On March 18, ACFO-ACAF filed a policy grievance regarding the Employer’s failure to implement seamless and uninterrupted benefits under the Public Service Health Care Plan (PSHCP) Directive following its transition from Sunlife to Canada Life and its adverse effects on members.
Policy grievance details
As you likely know, there have been several fundamental issues with the transition of the Plan to Canada Life, including but not limited to:
- Reaching an agent at Canada Life and long delays;
- Lack of access to benefits;
- Arbitrary and erroneous denials of claims;
- Interruptions in benefits, pending manual reenrollment;
- Long delays in processing claims; and
- An increased administrative burden.
Our grievance is seeking both the formal acknowledgment from the Employer that they have violated the applicable provisions of the Comptrollership (CT) Collective Agreement and corrective measures for the CT group to address past and ongoing implementation issues.
A copy of the grievance filed is available here (opens in a new tab).
Individual recourse and damages
We remain hopeful that a resolution to issues with the PSHCP can be reached soon. In the meantime, if you have suffered personal damages and wish to seek individual recourse, here’s what you need to know:
Issues with coverage or claims denied by Canada Life
The quickest way to resolve any issues related to the denial of a claim or coverage under the Plan, or if you received a lesser reimbursement than expected, is to submit an appeal with the PSHCP Administrative Authority. PSHCP appeals are heard on a quarterly basis by the Administration Authority. The process can be found here (opens in a new tab).
Filing a grievance
Grievances focus on the employer’s responsibility under the collective agreement to provide a functioning health care plan. Filing a grievance may be appropriate in limited situations where severe hardship was experienced, including but not limited to:
- Canada Life failing to process a claim or provide reimbursement within a reasonable time and you incurred interest on a credit card as a result;
- you were unable to reach Canada Life in a timely manner to obtain assistance, and as a result, treatment was delayed and caused negative health implications;
- you were unable to submit a claim because of Canada Life’s conduct in some way and this caused negative financial or health implications;
- you experienced other issues that are directly attributable to Canada Life which caused negative financial or health implications; and
- you had to delay care for a condition related to your age, disability, or other protected human rights ground under the Canada Human Rights Act.
If you would like to file a grievance to seek individual damages for the hardship you have experienced or are experiencing, please contact labourrelations@acfo-acaf.com with the details of your case to determine if this is the appropriate course of action.
