Government Operations Committee on Dec. 7th, 2023

[Thi Vu, Regional Vice-President, Group Customer Division, Quebec Region, Canada Life]

Thank you, Ryan.

Canada Life is the largest benefits provider in Canada. We take the trust that Canadians place with us seriously. Our success is rooted in our ability to provide personal and dedicated service to our customers.

Let me be clear: during the past few months, the service some PSHCP members and their families received did not meet their expectations or ours. Their experience is not acceptable. We have been working tirelessly with the Government of Canada to fix it.

The Public Service Health Care Plan is the government’s benefit plan. As the plan sponsor, the government designs the plan and determines the benefits and coverage. Canada Life administers the plan, and its role is to pay claims as directed by the government.

When Canada Life began the administration of the PSHCP, the transition was the first of its kind in Canada. The scale and size of the PSHCP makes it unique in Canada. It provides health benefits to over 1.7 million Canadians, including federal public servants, retired public servants and their families. The transition of the PSHCP to Canada Life was the largest transition of a benefits plan in Canadian history. It came with real-time challenges, some of which were not anticipated.

We also recognize that there were other significant changes for plan members taking place at the same time as the transition to Canada Life. This included benefit and coverage limits changes to the plan introduced by the government that came into effect on July 1.

The combined impact of the government’s changes in coverage and the transition of plan administration to Canada Life resulted in thousands of calls to our call centre, leading to long wait times and service disruptions. Regardless of what caused these challenges, we have been focused on fixing them, so that members and their families can access the benefits they are entitled to. Our goal is always to see that every eligible claim is paid and that we provide exceptional service to our customers.

[Ryan Weiss]

Mr. Chair, we are here today to reiterate our ongoing commitment to making this right.

As part of this commitment, Canada Life implemented a customer service action plan. This reduced call centre wait times. It accelerated claims payments and it escalated urgent cases. This included, as noted previously, extending call centre hours to seven days a week, doubling our call centre agents and adding more claims examiners. It also included introducing urgent escalation process channels to identify and resolve special cases.

We've also worked hard to be transparent to plan members throughout this period, publicly posting our progress on improving service standards and updating frequently asked questions on a regular basis.

Our action plan is working. Call wait times, as noted, are now, on average, within approximately one to three minutes, and claims are being processed within approximately two days.

Our top priority now is maintaining service levels so that all public service health care plan members—

[The Chair, Conservative, Kelly McCauley]

I have to ask you to wrap up, Mr. Weiss.

[Ryan Weiss]

—continue to get access to their benefits. We are working with the government to prepare for the upcoming changes they have made to the plan to take effect on January 1.

For over 175 years, Canadians have trusted Canada Life to deliver on its promises. We take that very seriously.

We now look forward to answering any questions the committee may have. Thank you.

[The Chair, Conservative, Kelly McCauley]

Thank you, Mr. Weiss.

Mrs. Kusie is next, please, for six minutes.

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

Thank you very much, Mr. Chair, and thank you very much to our witnesses from Canada Life for being here today.

I'll open by saying the same thing I said to your governmental counterparts. As you indicated, this is a serious issue that has had a significant impact on public servants who have served Canada, and their families.

I want to provide a couple more stories that we have seen in the media that testify about the difficult time these families have been through.

The first one is from Sabrina Hoque.

Aydan Clark, age three, “was diagnosed with global developmental delay when he was three months old. He receives weekly speech therapy, occupational therapy and physiotherapy. With a $1,500 cap on physiotherapy, his parents aren't sure they'll be able to provide him the care he needs.”

'I'm determined I'm not going to change his...plan,' his mother told the CBC. 'It's a stress and it's very frustrating.'

[She] spends about $400 per month for regular physiotherapy, plus another $1,650 for intensive physiotherapy every four months.

'So far, knock on wood, within [the] three years, there has been no regression and that's because we've kept a steady pace. We've been very determined. We've been on the ball with making sure that he gets weekly physiotherapy sessions',

But she said the physiotherapy cap has had a dramatic effect on the family's lives.

'We're left hung to dry,' she said.

'We're hitting a wall already with the nonexistent customer service. When we push through that wall...we connect with someone, to [then] be hit with another wall where there's no exception for families who are dealing with lifelong challenges.'

This one is from Allison Abraham:

[She has not] been able to submit her medication for Crohn's disease through Canada Life and she worries the drug company will stop paying for it because she's supposed to have medical insurance.

'When the government switched to Canada Life, we were promised seamless transfer of insurance. It has been nothing but a pain though. One of my life saving drugs...is about $20,000 per injection, which I get every eight weeks. Without this drug, I would be bedridden and dying. Unfortunately, since the insurance switch, I do not have coverage. I have spent countless hours calling to make sure my coverage is active, but still can't process anything via their website or at the pharmacy. Thankfully, [they have] offered me temporary relief in order to get me my medication. It is infuriating that I am having to rely on a service that people who actually don't have coverage use, because my insurance provider can't get it together. I fear every time I order my medication that this will be the last time that it is covered.'

My first question for Canada Life is, did you have a discussion as to the resource requirements with the government prior to the July 1 implementation?

[Ryan Weiss]

Thank you, Mr. Chair.

To the honourable member's question, certainly we've discussed, as mentioned in the previous testimony as well.... In the 18-month start-up period there was significant collaboration with the government to ensure that we were working through a lot of the deliverables and being ready for the July 1 date.

Resource discussions were not a significant part of that discussion, although we had done our own estimates, based off of many of the historical points of data that were provided within the request for proposal from the previous contractor.

As noted several times, 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. It was the addition of all of those changes together that created these unforeseeable challenges.

Regardless of that, we acted quickly and in collaboration with the government to enact our customer service action plan. To that, we have increased our call centre agents and increased our claims examiners.

Certainly we know that people are frustrated in the individual circumstances cited there. They do not meet the service standards that we would expect. However, our customer service action plan is working now and we are able to take calls with one to three minutes. We are committed to processing every eligible claim within the two-day period that we have now.

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

Thank you.

Is it the standard practice of Canada Life to require manual enrolment when switching between plan administrators?

[Ryan Weiss]

To the honourable member's question, we understand that the government had the objective of completing a full re-enrolment in order to clean up a lot of the enrolment data and to make sure that we had everyone eligible on the plan. That was cited, of course, very publicly in the contract and was something we worked towards throughout that start-up period.

On the rest of our contracts, typically this is not a standard practice, but again, the plan of the PSHCP is unique. As cited by Treasury Board earlier in their testimony, the dispersion and high number of people all across the country—and some even posted abroad—necessitated a look at a manual re-enrolment process.

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

In your estimation, then, what was the overall impact on call times and claims processing because of the use of manual enrolment, please?

[Ryan Weiss]

The initial manual re-enrolment period was certainly the driver of the majority of calls in the early parts of the contract. There were some people who were not able to access their benefit at that time, so we worked collaboratively with the government again to quickly enact the first part of our action plan, and that was to complete an accelerated enrolment to auto-enrol all remaining members.

Once that was completed, call volumes dropped significantly and it stopped becoming the significant and major issue that we were facing in our contact centres.

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

For what period of time would you say this was a significant percentage of your calls—the adjustment for the manual enrolment?

[The Chair, Conservative, Kelly McCauley]

Give a very brief answer, please.

[Ryan Weiss]

Thank you, Mr. Chair.

For most of the summer months, the first two months of the contract, this was the majority issue, but it did begin to subside from there in September.

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

Thank you.

[The Chair, Conservative, Kelly McCauley]

Thanks very much.

Mr. Powlowski, you have six minutes, please.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

When the government officials were here earlier and talked about the goals of the new revised plan, one of the things they listed was more opportunities for indigenous Canadians. I thought that was interesting because the one complaint I personally heard about Canada Life was from an indigenous friend who works in the civil service.

He immediately had a problem, in that apparently Canada Life was telling him that it should be non-insured health benefits that pay for his medications, not Canada Life, but he heard the the opposite from the non-insured health benefits plan, which said, “No, that should be Canada Life.”

Apparently that's been sorted out, but what was the problem there? Also, do there continue to be problems with indigenous people and their coverage and what they get under non-insured health benefits versus your plan?

[Ryan Weiss]

I cannot comment on the specifics of the individual case without those specifics and certainly would not want to do so publicly. I will comment broadly and will offer the suggestion as well that if you want to take it off-line,3 we'd be happy to look into this issue, even though you've noted that it seems to be resolved.

That said, we are committed to administering the plan as per the plan directive, as per the contract. That does include coordinating between other programs, whether they be government or the NIHB, as it's known, and as you've cited. We are working hard to make sure our members understand that and can answer their questions.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Thank you.

I heard of this one instance, but probably there are other similar instances of people within a family having another member of the family being covered—for example, a spouse who also has insurance. I personally am not in that category. Is that a problem? Has that changed under the new plan? Because, again, I know that often, for example, under your plan, my family is covered, but under my spouse's plan, perhaps I'm covered as well. Has that changed since we've changed over to Canada Life?

[Ryan Weiss]

On the question from the honourable member, no, in short, that has not changed. It is industry practice for us to essentially coordinate benefits, as it's termed, between other programs if other coverage is available, and there are industry standard guidelines that dictate which coverage prioritizes others.

It was also one of the objectives of that enrolment process to collect good data and refresh all the data on where other coverage existed. It was one of the main objectives as people went through that process not only to confirm contact information, details around the members and dependents who might be covered, but also to make sure they would cite whether they had other coverage so that we could coordinate that seamlessly and automatically.

We did achieve some good objectives there in cleaning that up, and it was certainly to the betterment of members that we have accurate information on coordinating benefits.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Hopefully I can ask a couple of specific questions in my remaining time.

As a long-time doctor, I am more familiar with being on the other side of the stretcher, but as someone who occasionally has used the health care system, I've been frustrated with some of the payments I've had to make that I thought were covered.

One is that I was surprised when I once got a bill for an ambulance ride. Another one is maternity benefits, for which there always seem to be gaps in our government-provided coverage. A third one is physio, which Ms. Kusie brought up. I thought that you actually increased the benefits for physio.

[Ryan Weiss]

If I understand the member's question correctly on whether we did increase the benefits or not, there are a couple of points of clarification.

First, most importantly, it was the government's decision—obviously through their process and through the negotiated collective bargaining process—to set that standard. I think there was a good discussion that you had here from the Government of Canada in the earlier testimony on how that was done and how it was collaborated on, for example, with industry bodies and association bodies.

Second, I do believe that the change there, as was noted earlier, was not a reduction in benefits but rather an adjustment, whereas previously people had that corridor of benefits that was an unlimited amount. Then, through that collective bargaining process, it was adjusted down to a cap of $1,500. Again, I cannot comment on the efficacy of that, but certainly, as the administrator, we are committed to adjudicating all claims per the new negotiated agreement and in accordance with those provisions.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Do you know anything about maternity benefits?

[Ryan Weiss]

I do not believe there were any changes to the maternity benefits as part of that program. As was cited earlier, we can certainly share the 43 changes that were made effective on July 1, but I do not believe there were any changes made to maternity benefits.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Mr. Weiss, I think you'd rather tell us about what's better in the new plan than in the old plan rather than what's worse in the new plan.

I'll give you a minute to tell us what else we are getting under your plan that perhaps we didn't get under the old plan.