Supporting Information - Ill Health Retirement Underpin for applications spanning the alpha transition period

PCSPS will be closed from 31 March 2022. All members who remain in PCSPS on 31 March 2022 will be moved to alpha on 1 April 2022 which includes all members who have an open application to take ill health retirement from PCSPS, or an appeal relating to a prior decision on a previous ill health retirement (IHR) application. 

Members who move to alpha, whilst awaiting an outcome on an IHR application or appeal, having submitted the original application prior to 1 April 2022, with a last day of service on or after 1 April 2022, will be assessed against the criteria of the PCSPS and alpha schemes by the Scheme Medical Adviser (SMA) Health Management Limited (HML). 

Some members who apply for IHR in PCSPS may be eligible for a higher IHR benefit in PCSPS than the one they would receive in alpha, should the approval of their application not be completed until they have moved into the alpha scheme. Provisions are being made so that no member is placed in a less beneficial position as a result of moving schemes. Some members may have been eligible to receive a higher benefit in PCSPS but moved to alpha while their application or appeal was in progress. For these members, an uplift to their benefit – referred to as an ill health retirement underpin – will guarantee they receive at least the level of benefits they would have received as a member of PCSPS.

Members who are eligible

Members who were afforded full protection when the alpha scheme was implemented in 2015, but who will move to alpha on or before 1 April 2022, where:

• They have a prior in-progress application to retire on the grounds of ill health, which was submitted to the Scheme Medical Adviser (SMA) prior to 1 April 2022 or they receive an upheld outcome for an appeal against a decision on a previous IHR application where that original application date was prior to 1 April 2022
• The member’s last day of service is on or after 1 April 2022
• The application for IHR is approved

The process changes are only for members who meet the eligibility criteria outlined above. All other IHR applications relating to standard alpha members, or new IHR applications submitted on or after 1 April 2022, should be treated as standard applications in the scheme the member is currently enrolled in.

Employer Actions and Changes to Process

You will be required to submit additional information for in-scope IHR applications once approved by the SMA, to the scheme administrator MyCSP. Complete the following steps:

• Identify if the application is in scope. To do this:
  • Validate that the application was received by the SMA prior to 1 April 2022
  • Validate that the last day of service is on or after 1 April 2022

As a result of this change, you can now expect to receive either one or two medical certificates from the SMA.

• Where a single certificate is received, but the above criteria (application date and last day of service criteria) are met:
  • Contact the SMA using the suggested wording (below) as a guide to confirm:
    • Was the member correctly assessed against a single scheme?
    • Should a dual assessment have been performed, i.e. should the member have been assessed against both the PCSPS and alpha schemes?
    • If a dual assessment should have been completed, the SMA will need to perform this before MyCSP can produce a benefit quote for the member
    • If a dual assessment was completed, then two medical certificates should be provided. If either certificate is missing then the SMA will need to provide a copy of that missing certificate

When submitting information to MyCSP, having determined that the application is in scope, you should provide:

• The date the application was submitted to the SMA, to be provided in the additional information section of the Request for Services (RFS)
• The last day of service agreed for the member, to be provided in the additional information section of the RFS
• The scheme(s) which the member was assessed under by the SMA, to be provided in the additional information section of the RFS
• The scheme(s) in which the member was approved for retirement on ill health grounds, to be provided in the additional information section of the RFS
• Copies of all medical certificates as provided by the SMA

If there is any information missing, you’ll be required to follow up with the SMA using the suggested wording (below) as a guide to confirm.

Due to the time sensitive nature of many applications to retire on grounds of ill health, where an application falls in scope of this process change it is crucial to minimise any administrative delay in processing the application for our members. The SMA have requested that any requests for further information, documentation or clarification in respect of an in-scope application follow the suggested wording:

In progress applications

Please be aware that some applications may have started before the implementation of this process change.  Ensure the dual assessment eligibility criteria are considered before forwarding the application to MyCSP as below:

• Applications which have passed through the SMA process but not yet sent to MyCSP may have only received a single assessment. In such instances, refer those cases back to the SMA using the suggested wording (above) before sending to MyCSP
• Some applications may have arrived with MyCSP already. In such instances, MyCSP will contact you and ask you to request additional assessments or information from the SMA using the suggested wording (above).
• In scenarios where a member has already received a copy of an outcome report indicating eligibility for an award to be made in PCSPS, but who requires an additional assessment (in alpha) for the purposes of calculating the underpin, then the member may receive a subsequent outcome report now indicating their eligibility for an award in the alpha scheme. In such a scenario, we ask that employers communicate with members to reassure that while this may be confusing, the steps being taken are in place to ensure they receive the highest possible benefit that can be awarded and clarification will be provided in their Ill Health Retirement quote regarding the level of benefits which will be paid.

Member Impact

All additional actions, as outlined above, should be completed as a priority as these process changes are being made to ensure that no detrimental impact is felt by members. The members have been approved for retirement on grounds of ill health in receiving quotes and payment of benefits and we do not wish to cause delays.