The Federal Superannuates National Association Kingston & District Branch, c/o Box 1172, Kingston, Ontario K7L 4Y8, Telephone 1-613-384-2440 .-. Click on a comment link to express your view on a post. Alert a friend, to a post, by clicking on its envelope icon.

Thursday, May 13, 2010

PSHCP Benefit Card

This message is to advise you of some additional information that has been posted on the National Joint Council Web site regarding the PSHCP Benefit Card.


This "Frequently Asked Questions" (FAQ) document highlights the fact that positive enrolment will be mandatory - every plan member will have to complete positively enrolment to be able to submit claims for reimbursement.


17. What happens if some plan members choose not to enroll themselves or their dependants? Will it affect their claims?


Yes. Members who have not completed positive enrolment by the time electronic claims processing starts will have their claims returned with details on what they need to do to complete positive enrolment, on paper or electronically. Under the new contract, claims for all benefits will not be processed until the member completes positive enrolment."


The FAQ is posted at http://njc-cnm.gc.ca/doc.php?did=492&lang=eng.


Personal information on every plan participant (name, permanent address, date of birth, etc.) must be provided to Sun Life through the positive enrolment process. Members will have the option of completing positive enrolment either on paper or electronically.


Plan members will also have the option either of receiving a plastic PSHCP benefit card in the mail or printing a paper version from the Sun Life website.


As of November 1, 2010, the PSHCP benefit card will be accepted at pharmacies in Canada to purchase eligible prescription drugs and certain medical supplies.


All plan members will continue to be eligible for reimbursement of prescription drugs by the PSHCP whether they use the PSHCP benefit card or submit claims using the paper Claim Form posted on the PSHCP Administration Authority Web site at www.pshcp.ca.


An information package on how to complete positive enrolment will be sent by Sun Life in July 2010, either by e-mail or regular mail.


Members who have registered on the Sun Life plan member Web site and have a vallid e-mail address on file will receive information by e-mail on completing positive enrolment online. If you are not registered on the Sun Life website and wish to complete positive enrolment online, please go to www.sunlife.ca/pshcp and click on "Register Now". Be sure to include your preferred e-mail address.


Otherwise, the information package and enrolment form will be mailed to the last known address of plan members (from your most recent claim). If you are not sure whether Sun Life has your up-to-date address, please call the PSHCP call centre at 1-888-757-7427 to confirm that your correct address is on file. Remember, the files for the dental plan are separate from those for the PSHCP, so you will have to confirm your address specifically for the PSHCP.


More information will be available in the PSHCP Bulletin #24 which will be published next month (June 2010)."

Tuesday, May 04, 2010

Dental coverage for those living in long term care/residential facilities

The PDSP and the PSHCP offer coverage for eligible dental care and services regardless of place of residence. However, dental care may be provided for seniors or low-income seniors in long term care facilities or residential facilities as per each provincial/territorial legislation. Legislation varies from province to province and in fact from region to region.

“…The Pensioners’ Dental Services Plan (PDSP) is intended to provide coverage to eligible pensioners for specific dental services and supplies that are not covered under a provincial or territorial health or dental care plan.”
PDSP Rules (April 1, 2006)

Where to claim the amounts not covered under a provincial/territorial health or dental plan will depend on whether the expenses were for oral surgery or for accidental injury.

“…If a member is covered under the Public Service Dental Care Plan, the Pensioners’ Dental Services Plan, the RCMP Dependants Dental Care Plan, or the CF Dependants Dental Care Plan, claims for expenses for oral surgery should first be submitted to that [dental] plan. Any amount not covered by that plan may be submitted to the PSHCP. (amended September 8, 2006)”
PSHCP Directive (April 1, 2006)

“…If a member is covered under the Public Service Dental Plan, the Pensioners’ Dental Services Plan, the RCMP Dependants Dental Care Plan, or the CF Dependants Dental Care Plan, claims for expenses for accidental injury should first be submitted to the PSHCP. (amended September 8, 2006)”
PSHCP Directive (April 1, 2006)