Ambassadors raise alarm as government staff abroad struggle to access health coverage

All of Canada's top diplomats have taken the extraordinary step of writing a joint letter to their superiors warning of an "untenable" situation as their health insurance provider fails to process claims for Canadian staff working abroad.

The letter, obtained by CBC News, is written on behalf of all Canada's heads of mission and ambassadors around the world. 

"What was already a challenging situation has become further untenable due to the cyber attack" on the company providing health-care coverage, the letter states. It is addressed to deputy ministers at Global Affairs Canada (GAC).

That company, MSH International, said a "cyber incident" was detected on Feb. 9. It has paused claims processing while an investigation is underway.

In their letter, the diplomats note the real-life consequences of uncertain access to health-care coverage.

"We are also aware of employees foregoing and/or postponing medical treatments (e.g. psychological treatments, physiotherapy and some drug treatments) due to concerns that they may not be reimbursed," they say in the letter.

Diplomatic sources who spoke to CBC News emphasized the stress that these challenges have placed on some employees.

In a recent report looking at the future of the foreign service and the need to modernize and improve recruitment, the Senate's foreign affairs and international trade committee recommended that the government put more resources into better supporting families abroad.

The problem also affects retirees who are relying on the coverage.

Retired Canadian ambassador Dennis Horak was travelling in the United States last October when his wife experienced a medical emergency that required hospitalization.

Horak said it took him nearly three days to get hold of MSH International to open a file.

"I phoned them every hour. I stayed on the phone for hours at a time. Waited for callbacks that never came and then finally, more than two and a half days later, I finally got a hold of them," he said.

"It was extremely frustrating at a very, very stressful time." 

Insurance company Canada Life became the administrative services provider for Public Service Health Care Plan (PSHCP) members on July 1 of last year.

Canada Life subcontracted out-of-country emergency travel and insurance administration to MSH International.

The letter says that while employees in Canada are being provided with stable health insurance coverage, staff working abroad are not — and they "carry significant financial burdens due to a failure to be financially remunerated as they are entitled to be."

The letter says the new system managed by MSH International "has failed to function from the outset," forcing GAC to introduce emergency loans as a means to cover health-care costs — a situation "not everyone is comfortable with."

"The recent suspension of services due to the cyber attack on MSH is a step beyond what is acceptable for thousands of staff. In this context, the communications issued by TBS [Treasury Board Secretariat] have also unfortunately lacked a timeline for resolution," says the letter.

Pamela Isfeld, president and chair of the Professional Association of Foreign Service Officers (PAFSO), said members of her union reported problems with accessing their health insurance from the moment MSH International took over administration of overseas coverage.

Isfeld said that while GAC has been proactive in trying to help overseas employees facing health-care costs, the government shouldn't have to compensate them because a private company isn't doing its job.

"We have Global Affairs Canada, which is a government department facing a budget crunch like everywhere else," she said.

"And right now it's got, the last number I heard was over $2.3 million held up in advances covering for a private, for-profit company that is not able to get its act together to properly reimburse people and give them the coverage that they are paying for."

Isfeld said Canadian foreign service officers based in the United States are facing a particularly scary situation because there's no public health care system to fall back on.

Diplomatic sources told CBC News Canadian staff abroad are looking to the Treasury Board, which oversees Government of Canada contracts, for an urgent resolution.

CBC News is not naming the confidential sources because they were not authorized to speak publicly.

Those sources said that Treasury Board officials held a call with staff in the United States last Thursday to discuss the ongoing issue.

At the end of the call, Canada's Ambassador to the United States Kirsten Hillman summarized what she heard from staff in the embassy — including a call for the government to put all employees at the embassy on American private insurance plans until the issues with MSH International are resolved.

According to the sources, Treasury Board officials said on the call that they will look into the request.

CBC News reached out to TBS for an update on the situation and asked whether the department could estimate when MSH International will resume processing claims for PSHCP members.

A spokesperson for TBS declined to provide a timeline.

MSH says it expects to restore claims processing soon

"An investigation is ongoing, and the Government of Canada will continue to work closely with its partners to prevent, detect and manage cyber threats. For information on the actions taken by Canada Life and MSH International related to this incident, please contact them directly," said spokesperson Martin Povin in a media statement. 

GAC said in a statement provided to CBC News that it recognizes the challenges being faced by its Canadian staff and their dependents abroad.

"The impact of these challenges on the well-being of staff is of utmost importance to us. We are working with the Treasury Board Secretariat, which is directly engaged with Canada Life to find a timely resolution," said the department.

MSH International said in a statement provided to CBC News that the company expects to resume secure claims processing services "in the very near future."

"Throughout this incident, MSH has continued to help PSHCP plan members outside of Canada access the medical care that they require. The contact centre has continued to operate without disruption," reads the statement.

MSH International also said it has been able to "effectively help individuals outside of Canada access medical services when they need them." But the company acknowledged that claims processing times have been longer than the company would like, due to "higher-than-expected volumes."

As for Horak, he said he is still waiting for MSH International to process some of the bills associated with the medical emergency and that it's impossible to get anyone from the company on the phone.

"If it wasn't so serious, I'd call it a joke. But it's not a laughing matter," he said.

"This didn't begin with the hack. This has been a problem from the very beginning, certainly with MSH, in my experience."