Government Operations Committee on Dec. 7th, 2023

[Ryan Weiss]

Thank you, Mr. Chair.

I just wanted be clear that we do know the plan did change from the previous administrator to our plan, now administered by Canada Life. We talked about the negotiated changes, of which there were several: some to improve and augment the plan and to modernize it, and some to perhaps change some of the coverage levels. I'm not sure it's an appropriate comparison between the two to say there were no gaps in coverage, but we are administering completely to the plan directive and to all the coverage and benefit levels that have been negotiated through the collective bargaining process.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Would it be possible for you to identify what the shortfalls are that you are hearing about from your clients, compared to the previous plan?

[Ryan Weiss]

Absolutely. I think we can also supplement to the committee some further details outlining all the different changes, if that would be helpful.

Just for context, there are a couple of examples here. We have talked about the physiotherapy one at length. Perhaps another good example would be that where it is allowed, in certain provinces there was the introduction of a cap on the dispensing fee that is paid for certain drugs.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Okay. Would it be possible, Mr. Chair, if I could get support from the committee, to ask for that in writing to the committee by January 15?

[Ryan Weiss]

Absolutely, Mr. Chair.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Great. Thank you, everybody.

What compensation can we expect for those who suffered because of your inability to process benefits in a timely way? I'm thinking in terms of single parents who had to put their children's medications on credit cards and incurred interest while waiting weeks or even months for reimbursement.

[Ryan Weiss]

I want to start by saying that we do know that people were very frustrated by some of the transition issues. We do know the service that some members expected and the families received did not meet their expectations nor ours, and we've been working very hard to fix that.

I've talked a little bit about our customer service action plan, and we have most of those issues behind us now, with the call centre wait times between one to three minutes and the ability to pay claims within about 2.2 days.

I think, to the honourable member's specific element, what has been most helpful in those cases is our urgent escalation process whereby, if a member was experiencing financial hardship or felt they hadn't had their eligible claim processed, they could reach out to us. There, we would take an escalated process to make sure we reached out to that member, and we would move their inquiry right to the top of the line. That was very helpful, and we were very public about that when we were behind on claim processing times. We made sure, for those who may have experienced that hardship, if they had to, for example, put some payments on their credit cards, that we could accelerate those and prioritize them for quick and prompt payment.

[Gord Johns, NDP, Courtenay—Alberni, BC]

That's if they could get through.

We hear that significant problems persist for public servants posted abroad—you touched on this a little earlier—or for those who have emergency claims while out of the country.

What are the processing times for these claims? Many of these claims are for urgent issues and can cost many thousands of dollars. How are you going to fix that?

[Ryan Weiss]

Thank you, Mr. Chair.

For context on the question, the coverage provided to members and to Canadians posted abroad in the public service is very important, but it's also one of the most complex elements of the public service health care plan. We know it's complex because there are different jurisdictions to handle and different medical centres in each and every country. Forms may be different and payments will be made in local currencies.

As a result of that, our customer service action plan has outlined improvements specific to those posted abroad. While the service standards there are still not up to our expectations, we are working hard to improve them.

One of the key elements, which you touched on, is prioritizing emergency claims and emergency issues. I want to be clear that if a member calls today with an emergency, we absolutely prioritize that. If a member has a claim that needs to be paid and that needs to be escalated, we do, as I noted, have an urgent escalation process for them to expedite the processing of that claim.

[Gord Johns, NDP, Courtenay—Alberni, BC]

I actually want to go there.

We've seen articles in the media. We've heard from our constituents about very serious conditions being exacerbated by the situation, such as people with cancer not getting their drugs in a timely way or people with serious neurological conditions not having access to the medicine they need.

A constituent of mine—Tom from Hornby Island—was having issues obtaining his wife's life-saving medications. He reached out to my office because his wife had only six days left of heart medication. During the health switchover, their prescription coverage was cut off. Canada Life decided that B.C. residents on the pharmacare program should have pharmacare paid for first by it and then by Canada Life. This should have been a smooth process because Sun Life had all of their information.

Tom was distressed and wondering why Canada Life had cut off his medication coverage. Our office had urgently requested that your company solve the issue so Tom's wife could access her medication.

This is unacceptable. Maybe you can help me understand how you're going to fix this.

[Ryan Weiss]

Thank you, Mr. Chair.

To the honourable member's question, I want to reiterate that we do know people were frustrated by some of the issues they experienced during the transition. I can't comment on that example in particular, but we did work with members of Parliament and our partners in the Government of Canada to implement an escalation process for those who had constituents come into their office who were facing serious or urgent issues, such as the one you cited.

That process has worked quite well since July—

[The Chair, Conservative, Kelly McCauley]

I have to cut you off there, Mr. Weiss.

Mr. Johns will have another round and perhaps you can finish off then.

Ms. Block, go ahead for five minutes.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Thank you very much, Mr. Chair.

Welcome to our witnesses from Canada Life.

I want to go back to the opening comments of Ms. Royds, in which she noted that the contract was for administrative services and that it included a start-up phase of 18 months for Canada Life to take the necessary steps to prepare to administer the plan. I assume that happened before the operations phase began on July 1, 2023. You can confirm that when I'm done asking my question.

She went on to say that, as with any large switch from one service provider to another, especially for programs of this magnitude, issues with transition are not unexpected and are therefore planned for by all parties.

We've heard throughout the testimony today that some things may not have been well planned for.

Can you provide to the committee what benchmarks or milestones Canada Life proposed with regard to its integrated schedule for the start-up phase?

I know, Mr. Weiss, that in response to another question you advised that resource discussions did not take place. What did Canada Life put in place in your integrated schedule in order to prepare for the start-up phase of taking over this contract?

[Ryan Weiss]

Honourable member, I can confirm that your assumption is correct. The 18-month start-up phase was the 18 months immediately preceding the July 1 operations ready date.

With regard to the second question on what, in our integrated schedule, the specific milestones were in preparation, for context I will pick the highlights. The integrated schedule was over 3,000 lines long. It was quite detailed to make sure that we could capture progress against all the specific requirements of the contract. That being said, major elements of the integrated start-up phase focused around the positive enrolment period, which had a defined period that began towards the end of March and continued right up until July 1, tracking those major deliverables.

A second major one was all the systems that needed to be built and tested by the contractor—which, in this case, was the Treasury Board—and brought into production for that July 1 date.

There were also significant milestones around the audit and claims verification program, ensuring that our contact centre and our claims-processing systems were all online and ready. Of course, there was also the screening of all personnel by the industrial security process, as administered by the Government of Canada. Each of those milestones was tracked rigorously. There was weekly reporting back to the project authority. As noted earlier, there was collaboration between both parties, often on a daily basis, to make sure that we were tracking well to that schedule.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Thank you very much.

In her remarks, Ms. Royds also commented on where you are today. I would like to provide you with the opportunity to advise us if the heightened workload from the changeover has decreased to a level that was expected for the ongoing service level for the plan.

[Ryan Weiss]

We have not yet seen a return to the level that was expected or that was historically experienced by the previous administrator. That said, we are achieving our target service levels now with the increased resourcing that we have brought on board over the last several months. One of the reasons we believe it has not returned to the level expected yet—although it will in the future—is that there are still some additional plan-design changes to come into force for the membership.

The major one of those still remaining would happen in January. We talked earlier about generic drugs. The utilization of generic-drug substitution will come into force for those who had brand-name drugs before July 1. We do anticipate that this will generate a significant number of calls, but we are increasing our resourcing to help support it.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Thank you very much.

I'm wondering if you have any details or statistics on how often doctor recommendations for non-generic drugs are accepted.

[Ryan Weiss]

I do not have those figures handy at this point. We'd be happy to provide them to the committee. More importantly, we are administering those exception requests—excuse me—based on the specific provisions set forth by the—

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Please feel free to help yourself to water if you need to.

[Ryan Weiss]

Thank you. I apologize.

The point I was making there is that we are administering a further directive and per the guidelines set out by the government on those forms.

[Kelly Block, Conservative, Carlton Trail—Eagle Creek, SK]

Thank you very much.

Thank you, Mr. Chair.

[The Chair, Conservative, Kelly McCauley]

Thank you, Mrs. Block.

Mr. Bains, go ahead.

[Parm Bains, Liberal, Steveston—Richmond East, BC]

Thank you, Mr. Chair.

Thank you, Mr. Weiss and Ms. Vu, for joining us today. Thank you, Mr. Weiss, for recognizing numerous times the challenges and for owning up to some of the, maybe, mistakes that took place along the way in this transition.

Just in your previous answer there, you mentioned that there's going to be some time to get to the required achievement levels. How long do you think it will take to get to the required achievement levels that the previous provider had?

[Ryan Weiss]

I want to qualify, perhaps, some of my comments there.

We do expect to achieve target service levels much sooner than the actual volumes that would have been achieved from the previous contract. To be clear, we do have the resourcing now to improve our contact centre and wait times, as noted previously. We do expect to see that from here on out.

What I was referring to in the previous question was that the volume of calls will not recede to historical standards until we are through many of these plan-design changes.

[Parm Bains, Liberal, Steveston—Richmond East, BC]

Thank you.

Do you have numbers—timelines, target dates—that you're working on? You have a team of people. What have you assigned to them?