Public Service Health Care Plan Directive Table of Contents General Application Effective date Purpose and scope of the PSHCP Terms and Conditions Claims appeal procedure Purpose of the Public Service Health Care Plan Management of the Public Service Health Care Plan PSHCP Trust Financial Management Amendment of the Plan Document Administration of the PSHCP Administrator Definitions Eligibility I - Employees, Civilian Members of the RCMP II - Members of the RCMP and of the CF Regular and Reserve Component III - Pensioners IV - Dependants Commencement, Amendment and Termination of Coverage When an Application is Required Effective Date of Coverage Waiting Period A. When Joining the Plan B. When Amending Coverage C. When Transferring Coverage D. When Continuing Coverage Termination of Coverage Voluntary cessation of coverage Involuntary cessation of coverage Contributions Payment of contributions while on leave without pay Employee Contributions Only Employee and Employer Contributions Retroactive Change in Coverage Administrative Errors Available Coverage Supplementary Coverage Comprehensive Coverage Eligibility for Provisions Employees, Dependants of Members of the CF and of the RCMP Plan Provisions Claims Appeals Payment of Benefits Deductible Amount Co-Payment Overpayments Co-ordination of Benefits Subrogation General Exclusions and Limitations Extended Health Provision Drug Benefit For: all members Catastrophic Drug Coverage in the Event of High Drug Costs Exclusions Vision Care Benefit For: all members Exclusions Medical Practitioners Benefit For: all members Exclusions Miscellaneous Expense Benefit For: all members Exclusions Dental Benefit For: all members Lower Cost Alternative Accidental Injury Oral Surgical Procedures Exclusions Out-of-Province Benefit For: members with Supplementary Coverage Emergency Benefit While Travelling Emergency Travel Assistance Services Official Travel Status Referral Benefit Exclusions Hospital Provision For: all members Eligible Expenses Level I, II and III Exclusions Basic Health Care Provision For: all members with Comprehensive Coverage Eligible Expenses Exclusions Hospital (Outside Canada) Provision Eligible Expenses Exclusions Summary of Maximum Eligible Expenses Length of time a prescription is valid Schedule I - Participating Employers Schedule II - Employers Withdrawn from the PSHCP Schedule III - Designated Persons, Boards and Agencies Schedule IV - Recognised Ongoing Pension Benefits Schedule V - Monthly Contribution Rates Appendix A – Employee Monthly Contribution Rates Appendix B – Members of the Canadian Forces/RCMP Monthly Contribution Rates Appendix C – Pensioner Monthly Contribution Rates Appendix D – Employer Monthly Contribution Rates Schedule VI - Full Employer-Paid Coverage Schedule VII - Life-Sustaining Drugs Therapeutic Class: Next Related Links Print Full Directive Schedule I - Participating Employers Schedule II - Employers Withdrawn from the PSHCP Schedule III - Designated Persons, Boards and Agencies Schedule IV - Recognised Ongoing Pension Benefits Schedule V - Monthly Contribution Rates Schedule VI - Full Employer-Paid Coverage Schedule VII - Life-Sustaining Drugs
