. With extended call centre hours, we will be temporarily suspending chat and email capability from your PSHCP Member Services account through My Canada Life at Work™. This temporary suspension from November 6, 2023, to December 17, 2023, will enable timely responses by eliminating duplicate requests and ensuring your inquiries are received and processed faster.
If you need assistance, please reach out to us through the PSHCP Member Contact Centre at 1-855-415-4414 (toll-free), during our usual hours from Monday to Friday from 8 am to 5 pm, your local time. As part of our extended hours, we will also be available on Saturdays and Sundays between 9 am to 5 pm ET until December 17, 2023.
- Increasing the number of PSHCP Member Contact Centre agents
Since early July, we have been investing in our PSHCP Member Contact Centre capacity. This process requires us to recruit, screen and secure government security clearances, in addition to traditional training for new agents.
With the increased call centre capacity, we are seeing meaningful improvements to wait times and will continue to work to bring wait times down further.
By December, we will have enough capacity to be able to respond to customer inquiries, resulting in wait times of 5 to 10 minutes.
2. Improving claims processing times
- Engaging with medical providers (especially pharmacies). We continue to connect with pharmacies directly to ensure they update the plan details in their systems. This has reduced incorrect claim decisions at the pharmacy.
- Increased number of claims examiners. We have increased the number of claims examiners to process claims faster.
- Accelerating the enrolment process for members. In collaboration with the Government of Canada, we accelerated the enrolment process to ensure members have access to their benefits. Calls regarding positive enrolment are being handled promptly.
3. New escalation process for urgent need and priority cases
- As of November 6, 2023, we are expanding our processes to ensure urgent claims for life-sustaining prescription drugs, medical services and supplies are prioritized.
- We have introduced an Urgent Situations Review team. This team reviews urgent situations to ensure members have access to their PSHCP coverage. We also have assigned a special team of claims examiners to review declined claims to ensure that compassionate care is provided.
We are confident this will make a real difference for those who need it most. We are already seeing reduced wait times and more claims processed faster.
If you have questions concerning changes to your PSHCP coverage, we encourage you to:
- Ensure you review the Plan Directive. There have been a number of improvements and changes implemented effective July 1, 2023, following negotiations with the PSHCP Partners Committee, comprised of Employer, Bargaining Agents and pensioner representatives, that may mean some claims may be paid differently than before July 1, 2023. The following links provide more information:
- Please read our updated FAQ, which may be the fastest way to resolve your issue.
As we work on improving, we will continue to keep you informed of developments as they arise. We have made some forward-looking statements in this document and will inform you if our estimates change.
Thank you for your continued patience and understanding.