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Public Service Health Care Plan Directive - April 1, 2006

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This Directive was developed in partnership by employer and bargaining agent representatives at the National Joint Council. Its provisions form part of the collective agreements of the participating parties under the By-Laws of the National Joint Council. The provisions also apply to persons not covered by collective agreements as indicated in the Directive or by employer policy.



For more information on the National Joint Council, visit their web site at http://www.njc-cnm.gc.ca.
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 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 Termination 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 Plan Provisions Claims Appeals Payment of Benefits Deductible Amount Co-Payment Overpayments Co-ordination of Benefits Subrogation General Exclusions and Limitations Extended Health Provision Extended Health Provision - Drug Benefit For: all members Catastrophic Drug Coverage in the Event of High Drug Costs Exclusions Extended Health Provision - Vision Care Benefit For: all members Exclusions Extended Health Provision - Medical Practitioners Benefit For: all members Exclusions Extended Health Provision - Miscellaneous Expense Benefit For: all members Exclusions Extended Health Provision - Dental Benefit For: all members Oral Surgical Procedures Exclusions Extended Health Provision - 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 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 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
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Date Modified: 2009-03-05

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