Government hits Canada Life with financial sanctions – CBC.ca Achi-News

The federal government has begun imposing financial sanctions on Canada Life after months of protests by public servants, retirees and their families who were left behind fighting for medical claims to be covered.

Public Services and Procurement Canada (PSPC) said it was “taking steps to address start-up delays faced by Canada Life and has begun applying financial outcome mechanisms under the contract,” according to a statement from spokeswoman Michèle LaRose .

He said PSPC is not yet in a position to share details about the nature of the sanctions.

On July 1, 2023, the federal government transferred responsibility for the public service health insurance plan from Sun Life to Canada Life.

The company had a six-month transition period before the government could begin assessing the level of service, according to tender documents for the $514 million contract.

For months, the federal government has repeatedly stated that it prioritizes working with Canada Life to improve service, before resorting to financial penalties or suspension of payments.

During that time, CBC News heard from several members of the Public Service Health Care Plan (PSHCP) complaining of long waits, not being able to get through to an agent and claims being rejected without explanation.

A spokeswoman for the Professional Institute of Public Service of Canada (PIPSC) said she hopes the sanctions will serve as a warning to spur change, but said they are only the first stab at fixing what’s wrong.

“These sanctions are really only in recognition of the fact that Canada Life is not respecting its contract,” said Stéphanie Montreuil.

“It does not compensate our members. It doesn’t make sure there’s a plan in place so this doesn’t keep happening, so it’s really just a start – and the bare minimum at that.”

Canada Life says early challenges ‘resolved’

A Canada Life spokesperson said Wednesday that early challenges related to the transition “have been resolved.”

“Canada Life provides benefits under this plan in Canada within expected service levels, including answering calls within 30 seconds and processing electronic claims within an average of 1 day,” the spokesperson wrote in an email.

The president of the Professional Association of Foreign Service Officers (PAPSO) said its members are frustrated and angry about delays in coverage outside Canada.

Pamela Isfeld welcomed the news of sanctions as a “positive step,” but said the government is still responsible for actually solving the underlying problem.

“As a taxpayer, I’m happy to learn that they’re not going to continue to pay this very lucrative contract, even when they don’t receive the service,” he said.

“But as a representative of 2,000 foreign service officers here in Canada, we still have the same problem with the lack of an adequate health insurance plan, especially overseas and especially in the United States where the problems are worst,” added Isfeld.

“That still needs fixing.”

The subcontractor MSH International handles the international side of the scheme, including emergency travel provision and comprehensive provision.

As far as PSPC is concerned, however, Canada Life is still ultimately responsible.

“As the contractor on this project, Canada Life is responsible for ensuring that all deliverables specified in the contract are met, including work that is subcontracted to other companies,” said LaRose.

Struggling to get overseas claims insurance

Isfeld said delays in processing the claims of members and some family members are “enormous.”

“In some cases, it is a question of large sums of money, and when the refund comes, there is only a certain amount in their bank account. It does not match the amount claimed and there is no explanation,” he said in French.

That’s what happened to Sonia Rioux, who lives in Europe with her military spouse. She was awaiting reimbursement for medical expenses from a trip to Australia in July.

The couple were in a remote area preparing for a hiking excursion when Rioux began to suffer abdominal pain. It was getting worse and worse, so she went to a clinic where nurses decided to fly her to the nearest hospital for emergency surgery.

She estimates the total cost to be more than $8,000. That was the end of her journey — but only the beginning of her struggles with MSH International.

Rioux said she began her application with MSH International at the end of August. In mid-April, he received a refund of about $2,000, with no clarity on which bill was covered.

Rioux said she feels powerless and trapped because nothing she’s tried seems to work, leaving her with “no escape.”

“It’s becoming almost worrying,” he said in French. “I won’t give up, but it’s very tiring for me.”

Unions looking at legal solutions

PAFSO has decided to follow the example of the Public Service Alliance of Canada (PSAC) and study all possible legal solutions to force the government to provide an active health plan.

“It’s the employer’s responsibility, and it’s time for them to find a way to get it done,” Isfeld said. “We have not ruled out any legal options at this time. Everything is on the table.”

PAFSO lawyers are studying whether it would be possible to get a ruling forcing the government to implement a temporary system that would allow employers to take out private insurance, he explained.

The union has also filed a policy complaint with the Treasury Board. The document obtained by Radio-Canada states that the change to a new insurance provider violates the collective agreement because “it does not take into account the rights of the members to an active health insurance system.”

PSAC, Canada’s largest public sector union, filed a similar complaint in February.

Both unions are demanding that all affected public servants be compensated for the harm they have suffered including stress and pain, as well as financial losses.

PSAC national president Chris Aylward said in a written statement that he is encouraging all his members to file individual complaints to put pressure on the employer.

Montreuil said PIPSC is now in the process of filing a complaint.

Government ‘working daily’ with the insurer

The federal government said it is still pursuing Canada Life to ensure it meets its contractual obligations.

“We are working daily with Canada Life to make it understand that the company it subcontracts for international coverage must improve the situation and ensure that contractual obligations are respected to’ r letter,” Treasury Board President Anita Anand said in a written statement.

“All public servants deserve the highest quality service for their health care plans.”

A spokesperson for the Treasury Board Secretariat, Joie Huynh, noted that Canada Life had taken several measures to improve service since November, and that there were “important improvements in waiting times and delays in processing.”

He added that Canada Life is working with MSH International to implement an action plan for international insurance.

Canadian Global Affairs employees living abroad can also count on interest-free cash advances from the government to cover medical expenses until they can be reimbursed by MSH International.

A spokesperson for Canada Life said in an email that the company is working with MSH International and the federal government to improve the level of service for public servants and retirees living or traveling abroad.

MSH International program delivery director Jina Park said the company had implemented measures to speed up processing times, reduce call center waiting times and prioritize urgent cases.

“We have doubled our claims processing capacity and continue to add more staff to meet demand that was higher than anticipated in the RFP,” he wrote in an email.

Ad blocking test (Why?)

Source link

Related