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'we are sorry': canada life testifies at commons committee on public service health plan
the $514-million contract was awarded to canada life in november 2021 following a multi-year retendering process.
dec 8 2023
6 minute read
shaun barattia says the switch of the public service health care plan has been devastating for his family as canada life is no longer covering the same amount of necessary medical supply costs for his daughter as was the case before july 1 with sun life.
tony caldwell
/
postmedia
representatives from canada life assurance company apologized at a house of commons committee on thursday for the lack of a “smooth” transition in taking over administration of public servants’ health plan as members faced ongoing challenges.
ryan weiss, senior vice-president of national accounts at canada life, acknowledged that the switch had not been seamless.
“we know that the transition has not been smooth for all members of the public service health care plan,” weiss said. “to those who had a poor service experience in recent months, we are sorry.”
the administration of the plan for more than 1.7 million public servants, retirees and dependents transferred to canada life from sun life on july 1.
the $514-million contract was awarded to canada life in november 2021 following a multi-year retendering process that involved “three compliant bidders,” according to mollie royds, associate assistant deputy minister of the procurement branch at public services and procurement canada. royds said thursday that she could not share the names of other bidders.
since the changes took effect, hundreds of members have spoken out about difficulties in accessing services, reaching customer support and making claims.
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shaun barattia said the switch from sun life to canada life had been devastating for his family as the new plan was no longer covering hundreds of dollars of supplies monthly that his six-year-old daughter relied on.
barattia, an ottawa resident, said he joined the federal public service just under a year ago, adding that the health benefits were a huge draw. now he is working a second, 30-hour-a-week job, on top of his full-time public service position, just to pay the bills.
when he began working for the government, barattia said sun life covered around $600 per month in supplies for his daughter, lucy, who has autism and avoidant restrictive food intake disorder and is fed by a tube. after the transition to canada life on july 1, however, the cost of feeding bags, cleaning materials and wound care fell onto the family.
“our claims that were submitted came back rejected, and it was like having the rug pulled out from under you,” barattia said, adding that lucy had been making progress in gaining weight, a process that has taken years after she previously declined to below the tenth percentile. “we felt blindsided.”
six-year-old lucy has autism and avoidant restrictive food intake disorder, requiring her to be fed by a feeding tube.
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barattia said the process of figuring out why these supplies were no longer covered was confusing as the government had shared no information about changes to coverage related to enteral feeding.
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ahead of the transition, in september 2022, the government announced several changes to the public service health care plan following negotiations with retiree representatives and federal unions, including the public service alliance of canada.
marie-chantal girard, senior assistant deputy minister of employee relations and total compensation at the treasury board secretariat of canada, said during thursday’s meeting that it was important that contracts the government signed on behalf of canadians were competitive with the market. she said canada life was working to reimburse members who had to pay out-of-pocket and were owed money “based on the plan’s parameters.”
girard reassured committee members that “everything that was covered before remains covered.”
while some new benefits were included in the plan, such as occupational therapist and dietitian services as well as $75,000 in gender-affirming care, there were also changes and reductions to drug coverage and services, including new caps on dispensing fees and physiotherapy.
“whatever decisions were made and however this went down, i was affected negatively and it’s affecting my wife and our daughter,” barattia said, adding that he and his wife also had other children.
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after years of seeking medical support from ontario, which now covers $1,000 a month in formula as well as therapy costs and some feeding supplies, the added stress has taken a toll on the mental health of both him and his wife, candace barattia, who quit her job as a nurse due to lucy’s frequent hospitalizations, barattia said.
“me personally, my wife, we feel exhausted to have to fight over every item, saying it was already covered and it’s no longer being covered,” barattia said. “we don’t even scrape by; we operate annually at a net loss. we’re living off credit as it is. we’re not going to be able to pay bills.”
“whatever decisions were made and however this went down, i was affected negatively and it’s affecting my wife and our daughter,” shaun barattia says,
tony caldwell
/
postmedia
out of $600 in monthly costs, barattia said he had been able to get canada life to commit to paying around $300 by going through the company’s appeal process.
he said he would continue to fight to receive the same coverage he had before july 1.
“(lucy) needs my wife and i by her side,” barattia said. “when she’s learning and trying to eat new things, she improves. if i have to go out and work 30 to 50 hours additional hours a week to pay for supplies, which i will do, that doesn’t help her. we just want the best for her.”
weiss said canada life had worked to address issues by increasing the number of call-centre agents and claims examiners and introducing an urgent escalation process.
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“the complexity of the change and the quantity of changes that happened at the july 1 transition date did lead, unfortunately, to a number of calls and service issues that were unforeseeable,” weiss said.
the government’s requirement for members to re-enrol played a major part in increased and unexpected call numbers during the summer months, weiss said. once auto-enrolment was implemented, calls dropped “significantly.”
he noted that, while re-enrolment was typically “not a standard practice,” the pshcp plan was “very unique.”
girard said the idea behind re-enrolment was to allow for a “clean state” and a “base of information” to implement the new plan. she noted that privacy issues were a driving factor, adding that some people covered under the old plan were dependents who were no longer covered, while some members had since retired or died.
weiss, the canada life executive, acknowledged that resourcing was not a significant part of the discussions during the 18-month “startup period” before the insurance company began administering the public service health plan, but said it had estimates about call volumes based on data from sun life.
while call volumes have not yet hit normal levels, compared to levels seen while the plan was under sun life, weiss said wait times had been reduced to an average of one to three minutes. he added that claims were now being processed within around two days.
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weiss said canada life only expected call volumes to reach “historical standards” by late 2024, given that some additional plan changes — including mandatory generic drug substitution — had yet to take effect
royds said, “there is still work to do and we have lessons learned that will be applied both to this contract and to other major transitions. but we are trending towards the service level that members expect and have the processes and mechanisms in place to respond as issues arise.”
conservative committee member stephanie kusie said she was “not sure” any new information was shared by canada life or government officials on thursday, though she believed it was necessary to indicate to public servants that parliamentarians recognized the transition had not been smooth and wanted the government to be held accountable.
kusie said she “took comfort” in the fact that call-centre wait times had decreased, but noted that, if the situation remained stagnant into the spring, she would look to have another meeting of the committee.
“public servants have to have confidence in their benefits system,” kusie said.
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