The Plan is supported through contributions from the Treasury Board of Canada, participating employers and Plan members. The Treasury Board of Canada and participating employers must make contributions in accordance with the Trust Agreement.

The PSHCP contributions are identified in Schedule V. Monthly contributions from members, where applicable, are payable one month in advance of the effective date of coverage. They are deducted from salary or a recognised pension, survivor's or children's benefit, as authorised in writing by the member. In the case of the VAC client group, contributions will be taken directly from the member's bank account. (amended September 8, 2006)

Employees identified under Schedule VI, as amended from time to time by the Treasury Board of Canada, are entitled to the full employer-paid coverage under the family Hospital Provision Level III. When these members proceed on leave without pay, for whatever reason, full employer-paid coverage continues.

Members of the CF and RCMP or pensioners who are in receipt of an ongoing recognised pension and are paying monthly PSHCP contributions from that pension, and who become employed in the Public Service, may choose to be covered under the PSHCP as employees if they are eligible. However, it is the member's responsibility to advise the pension office to discontinue PSHCP deductions from their pension benefit, and to apply for coverage under the PSHCP as a Public Service employee.

Members who proceed on seasonal/sessional lay-offs, so that there is no salary in any month from which the required contribution may be deducted, may continue their coverage and that of their dependants by paying the required contributions, in advance to their designated officer by cheque or money order made payable to the Receiver General for Canada.

Payment of contributions while on leave without pay

Coverage under the Plan continues while an employee is on Leave Without Pay (LWOP) unless that employee provides notice in writing that he or she wishes to opt out of the Plan during the period of LWOP. If such notice is provided, coverage will be cancelled effective the month following the month in which the notice is received by the designated officer.

A member going on LWOP who does not opt out of the PSHCP for the period on LWOP, will be required to either:

  1. pay the required contributions in advance; or
  2. pay the contributions owing in a manner to be determined by the employer, on ceasing to be on LWOP, whether due to a return to work or ceasing to be employed.

An employee who has not chosen to pay the required contributions in advance will be deemed to have opted to pay the contributions retroactively on ceasing to be on LWOP.

All reference to leave without pay assumes that the leave has been duly authorised by the employer.

Employee Contributions Only

Employees are required to pay only their contributions when on leave without pay for the following reasons:

  1. for the purpose of undergoing training or instruction to the advantage of the employer;
  2. for the purpose of serving in the CF;
  3. because of pregnancy, illness or disability;
  4. to serve with any organisation (other than a Public Service bargaining agent or credit union) where the leave is certified as being to the advantage of the department, or is being performed at the request of the Government of Canada;
  5. for the purpose of carrying out paternal responsibilities, i.e. caring for his child;
  6. for personal needs for a period not exceeding three months, when the leave was approved by the appropriate authority as leave for personal needs;
  7. for parental leave for care and nurturing which occurs up to 52 weeks after the birth or adoption of the child;
  8. for the first three consecutive months of any period of leave without pay (including self-funded leave);
  9. for the first three months of absence from duty while on off-pay or off-duty status;
  10. for the leave portion of the leave with income averaging arrangement;
  11. for the leave portion of the pre-retirement leave arrangement.

Employee and Employer Contributions

Both the employee's and the employer's contributions must be remitted by the member when:

  1. taking any kind of leave without pay for reasons not listed above;
  2. an employee who was laid-off chooses to retain coverage for up to one year following lay-off from the Public Service;
  3. the survivor of a member who was pregnant at the time of the member's death chooses to continue coverage for the period during which the survivor is pregnant, and confined following the pregnancy; (amended September 8, 2006)
  4. the survivor of a member with Comprehensive Coverage chooses to maintain Comprehensive Coverage for a period of six months after the date of death of the member;
  5. an employee is on suspension or on unauthorised leave without pay;
  6. a member who ceases to be employed during pregnancy and is not in receipt of an ongoing pension benefit, chooses to continue her coverage until the end of the month in which the pregnancy is terminated or the end of the month in which the child is born;
  7. a former deputy head is a participant under the Special Retirement Arrangements Act and chooses to maintain coverage under the Plan;
  8. CF Reserve Component: Class A and B Reservists of the CF are engaged for a period of less than 180 days. Class B Reservists who are engaged for a period greater than 180 days only pay the member contributions.

Note:

When the reason for the leave without pay changes and such change requires a different rate to be paid, the new contribution rate shall be effective the first of the month following the month of the change in the reason for the leave without pay.

Retroactive Change in Coverage

Where a member requests a retroactive amendment in PSHCP coverage due to a change in status (i.e. no more dependants), the following rules will apply:

  • a Plan member who fails to amend coverage in a timely manner can request a refund of member contributions as far back as January of the calendar year in which the request is received by the designated officer;
  • discretionary authority has been given to the designated officer to refund members' contributions for a period not exceeding 5 years under extenuating circumstances such as where a person acting in a fiduciary capacity takes over the affairs of a person who is no longer capable of looking after their own affairs.

Administrative Errors

When it is discovered that a member complied with application requirements, but due to anadministrative error no contributions were deducted from salary or pension, the member will have the option to:

  1. re-apply for coverage, but in this case, coverage will not be subject to the normal three-month waiting period; or
  2. pay all the outstanding contributions, i.e. retroactively from the date the contributions should have been deducted from pay or pension. The outstanding contributions will be deducted as one lump sum from pay or pension.

The same rule would apply if the contributions deducted were incorrect, i.e. providing a lower level of coverage than the coverage for which the member had applied. However, if the deductions were made in excess of the required contribution, the designated officer would authorise the reimbursement of the contributions and the deduction of the correct contribution from pay or pension.