Public Service Health Care Plan

The Public Service Health Care Plan (PSHCP) is an optional health care plan for federal public service employees and their eligible dependants. It is designed to supplement your provincial/territorial health insurance plan for reasonable and customary eligible expenses. In other words, the Plan will reimburse you for all or part of your costs for eligible medical services and products once you have taken advantage of the benefits provided under your provincial/territorial health insurance plan or other third party source of health care assistance to which you are legally entitled. For further information on the PSHCP eligibility and coverage, please refer to the Public Service Health Care Plan at a glance.

  • How to Apply for or Modify your Coverage Under the PSHCP

    In order to receive your PSHCP benefit card and have your claims covered under the Plan, you must first complete the positive enrollment process with administrator Sun Life Financial via their website. Please note that it will take approximately 2–3 weeks before the insurer is notified of your coverage request. You will need your certificate number and can refer to new member to the plan for instructions on how to complete this process.

    Through Phoenix Self Service , you are able to start, amend or stop your Public Service Health Care Plan (PSHCP) coverage and deduction as long as your account is in "waived" status. For step-by-step instructions please refer to the Phoenix UPK ; the waive date will be your eligibility date.

    Note: If you are experiencing difficulties with the Phoenix Self-Service application, contact the  Client Contact Centre at 1-855-686-4729 for assistance.

    If you are experience difficulties with the Positive Enrollment process, please contact Sun Life Financial directly at 1-888-757-7427

  • Application exceptions

    Although employees can generally apply for or modify their coverage using Phoenix Self Service, there are certain exceptions that can only be processed by the Pay Centre:

    • If your dependant(s) becomes an employee of the Public Service and receives their own PSHCP coverage;
    • To switch from Supplementary to Comprehensive coverage;
    • To switch from Comprehensive to Supplementary coverage;
    • To add a dependant who has their own PSHCP coverage;
    • An employee is on unpaid leave or does not have access to Phoenix Self-Service.

    To submit your request to the Pay Centre you must complete the PSHCP Employee Application Form (TBS 6491) and send it via a Pay Action Request (PAR) form for processing.

    • Top right corner: Enter the total number of pages including the PAR form and the date;
    • Section 1: Enter Employee Information;
    • Section 2: Work Type—select "Benefits";
    • Section 3: Sub Type — select "PSHCP Exceptions" and enter the effective start date (the date your coverage will change);
    • Section 4: Enter your manager's name and contact information as the requestor and clearly identify your request in the comments (Example: Attached is my application to amend my coverage, please add my spouse as a dependant under my PSHCP plan);
    • Section 5: Not applicable. No trusted source is required for this type of request.

    Important: If any of the above information is not completed and the required documents are not included, the PAR will be rejected causing delays in the processing of your request.

    There are three methods to submit the completed PAR form and the required documents to the Pay Centre:

  • Coverage While on Extended Leave Without Pay

    Important:  If you are going on a period of leave without pay (LWOP), you can generally continue to be covered under the Plan, however, depending on the length and the type of your leave, you may be required to pay the full cost of your coverage (employer and employee monthly contributions combined). Before proceeding on leave, you should contact the Public Service Pay Centre for information regarding coverage continuation and its financial impacts. If you wish to cancel your coverage, you must provide a written request to the Pay Centre to opt out of the plan otherwise you will be deemed to have opted to continue coverage and will have to pay all necessary contributions upon your return to work.

  • How to Submit a Claim for Health Care

    You are responsible for submitting your own claim for expenses incurred within the allowable timeframe via one of the following methods:

    1. You can submit a claim online after you register on Sun Life Plan Member Services Website and sign up for direct deposit. You will need your contract number and member ID which you will find on your PSHCP benefit card or your claim statement. You will also need to provide your banking information for direct deposit.
    2. Once registered at www.sunlife.ca/pshcp you can also submit a claim using the mySunLife mobile application. Download it for iPhone on the Apple App Store or for Android devices from Google PlayTM.

    3. You can also submit via paper by completing and signing the Public Service Health Care Plan (PSHCP) Claim form (PDF, 614 KB). Make sure to attach supporting documentation (original receipts, bills, invoices, physician or practitioner statements, and/or questionnaires, etc.) Keep copies of your receipts and your claim form as originals will not be returned. Mail your completed claim form for supplementary coverage to the administrator at the following address:

      Sun Life Assurance Company of Canada,
      PO Box 6192,
      Stn CV,
      Montreal, QC H3C 4R2

      If you have comprehensive coverage, send your claim to the following address:

      Allianz Global Assistance:
      Public Service Health Care Plan
      P.O. Box 880
      Waterloo, ON N2J 4C3

      Members in the National Capital Region can also leave their claims in a drop box located in the lobby of the Sun Life claims office, located at:

      333 Preston Street
      Suite 300,
      Ottawa, Ontario K1S5N4
      Open Monday to Friday (8:30am to 4:30pm)

      For assistance, call the Sun Life PSHCP call center at (613) 247-5100 in the National Capital Region or 1-888-757-7427 (toll-free in North America).

  • Submit a Pay Escalation request
    Employee responsibility

    If you are experiencing a pay issue related to the health care plan, you must refer to the Pay Escalation Process and, if deemed appropriate, submit an escalated pay issue request  using the category Escalated Benefit issue, sub-category Public Service Health Care Plan (PSHCP).

    Manager / Section 34 Manager responsibility

    If an employee is on leave or has been terminated and is experiencing a pay issue related to the health care plan, you must refer to the Pay Escalation Process and, if deemed appropriate, submit an escalated pay issue request on their behalf using the category Escalated Benefit issue, sub-category Public Service Health Care Plan (PSHCP).

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