Government Operations Committee on Feb. 26th, 2024

[Seth Sazant]

The service is contracted by Canada Life to a company called MSH. Again, we're at arm's-length from Canada Life. We don't interact directly with them. It's the employer's obligation. They have the contract. We don't even have a copy of the contract between the employer and Canada Life. We can't intervene with Canada Life. What the employer is doing here, we're not entirely sure. I'm sure that steps have been taken, but we don't think they're sufficient.

[The Chair, Conservative, Kelly McCauley]

Ms. Vignola, go ahead, please, for six minutes.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Thank you, Mr. Chair.

Mr. Sazant and Ms. Hart, thank you for being with us.

Mr. Sazant, we have received briefs and, of a more personal nature, emails from people who have been harmed by Canada Life. I'll give you two examples. The first is the case of a new dad who hasn't received benefits related to his parental leave for over two months, despite numerous calls to the insurance company that have gone nowhere. The second example is that of a woman who received a prescription from her oncologist for a very specific drug to control her cancer. Canada Life has refused to cover the treatment, despite repeated explanations from the oncologist. So it would appear that a Canada Life agent thinks they know more about cancer pharmacology than an oncologist does.

Are you able to give us any statistics on the number of people whose health, financial life and life in general have been put at risk as a result of Canada Life's practices?

[Seth Sazant]

Thank you for your question, and I will answer in English.

We don't have specific figures to respond directly to your question about how many people's health is in danger. We have heard, I will say, from countless members who have had serious concerns about issues with their health and issues where Canada Life has been unresponsive and they've been unable to get through. We have specific concerns about how many people's health has been put in danger. I certainly couldn't put a number on it, but I would imagine that number is awfully high.

With respect to the situations that you raise, these are very common situations, unfortunately, that we hear from our members about. I wish these were one-off situations, but I think those are both very good representations of what we have been hearing from our members and the concerns we have.

One of the issues I think this may well be related to is the system of prior authorization for drugs. You mentioned someone who has issues—specifically, who has cancer—and is trying to get approval for a drug. There is a process in place for certain high-cost drugs whereby people have to get approved for that drug. This system is in place, and it is fundamentally failing our members.

There was a system that was negotiated between the parties. This was something the employer insisted upon as part of the deal in our negotiations for the provisions of the plan. We asked many questions about this. If a member is refused, how do they appeal? How long will it take for Canada Life to turn its decision around? We were told this would be quick, this would swift and this would be painless.

Now, here we are, eight months into this contract, and we are getting figures showing there are more than a thousand people who have been waiting for more than 16 days for even an answer from Canada Life. You point to someone who's been denied, but there are many people who are just sitting there, waiting to be told whether or not they're able to get the drugs they need. They're waiting on a decision from Canada Life, and their health is at risk.

We absolutely have major concerns about the way this is going.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Thank you.

With respect to the cyber-incident at MSH International, did health care plan members learn of it through the media, like I did?

[Seth Sazant]

Yes.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

So the company didn't reach out to help those individuals, other than to tell them to call an overwhelmed call centre. Is that correct?

[Seth Sazant]

I want to be clear. There may have been communication to members about this. I am not aware if that has happened.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

As a member of that plan, I received nothing.

Canada Life demanded that members' and their dependents' 10-year benefit history be transferred to it, even though the dependents were now adults and were no longer covered. Is it customary for a company to require that 10 years of personal data be transferred without even notifying plan members and their dependents?

[Seth Sazant]

I just want to be clear. Your question relates to keeping the data, the safety of it and how long it will be kept for.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

No, I'm talking about transferring data collected by Sun Life over the last decade to Canada Life.

[Seth Sazant]

I'll be frank and say I'm not.... This is a level of detail in terms of the provision of data that's going from Sun Life to Canada Life. Obviously, security's a major issue when we're talking about any participant's data.

Again, we've not been provided with the contract. We have asked for the contract between the government and Sun Life, and between the government and Canada Life. We have been refused the provision of that contract, which will likely contain those provisions, so we're actually not aware of what those provisions are.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Doesn't the mere fact that no one was informed of the transfer worry you?

[Seth Sazant]

Absolutely. There's an awfully long list of issues that we're concerned about when it comes to the provision of our members' information and the administration of this plan.

I appreciate the question. Absolutely, we have significant concerns.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Thank you.

[The Chair, Conservative, Kelly McCauley]

Thank you very much.

We'll go to Mr. Bachrach, please, for six minutes.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Thank you, Mr. Chair.

Thank you to Ms. Hart and Mr. Sazant for being here today. Obviously, this is an issue that's very concerning. I hope the committee can get to the bottom of what went wrong.

I'll just take it up to 10,000 feet and ask where you think things went wrong. Obviously, you don't have all of the information. You said you don't have the contract and you weren't privy to the process by which it was negotiated, but something has clearly gone sideways here. Either the government failed to negotiate a contract with Canada Life that is in the interest of your members, or Canada Life has failed to uphold the terms of the contract and has left your members high and dry.

Which of those do you think is the case?

[Seth Sazant]

I don't know that it's necessarily an either-or question. I think there are going to be some issues on both sides. I'm concerned that, as I've mentioned, there is a six-month grace period in the contract when there are very few safeguards. I think that people are probably surprised at the level of how poorly they performed according to the call centre metrics and the other provisions they're supposed to be following.

Without getting too speculative, I think there are definitely significant shortcomings that happened on the part of Canada Life. I think, relative to the contract the employer signed with Canada Life, there's some bearing there of why we're in this mess.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Staying at that 10,000-foot level, what does accountability look like, and who should be responsible for ensuring that your members are made whole?

[Seth Sazant]

We would say that accountability lies primarily with the government, as they negotiated this contract. We would expect, for example, that they would enforce the service level standards that are contained in that contract. In terms of making our members whole, that's a priority for PSAC.

Recently PSAC filed a policy grievance against Treasury Board arguing that, in terms of the poor transition of the plan's administration, it failed to protect the rights of members to a functioning health care plan as well as caused adverse impacts on members with disabilities and other intersecting identities.

As part of that grievance, we are asking for general damages for the pain, suffering and stress that this transition has caused. We are asking for financial compensation for those who have incurred financial losses as a result of the poor transition as well as a declaration that the way this has been managed has indeed breeched the collective agreement as well.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Reading through some of these examples, these stories, it seems like these are difficult situations to account for financially, because these people's lives have been profoundly affected. That would certainly be a start, recognizing the depth of the impact imposed on these folks.

You mentioned the issue of prior authorizations. Can you describe how well that was working under Sun Life, under the previous contract? Is this a long-standing problem that has been a problem for people for a long time, or is this really something that has cropped up with the new contract with Canada Life?

[Seth Sazant]

This is new, because this was a new provision to the plan itself. This was something the employer very much wanted to introduce to the plan. During negotiations, this was something that we felt we did not have much of a choice about in terms of ultimately settling with some form of prior authorization in place.

Our concerns during that process related to members appealing and concerns about members with very fragile health conditions who would need approvals or, at very least, a decision to then examine other options within a reasonable time frame.

We're absolutely stunned that it appears as though the system is just not working at this point. There are no answers. Again, this is a totally new system. We were assured that this would work seamlessly, that people would get their answers quickly and that we would have the chance to appeal. Clearly, that hasn't been the case.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

You mentioned MSH International, the subcontractor responsible for the coverage for members working abroad, and the issue of the cybersecurity breach.

Whose responsibility is maintaining the cybersecurity of the claims system?

[Seth Sazant]

That's an excellent question.

The company, MSH, is the one that is feared to have been breached. Whether Canada Life is ultimately accountable for the breach itself is a question I don't know the answer to. Ultimately, Canada Life is the one responsible and accountable for the administration of the benefits generally, whether it's subcontracted or not.

To directly answer your question, I'm not sure who ultimately will be accountable within their own contract.

[The Chair, Conservative, Kelly McCauley]

That's perfect timing.

Mrs. Block, go ahead, please.