National Joint Council

National Joint Council

National Joint Council

Français
  • About Us
    • What's New?
      • Gen Sec Annual Report - 2023-2024
      • NJC Annual Seminar
      • NJC Labour Relations Training Sessions for the LR Community
      • NJC Recognition
      • Photo Gallery
    • Current Committee Activities
    • NJC Constitution
    • NJC By-Laws
    • NJC Co-Development Process
    • NJC Results for Employees
    • Organization Chart
    • NJC Membership
    • NJC Statement of Values
  • Directives
  • Rates
  • Health Plans
    • Disability Insurance Plan
    • Public Service Dental Care Plan
    • Public Service Health Care Plan
  • Coordinators
  • Grievances
    • Search Decisions
    • Information Notice - Change in Grievance Practice
    • Guidelines
    • Grievance Process and Procedures
  • More
    • Publications
    • NJC Communiqués
    • LMCC
    • Links
Home » Directives » Public Service Health Care Plan Directive

Public Service Health Care Plan Directive

  • General
    • Application
    • Effective Date
    • Purpose and Scope of the PSHCP
    • Claims Appeal Procedure
    • Management of the Public Service Health Care Plan
      • PSHCP Governance
      • Financial Management
      • Amendment of the Plan Directive
    • Definitions
  • 1 Eligibility
    • 1.1  Employees, Civilian Members of the RCMP
    • 1.2  Members of the RCMP and of the CAF Regular and Reserve Component
    • 1.3  Pensioners
    • 1.4  Dependants
  • 2 Commencement, Amendment and Termination of Coverage
    • 2.1  When an Application is Required
    • 2.2 Effective Date of Coverage
      • Waiting Period
    • 2.3  Termination of Coverage
      • Voluntary Cessation of Coverage
      • Involuntary Cessation of Coverage
  • 3 Contributions
    • 3.1 General
    • 3.2  Payment of Contributions While on Leave Without Pay (LWOP)
    • 3.3  Employee Contributions Only
    • 3.4  Employee and Employer Contributions
    • 3.5  Retroactive Change in Coverage
    • 3.6  Administrative Errors
  • 4 Available Coverage
    • 4.1  Supplementary Coverage
    • 4.2  Comprehensive Coverage
    • 4.3  Eligibility for Provisions
      • Employees, Dependants of Members of the CAF and of the RCMP
      •  Pensioners
  • 5 Plan Provisions
    • 5.1  Claims
    • 5.2  Appeals
    • 5.3  Payment of Benefits
    • 5.4  Co-Payment
    • 5.5  Overpayments
    • 5.6  Coordination of Benefits
    • 5.7  Subrogation
    • 5.8  General Exclusions and Limitations
  • 6 Extended Health Provision
    • 6.1  General
    • 6.2  Drug Benefit (For All Members)
      • PSHCP Benefit Card
      • Prior Authorization
      • Mandatory Generic/Biosimilar Substitution
      • Pharmacy Dispensing Fees and Frequency Limits
      • Catastrophic Drug Coverage in the Event of High Drug Costs
      • Exclusions
    • 6.3  Vision Care Benefit (For All Members)
      • Exclusions
    • 6.4  Medical Practitioners Benefit (For All Members)
      • Exclusions
    • 6.5  Miscellaneous Expense Benefit (For All Members)
      • Exclusions
    • 6.6  Dental Benefit (For All Members)
      • Lower Cost Alternative
      • Accidental Injury
      • Oral Surgical Procedures
      • Exclusions
    • 6.7  Out-of-Province Benefit (For Members with Supplementary Coverage)
      • Emergency Benefit While Travelling
      • Emergency Travel Assistance Services
      • Official Travel Status
      • Referral Benefit
      • Exclusions
  • 7 Hospital Provision (For All Members)
    • 7.1  General
    • 7.2  Eligible Expenses - Level I, II and III
      • Exclusions
  • 8 Basic Health Care Provision (For All Members with Comprehensive Coverage)
    • 8.1  General
    • 8.2  Eligible Expenses
      • Exclusions
  • 9 Hospital (Outside Canada) Provision (For All Employees with Comprehensive Coverage, Excluding Pensioners)
    • 9.1  General
    • 9.2  Eligible Expenses
      • Exclusions
  • 10 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 - Recognized Ongoing Pension Benefits
  • Schedule V - Monthly Contribution Rates
    • Appendix A – Employee Monthly Contribution Rates
    • Appendix B – Members of the Canadian Armed Forces CAF/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
Next
Related Links
Print Full DirectiveDefinitionsSchedule I – Participating EmployersSchedule II – Employers Withdrawn from the PSHCPSchedule III - Designated Persons, Boards and AgenciesSchedule IV - Recognized Ongoing Pension BenefitsSchedule V - Monthly Contribution RatesSchedule VI - Full Employer-Paid CoverageSchedule VII - Life-Sustaining Drugs
© 2025 National Joint Council
Important Notices | Canada.ca
Contact Us | Home