Cyber attack creates insurance claims backlog
Sub-contractor providing coverage to public servants abroad now working
Following a cyber attack, the systems of a subcontractor to Canada Life that provides coverage to public servants abroad are back up and running. What's left now is a backlog of claims.
On Feb. 12, the Treasury Board of Canada Secretariat issued a news release reporting that a cyber attack was affecting the systems of MSH International, a subcontractor to Canada Life under the Public Service Health Care Plan.
To protect its network and data, Treasury Board said, MSH turned off its services and was unable to process PSHCP claims, with members unable to log into their portal.
A letter to deputy ministers at Global Affairs Canada, signed by all Canadian ambassadors and heads of mission abroad, expressed concern about the “untenable” situation made worse by the cyber attack.
The letter said the suspension of services was “a step beyond what is acceptable for thousands of staff,” adding that government communications lacked a timeline for resolution.
It also said the new system of providing emergency travel and health coverage abroad had “failed to function from the outset of its implementation.”
“This has meant that, while employees in Canada are being provided with stable health care insurance via Canada Life, for all intent and purposes staff working abroad for Canada have not (except DND), and carry significant financial burdens due a failure to be financially remunerated as they are entitled to be,” the letter said, adding that loans had been introduced by Global Affairs Canada, though “not everyone is comfortable with such an approach.”
Marilyne Guèvremont, a spokesperson for Global Affairs Canada, said the department recognized the challenges being faced by its Canada-based staff and their dependants abroad.
“The impact of these challenges on the well-being of staff is of utmost importance to us,” Guèvremont said. “We are working with the Treasury Board Secretariat, which is directly engaged with Canada Life to find a timely resolution.”
The administration of the plan for more than 1.7 million public servants, retirees and dependants transferred to Canada Life from Sun Life last July 1 following a multi-year tendering process. Canada Life subcontracted MSH to cover plan members posted abroad or travelling.
More than two weeks after the cyber attack was disclosed, MSH confirmed that its systems were in operation again and it had resumed all services, including claims processing and reimbursement.
“With systems restored, there remains a backlog of claims to process,” the Government of Canada website indicates.
The government said MSH was continuing to investigate potential privacy impacts from the cyber attack and Canada Life had introduced an urgent needs escalation process for claims for an “urgent, life-sustaining prescription drug, service, or treatment” or if a member was an individual with a disability or was experiencing financial hardships related to their claim.
“We can confirm a recent cyber incident has been contained, and all services are back online,” MSH spokesperson Pamela Kwiatkowski said. “Throughout this incident, MSH has continued to help PSHCP plan members outside of Canada access the medical care that they require.”
Kwiatkowski acknowledged that claims processing times for plan benefits outside Canada had been “longer than we would like” due to higher-than-expected volumes.
MSH inherited more than 14,000 invoices incurred before it took over as service provider, representing around five months of claims volume.
“We're actively hiring additional staff to meet this demand,” Kwiatkowski said, adding that the company had also introduced a process to prioritize high-cost claims so that they can be processed faster. “It's important to emphasize that claims processing times do not impact the ability of individuals to access medical care from health professionals.”
Pamela Isfeld, president of the Professional Association of Foreign Service Officers, said she had heard from hundreds of members having problems since the transition of the health plan.
“If they can't deliver on that promise to employees, then you know, people are going to be reluctant to take postings to go overseas,” Isfeld said, noting it was especially a concern in the United States, where there is no public health insurance. “Some people have claims going back to July or some even further.”
Mal Farquhar, who spent 35 years working at Fisheries and Oceans Canada, said he had been waiting since November for MSH to reimburse a claim.
While in Chicago, Farquhar said, his wife had a sinus infection and needed to go to a walk-in clinic. A month later, after making numerous calls to try to get pre-authorization, he went on the MSH website to submit a claim, valued at US$178.98 for the doctor's visit and prescribed medications.
However, he received no receipt for his submission. Farquhar unsuccessfully tried to call MSH again, having not received a call back.
“I've pretty much given up,” said Farquhar, who has since sent his claim to OHIP for the doctor's visit. “I will go back to the States because my son lives down there, and my grandkids, but I'm not going on a winter holiday because I have no confidence whatsoever. And, if I do, I'm probably going to pay out-of-pocket to buy additional insurance, which I've never, ever had to do in the past.”
The Public Service Alliance of Canada recently filed a grievance against the federal government for its conduct in transferring the administration of the health benefits plan.
It said the government's actions violated the collective agreement as the transfer was done “without due regard for the rights of all members” and in a manner that “caused adverse impacts,” on grounds protected by the Canadian Human Rights Act.
“The situation has impacted members across the country,” said the document dated Feb. 15. “Members have experienced stress, aggravation, and pain and suffering by being subject to a plan that is dysfunctional.”
In the grievance, the union expressed that it was seeking compensation for members for “all harms experienced” since the plan administration was transferred to Canada Life, including general damages for all employees for stress, aggravation, and pain and suffering, as well as damages for impacts to individuals who experienced financial losses.
The union said it also sought damages under the CHRA for “adverse effects experienced on the basis of prohibited grounds.
“By the nature of a health-care plan, the most severely impacted are those individuals with protected — and often intersecting — characteristics, including disability, family status, age, sex and gender identity or expression,” the document said.
Canada Life's online dashboard on PSHCP contact centre wait times and claims-processing times indicated that, on Wednesday, call centre wait times were zero minutes, with 100 per cent of calls answered within two minutes. As of Monday, the average digital-claim processing time was one day, and the average paper-claim processing time was six days.
“The stats look a little bit better, but the day-to-day issues of our members having their claims denied that they are eligible for is absolutely, as I said, unacceptable,” PSAC national president Chris Aylward said. “There's more than just a couple of bugs in the system. It looks like there's a monster or two in this system because it's just really atrocious.”
“We have members abroad as well that work in embassies, it's subcontracted out and is even worse than what we're seeing. It's obviously a mess.”