DATE: November 27, 2006
TO: Compensation Managers
Heads of Human Resources
Directors of Communications
Participating Separate Employers
PSDCP Members
Heads of Bargaining Agents
SUBJECT: Public Service Dental Care Plan (PSDCP) revisions for 2006, 2007 and 2008
This is to inform you that an agreement has been reached between the Treasury Board of Canada, the Public Service Alliance of Canada and the Bargaining Agent Side of the National Joint Council on changes to the Public Service Dental Care Plan (PSDCP) for 2006, 2007, and 2008.
Effective January 1, 2006
- Reimbursement up to 6 time units of scaling/root planing per covered person for the period January 1 to December 31 of any year. In cases of documented periodontitis, up to an additional 6 time units of scaling/root planing may be allowed in a given calendar year with the pre-approval of a Treatment Plan. Periodontal charting, x-rays and clinical details, including history of the person's periodontal condition should be submitted to the Plan Administrator with the Treatment Plan, as evidence of the nature of the patient's condition. The approved Treatment Plan for additional units will be valid for three consecutive calendar years before another pre-approval of a Treatment Plan is required.
- The maximum reimbursement amount for a calendar year per covered person for eligible dental expenses (excluding orthodontic services) will increase from $1,500 to $1,600.
- The maximum reimbursement amount for a calendar year per covered person for eligible dental expenses (excluding orthodontic services) for employees who join the PSDCP on or after July 1 of any year will increase from $750 to $800.
Effective July 1, 2006
- Prefabricated crowns for primary teeth ONLY will be covered under routine services. (This concerns stainless steel crowns previously covered under major restorations.)
Effective October 1, 2006
- Services received from independent dental hygienist will be covered if dental hygienists are licensed to province where services are rendered.
- Children recall exams, including cleaning and polishing, topical application of fluoride and bite-wing X-rays are limited to once every 6 months.
Effective January 1, 2007
- The replacement of dentures will be covered once every 60 months irrespective of the age of the denture.
- Reimbursement for a complete oral exam once every 3 years (36 months) except limited new patient exam, which will remain unlimited.
- Tomography coverage is discontinued.
- Silicate restoration coverage is discontinued.
Effective January 1, 2008
- The maximum reimbursement amount for a calendar year per covered person for eligible dental expenses (excluding orthodontic services) will increase from $1,600 to $1,700.
- The maximum reimbursement amount for a calendar year per covered person for eligible dental expenses (excluding orthodontic services) for employees who join the PSDCP on or after July 1 of any year will increase from $800 to $850.
All other provisions of the amended PSDCP agreement will remain in effect until December 31, 2008.
You should note that the Plan Administrator, Great West Life, will automatically review and adjust the claims of all PSDCP members, that is employees and their eligible family members (dependants) eligible for further reimbursement as a result of the increase in the new agreement. It is not necessary for PSDCP members to contact the Plan Administrator to receive adjustments on claims filed to date in 2006.
Practical reminders regarding the Public Service Dental Care Plan
- As a member of the PSDCP, it is your responsibility to be aware of the terms of the PSDCP prior to treatment. Be sure to have the plan and your certificate number ready when calling the Plan Administrator at one of the toll-free numbers shown below. General information or your individual detailed information is also available when you access your on-line account.
- Treatment Plans are strongly recommended when a treatment is expected to cost more than $300. Take note that the remarks included on the Pre-determination of Benefits statement provided by the Plan Administrator are part of the Treatment Plan assessment and must be read in conjunction with any amounts approved. A Treatment Plan is not an authority to reimburse services as deductibles, yearly maximums and previous year fee schedules still apply.
- Claims must be submitted within fifteen (15) months of the date the service was incurred in order for reimbursement to be made. Each claim for monthly orthodontic services must also be submitted within fifteen (15) months of the date of each visit.
- Dental claims submitted electronically by dental offices with respect to routine services will be adjudicated electronically by the Plan Administrator, if the required information is on file. The dental office will provide you with a copy of the Explanation of Benefits statement during your visit. Unless you have assigned payment to your dental provider, electronic submission of a claim will not affect your direct fund transfer option.
- You need to inform your dental office of any change of address and to confirm the student status of children between the ages of 21 and 25. It will ensure your personal information on file is maintained up-to-date.
Inquiries and paper claims should be directed to Great-West Life at the following addresses:
For Canadian residents outside Québec, for the National Capital Region and members posted outside Canada:
Winnipeg Benefit Payments
PO Box 6025, Station Main
Winnipeg, MB
R3C 3C7
Call Centres:
Toll free line: 1-800-957-9777
(Services in French and English)
Phone: 204-942-3589
TTY line for the deaf or hard of hearing:
Toll free line: 1-800-990-6654
Phone: 204-946-7281
For Québec residents, other than in the National Capital Region:
Montréal Benefit Payment Office
Place Bonaventure, Suite 5800
800 de la Gauchetière Street West
Montréal, Québec
H5A 1B9
Call Centres:
Toll free line: 1-800-663-2817
(Services in French and English)
Phone: 514-878-1288
TTY line for the deaf or hard of hearing:
Toll free line: 1-800-990-6654
Phone: 204-946-7281
Phil Charko
Assistant Secretary
Pensions and Benefits Sector
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