Public Service Health Care Plan Change from Sun Life to Canada Life

On July 1, 2023, the administrator for Public Service Health Care Plan (PSHCP) changed from Sun Life to Canada Life. For coverage to continue, affected patients must have completed positive enrolment with Canada Life. As part of this change, new plan numbers (Group IDs) were issued to members and their dependents.

PSHCP claims will continue to be adjudicated through Telus, but they will be processed under the sub-plan of Canada Life instead of Sun Life.

Starting July 1, 2023, you can bill PSHCP claims using the new CL bill code with the appropriate Group IDs.

Updating Affected Patient Folders

You have two options for billing PSHCP claims:

  • Use the SL bill code but update the Group IDs for patients with existing coverage.

  • Use the CL bill code with the appropriate Group ID.

To update plan information for a patient with existing PSHCP coverage:

  1. Open the Patient Folder.

  2. Select the 3rd Party tab.

  3. Do one of the following:

    • If you want to continue using the SL bill code, skip to step 4.

    • If you want to track claims using the CL bill code, select Add > search for the CL bill code > select OK.

  4. Enter the following information for the SL or CL bill code:

    • Relationship

    • Carrier ID - 12 (auto-populated)

    • Group ID - refer to Table 1 below for a list of Canada Life PSHCP Group IDs. If the cardholder/member is alive, their dependents should use the same group number as them.

      Table 1. Canada Life PSHCP Group IDs.

      Member Group ID
      Born in January - March 52111
      Born in April - June 52112
      Born in July - September 52113
      Born in October - December 52114
      Eligible Surviving Dependents 52115

    • Client ID - if you are using the CL bill code, this should be the same as the Client ID that was entered for the SL bill code

  5. If you are using the CL bill code, ensure the Active checkbox is selected for the CL bill code and deselected for the SL bill code.

  6. Select Save.

Frequently Asked Questions

No. You do not need to update your provider numbers in List Maintenance as a result of this change. Your PSHCP provider number remains the same.

Yes. You can run the Patient List report with "PSHCP" as the Third Party criterion. The report will list patients who have the SL and/or CL bill code in their Patient Folders AND had activity over the report period. Review the Plan and Group ID columns to identify which patients have a SL bill code and Group ID of 55555 entered. For more information, see Patient List Report.

Yes. If a patient completes positive enrolment with Canada Life, a new benefit card will be issued to them either digitally or through mail.

Refer to Table 2 below for troubleshooting common claim rejections.

Table 2. Common claim rejections and how to action them.

What was the claim rejection response? How do I action this?
INVALID PROVIDER NO. FOR THIS CARRIER Confirm your Provider ID is correctly entered in More > List Maintenance > Third Party Maintenance. The PSHCP Provider ID should be entered in the PSHCP row and follow the format: XX12XXXXXX.
INVALID CARDHOLDER

Use the patient's new benefit card to enter their plan information in the Patient Folder Third Party tab. For more information, see Updating Affected Patient Folders.

If the new benefit card is not available, refer to step 4 of Updating Affected Patient Folders for guidance.

If the claim is still being rejected, confirm the following with the patient:
INV SP. CRDHLD ID

Use the patient's new benefit card to enter their plan information in the Patient Folder Third Party tab. For more information, see Updating Affected Patient Folders.

If the new benefit card is not available, refer to step 4 of Updating Affected Patient Folders for guidance.

If the claim is still being rejected, confirm the following with the patient:
INVALID ISSUE NO Confirm the Client ID entered for the PSHCP plan in the Patient Folder Third Party tab ends in "01".

For questions regarding the entry of patient information in PharmaClik Rx, please contact ptscustomercare@mckesson.ca.

For general questions on the change from Sun Life to Canada Life, please consult the communication from Telus Health or contact the PSHCP Pharmacy Claims Support Centre at 1-800-668-1608.