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  4. Equitable Life Group Benefits Bulletin – May 2020

    In this issue:

    *Indicates content that will be shared with your clients


    Easy and convenient digital resources for your clients and their plan members

    During this time of physical distancing, people are looking for ways to interact with their providers virtually. We have several convenient digital tools available to make it easier for your clients and their plan members.


    For plan administrators:


    Plan administrator portal (EquitableHealth.ca)

    Our secure portal allows plan administrators to easily manage their plan anytime and anywhere. Instead of printing and mailing forms, they can make real-time updates at their convenience. The site also makes it easy to:

    • View or upload forms and other important documents;
    • Retrieve billing information;
    • Estimate monthly premium costs; and
    • View announcements, tips and reminders.

    Plan administrators can visit www.equitablehealth.ca to activate their account.

    Digital Welcome Kits

    Instead of paper kits that can easily get lost or quickly become outdated, plan members receive personalized welcome kits via an interactive email, including instructions on how to:

    • Activate their online group benefits account;
    • Download their digital benefits card;
    • Submit claims from their computer or mobile device;
    • Review their coverage details; and
    • Explore health and wellness resources.

    Easy automated payments

    Automated payments are a convenient way to avoid missed payments, suspended claims and disruption. Plan administrators simply complete the pre-authorized debit form and send to GroupCollections@equitable.ca. Or contact Group Collections about online banking and electronic funds transfer (EFT).

    We can help

    For assistance, plan administrators can contact their Client Relationship Specialist or our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca.


    For plan members:


    Plan member portal (EquitableHealth.ca)

    By logging into EquitableHealth.ca, plan members have secure 24/7 access to their personalized Group Benefits account. They can:

    • View and submit claims;
    • Review their coverage details; and
    • Access health and wellness resources.

    Electronic claims payment and notifications

    Once plan members have activated their Group Benefits account on EquitableHealth.ca, they can easily set up receiving their claim payments via direct deposit, and their claim notifications via email.

    EZClaim Mobile App

    Submitting claims is fast, easy and secure with the Equitable EZClaim® mobile app for iOS and Android devices. Plan members can view and submit health and dental claims and review their coverage details.

    Digital Benefits Cards

    Instead of digging through their wallets, plan members can download a digital version of their benefits card to their mobile device.

    We can help

    We’ve created a video guide to help plan members access and use their digital resources. For further assistance, plan members can contact our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca.


    Alberta government delaying biosimilar initiative

    As we announced in the February 2020 issue of eNews, the Alberta Biosimilar Initiative will require patients using several originator biologic drugs to switch to a biosimilar in order to maintain coverage through their Alberta government sponsored drug plan.

    Due to the increased demands the COVID-19 pandemic is placing on healthcare providers, the Alberta government has postponed the switching requirement. Affected patients will now have until January 15, 2021 to switch to the biosimilar version of their drug in order to maintain provincial coverage.

    We continue to investigate appropriate options to help ensure this provincial change does not unreasonably impact Equitable Life groups and patients and will keep you informed.
    For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.


    Yukon increasing Insurance Premium Tax

    The Yukon Government has announced that it plans to increase its Insurance Premium Tax rates effective January 1, 2021. The premium tax rates for group life and accident and sickness insurance are expected to increase from 2% to 4%. The new tax rates will be applied to premiums paid on or after January 1, 2021.


    Manitoba and New Brunswick relaxing drug limits

    In order to protect the drug supply during the COVID-19 crisis, residents of most provinces were temporarily limited to receiving a 30-day supply of drugs when filling a prescription. Normally, doctors prescribe a 90-day supply for most maintenance-type drugs.

    The Government of Manitoba and the Government of New Brunswick are now relaxing this 30-day limit for prescription drugs where shortages do not exist. They will address potential shortages of specific drugs if necessary.

    As the situation continues to evolve, there may continue to be changes to provincial legislation and prescription limits. Plan members should speak to their pharmacist for the most up to date information.


    Free guide to accessing virtual healthcare

    With many health clinics closed and the healthcare system under strain, people are looking to access a doctor and other health providers virtually.

    As we announced previously, we’ve made it easier for plan members to find the information they need using our Guide to Accessing Virtual Healthcare. This online resource provides information about and links to a range of virtual health services they need to take care of their health and the health of their family during these challenging times.

    The Guide also indicates which services are covered by public health plan, so there’s no cost to the patient to access them if they provide their valid provincial health card.
    We will continue to update the Guide as more virtual healthcare providers and services become available.

    The Guide is available on both EquitableHealth.ca and Equitable.ca.


    Homeweb for plan members who are losing coverage

    We know these are difficult times for Canadian employers and their employees. As businesses temporarily suspend operations, some employers have had to make the difficult decision to temporarily lay off employees or put their benefits coverage on hold.

    That’s why we were pleased to announce that Homewood Health® and Equitable Life will extend access to Homeweb, a personalized online mental health and wellness portal, for up to 120 days for plan members who have temporarily lost their benefits coverage due to COVID-19.

    Employees and their family members will continue to have access to the Homeweb website and mobile app, including:

    • iVolve, online self-directed Cognitive Behavioural Therapy;
    • Resources to support themselves and their family members through the COVID-19 pandemic;
    • An interactive online Health Risk Assessment; and
    • An online library of tools, assessments and e-courses.

    This will allow businesses undergoing financial hardship to provide some support to employees who are temporarily without benefits coverage.

  5. Equitable Life Group Benefits Bulletin – November 2021 In this issue: *Indicates content that will be shared with your clients

    Reminder: Deadline to opt out of New Brunswick biosimilar program*

    Earlier this year, we announced via eNews that on Feb. 1, 2022, we are ending coverage for some originator biologic drugs in New Brunswick in response to the province’s Biosimilar Initiative.* These changes will help protect your clients’ plans from additional drug costs while still providing access to equally safe and effective biosimilars.
     
    Do my clients need to take any action?
    No action is required if employers want to have the originator biologics excluded from their plan. Plan members taking these targeted originator biologics will be contacted directly to allow them ample time to transition to the biosimilar. Any cost savings associated with the change will be factored in at renewal.
     
    All groups, except myFlex clients, who wish to opt out of this change and maintain coverage of these originator biologics for existing claimants in New Brunswick can submit a policy amendment. Amendments must be submitted no later than Nov. 30, 2021.
     
    Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for New Brunswick plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.
     
    Groups that opt out of this change are also opting out of any future changes to our New Brunswick biosimilar initiative. This means that their drug plans will continue to cover any additional originator biologics for which we subsequently end coverage as part of the biosimilar program.
     
    Questions?
    If you have a question that isn’t answered here, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.
     
    * The list of affected drugs or conditions is dynamic and may change.

    Web Reports Quick Reference Guide now available for plan administrators

    A Web Reports Quick Reference Guide is now available for plan administrators on EquitableHealth.ca. This new guide offers a listing of our newest reports available on the plan administrator web. It also provides instructions for plan administrators outlining how to pull the report using the plan administrator portal.
     
    The guide is available under the Quick Links section on both the advisor and plan administrator portals on EquitableHealth.ca.

    Reminder: Review manual allocations for HCSAs and/or TSAs*

    If your client’s Health Care Spending Account (HCSA) and/or Taxable Spending Account (TSA) has manual allocations, they need to allocate these amounts to plan members each year. Please review all your plan members’ profiles on EquitableHealth.ca to ensure they have received their allocation(s) for the current benefit year.
     
    If your clients have Plan Administrator update access on EquitableHealth.ca, they can update these amounts online by doing the following:
    • Select “View certificate”
    • Select “Health Care Spending Account” or “Taxable Spending Account”
    • Select “Update Allocation” in Task Center
    • Enter amount in “Revised Allocation Amount”
    • Override Reason – “Plan Administrator Request”
    • Select “Save”
    If your clients have Plan Administrator reporting access on EquitableHealth.ca, they can determine which plan members have a zero allocation by running the “HCSA Totals by Plan Member” report online by doing the following:
    • Select “Reports”
    • Select “New”
    • Select “Next”
    • Select “HCSA” or “TSA Totals by Plan Member”
    • Select “Next”
    • Enter end date of “12/31/2020”
    • Select “Next”
    • Select “Finish”
    • View “Report”
    To provide us with the amounts to be updated, please have your client contact our Group Benefits Administration Team at GroupBenefitsAdmin@equitable.ca.

    Help your clients take advantage of our convenient digital options*

    We have several digital options available to make it easier for your clients to do business with us and for their plan members to access and use their benefits plan. Over 71% of plan administrators are managing their plan online and 78% of plan members are already using our digital tools.
     
    For plan administrators:
    • Online Plan Member Enrolment tool – allows all groups to add new plan members without the need for paper forms
    • Plan Administrator Portal (EquitableHealth.ca) – plan administrators can easily manage their plan anytime and anywhere
    • Digital Welcome Kits – personalized welcome kits are delivered to plan members via email
    • Easy automated payments – plan administrators can avoid missed payments by setting up pre-authorized debit or electronic funds transfer
    For plan members:
    • Plan Member Portal (EquitableHealth.ca) – plan members get secure, 24/7 access to their claims history, coverage details and health and wellness resources
    • Electronic Claim Payments and Notifications – plan members can get claim updates sooner in their email inbox and payments right into their bank account
    • EZClaim Mobile App – submitting claims from a mobile device is fast, easy and secure
    • Digital Benefits Cards – plan members no longer have to dig through their wallet – they can download their benefits card on their mobile device
    We can help
    We’ve created a brochure and a video guide to help plan members access and use their digital resources. For further assistance, plan members can visit www.equitable.ca/go/digital. They can also contact our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca.
  6. Equitable Life Group Benefits Bulletin – December 2021 In this issue: *Indicates content that will be shared with your clients

    Supporting plan members affected by the flooding in Nova Scotia and Newfoundland*

    The recent flooding in Nova Scotia and Newfoundland is having a devastating impact on the province’s residents.

    Here are some of the ways we can help support your clients’ plan members who are affected by the flooding.
     
    Prescription refills
    Until Dec. 31, our pharmacy benefit manager, TELUS Health, will allow early refills for plan members who have been evacuated and/or lost their medication due to the flooding.
     
    Replacement of medical or dental equipment and appliances
    If plan members in Nova Scotia or Newfoundland need to replace any eligible medical or dental equipment or appliances (e.g. prescription eyeglasses, dentures, etc.) due to the flooding, they can call us at 1.800.265.4556 before incurring additional expenses to see how we can support them.

    Disability or other benfit cheques
    If plan members affected by the flooding are receiving disability benefits or other benefit reimbursements by cheque, they can visit www.equitable.ca/go/digital for easy instructions on how to sign up for direct deposit. It’s easy and takes just a few minutes. They can call us at 1.800.265.4556 if they need help. We can also arrange for a different mailing address or replacement cheques if necessary.
     
    Mental Health Support
    A natural disaster can also take a serious toll on people’s mental health. All of our plan members have access to the Homeweb online portal and mobile app, including numerous articles, tools and resources designed to provide guidance and support in difficult times. Homewood has put together some suggestions on how to help employees affected by a natural disaster. 
     
    For your clients with an Employee and Family Assistance Program, remind them that their plan members have 24/7 access to confidential counselling through a national network of mental health professionals. Whether it’s face-to-face, by phone, email, chat or video, plan members will receive the most appropriate, most timely support for the issue they’re dealing with.
     
    If a client wishes to add the EFAP to their plan, we can do this quickly – often in just a few days. Simply contact your Group Account Executive or myFlex Sales Manager.
     
    Plan Administrator support
    We realize that the flooding may also be having an impact on the regular business operations of your clients in Nova Scotia and Newfoundland. If any of your clients are unable to carry out day-to-day plan administration, they can call us at 1.800.265.4556 to see how we can support them.
     
    We know this is a challenging time for many of your clients and their plan members. We will continue to monitor the situation and provide additional updates as appropriate. 
     

    Update: Changing certificate numbers on EquitableHealth.ca*

    Effective Dec. 10th, plan administrators will no longer be able to update or change plan members’ certificate numbers on EquitableHealth.ca. This change will ensure we can manage these changes more effectively to provide a smoother plan member experience.
     
    If your clients need to update a plan member’s certificate number, please have them reach out to Group Benefits Administration for assistance at groupbenefitsadmin@equitable.ca.
     

    Help plan members take advantage of convenient digital options*

    We have several digital options available to make it easier for your clients to do business with us and for their plan members to access and use their benefits plan.
     
    To help build awareness among plan members, we’ve created two posters that your clients can post on their intranet sites or in their office. The posters provide easy instructions on how to activate our secure, digital options.
     
    Please click on the links below to download the posters.
     
    EquitableHealth.ca posters:                                         EZClaim mobile app posters:
    EquitableHealth.ca English                                             EZClaim mobile app English poster                   
    EquitableHealth.ca French poster                                  EZClaim mobile app French poster
     

    Ontario optometrists and government to restart negotiations*

    The Ontario Association of Optometrists (OAO) announced it has paused its job action and will restart negotiations with the Ontario Ministry of Health on funding for optometry services.
     
    In September, Ontario optometrists began withholding services from patients covered by OHIP, including children, senior citizens and other patients with certain medical conditions, after negotiations with the Ministry of Health over compensation broke down.
     
    Residents of Ontario between the ages of 20 to 64 who aren’t eligible for coverage of eye services under OHIP were not affected by the job action. They were able to continue to receive eye exams from their optometrist and submit eligible claims to their benefits plan.
     

    QDIPC updates terms and conditions for 2022*

    Every year, the Quebec Drug Insurance Pooling Corporation (QDIPC) reviews the terms and conditions for the high-cost pooling system in the province. Based on its latest review, QDIPC is revising its pooling levels and fees for 2022 to reflect trends in the volume of claims submitted to the pool, particularly catastrophic claims.
     
    Size of group (# of certificates) Threshold per certificate 2022 Annual factor (without dependents Annual factor (with dependents)
    Fewer than 25 $8,000 $276.00 $771.00
    25 – 49 $16,500 $188.00 $527.00
    50 – 124 $32,500 $97.00 $328.00
    125 – 249 $55,000 $66.00 $223.00
    250 – 499 $80,000 $51.00 $173.00
    500 – 999 $105,000 $39.00 $153.00
    1,000 – 3,999 $130,000 $34.00 $133.00
    4,000 – 5,999 $300,000 $18.00 $71.00
    6,000 and over Free market – Groups not subject to Quebec Industry Pooling
     
    We will apply the new pooling levels and fees to future renewal calculations that involve Quebec plan members.
  7. Equitable Life Group Benefits Bulletin – March 2022 In this issue: *Indicates content that will be shared with your clients
     

    CLHIA launches industry anti-fraud initiative*

    In February, the Canadian Life and Health Insurance Association (CLHIA) announced a new anti-fraud initiative that is using advanced artificial intelligence (AI) to further identify and reduce benefits fraud.
     
    Equitable Life is excited to be a part of this important initiative. It will enhance our own fraud detection analytics by using AI to connect the dots across a huge pool of anonymized claims data. This will lead to more investigations and actions to mitigate the impact of fraud on your clients’ plans.
     
    The initiative is being led by the CLHIA and member insurers and is supported by technology provider Shift Technologies. It will be further rolled-out and expanded over the next three years.
     
    Benefits fraud affects more than just insurers. The costs of fraud are felt by employers and their employees as well. We are looking forward to being able to better identify and reduce benefits fraud.
     

    Provincial biosimilar update*

    BC expands its biosimilar initiative
    BC Pharmacare recently announced it is adding two rapid-acting insulins to the list of drugs included in its ongoing initiative to switch patients to biosimilar versions of high-cost biologics. Patients taking Humalog or NovoRapid for Type 1 or Type 2 diabetes will be required to switch to a biosimilar version of the drugs by May 29, 2022 to maintain coverage under the public plan.

    Biologics are drugs that are engineered using living organisms like yeast and bacteria. The first version of a biologic developed is also known as the “originator” biologic. Biosimilars are also biologics. They are highly similar to the originator biologic drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.

    How we are responding to protect our clients
    To help prevent this change from resulting in additional costs for our clients’ drug plans while still providing plan members with access to safe and effective medications, we will no longer cover Humalog or NovoRapid for plan members in BC. Effective June 1, 2022, claimants currently taking Humalog or NovoRapid will be required to switch to a biosimilar version of the drugs to maintain coverage under their Equitable Life plan and their BC Pharmacare plan.

    We will be communicating this change to plan administrators later this week. And we will be communicating with affected claimants in early April to allow ample time to change their prescription and avoid any interruptions in their treatment or their coverage.
    If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.

    Nova Scotia and Northwest Territories introduce biosimilar initiatives
    The governments of Nova Scotia and the Northwest Territories each recently announced they are launching biosimilar initiatives to switch patients from certain originator biologic drugs to biosimilar versions of the drugs.

    Patients in Nova Scotia using affected originator biologic drugs will have until February 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. Patients in the Northwest Territories will have until June 20, 2022, to switch.

    Equitable Life® actively monitors and investigates all biosimilar policy changes and the ongoing evolution of biosimilar drugs entering Canada.  We will keep you informed of any impact on private drug plans and how we are responding.
     

    Quebec decreasing insurance premium tax*

    The Quebec Government has announced that it plans to decrease its Insurance Premium Tax rates effective April 1, 2022. The premium tax rates for group life and accident and sickness insurance are expected to decrease from 3.48% to 3.3%. The new tax rates will be applied to premiums for the billing period beginning on or after April 1, 2022.
     

    Coming soon: A survey to understand how we can better serve your clients’ needs*

    We are committed to providing your clients and their plan members with industry-leading service. We’ve introduced several enhancements over the past year to make it easier to do business with us. And we’re continually looking for ways to improve.
     
    In the coming weeks, we will conduct a survey of your clients to help us understand how we can better serve them. On March 28, we will send plan administrators an email with a link to the survey. The survey will remain open until the end of the day on April 11 and will take between five and 10 minutes to complete. Please encourage your clients to participate. Their feedback will be confidential, and their responses will help us improve our service and ensure we’re meeting their expectations. We may also follow up with plan administrators directly to address any concerns they’ve identified.
     
    We know your clients’ time is valuable. So, each plan administrator who completes the survey will be entered into a random draw for a chance to win one of 25 prepaid gift cards for $25.
     

    Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare*

    If your clients have plan members in British Columbia, Manitoba or Saskatchewan, the provincial government offers a Pharmacare program to support prescription drug costs.  Plan members in these provinces must register for their provincial Pharmacare program to maintain coverage under their Equitable Life drug plan.
     
    Registration is easy! We will send two registration reminder messages directly to plan members’ pharmacists and post them on their Explanation of Benefits. We’ve also created a step-by-step guide that your clients can share with their plan members.
     
    English version
    French version
     
    For more information about the provincial Pharmacare programs, including how plan members can register, please visit:
     
    For British Columbia residents: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents  
     
    For Manitoba residents: https://www.gov.mb.ca/health/pharmacare/apply.html
     
    For Saskatchewan residents: https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/extended-benefits-and%20drug-plan/drug-cost-assistance#eligibility
     
     
  8. Equitable Life Group Benefits Bulletin - October 2022

    Introducing new Gender Affirmation Coverage for group benefits plans

    Providing an inclusive benefits plan can play a critical role in fostering a workplace culture that welcomes diversity and helps employees thrive. While most provinces cover the cost of gender-affirming surgery, each person has unique needs. Some may require procedures that are not publicly covered.

    That’s why we’re pleased to introduce a new coverage option for gender affirmation surgical procedures that are not covered by provincial health plans. Gender Affirmation Coverage helps plan sponsors to close the gap where provincial health coverage ends. 

    Coverage details and eligibility

    Gender Affirmation Coverage can be added to any Equitable Life plan with an in-force Extended Health Care plan. It provides coverage for gender-affirming procedures that are not covered by provincial health plans. This might include tracheal (Adam’s apple) shaving and voice surgery. It will also cover some additional procedures to further align the plan member’s features to the transitioned gender, such as facial bone reduction and cheek augmentation. This makes a wider variety of gender-affirming surgeries accessible to plan members and helps minimize their out-of-pocket costs.

    Plan members are eligible for coverage with a diagnosis of gender dysphoria from a qualified health care professional. 

    Offering a more inclusive benefits plan

    The coverage provides one more way for your clients to offer more inclusive coverage and to offer holistic support to their plan members undergoing a gender transition. We have developed this coverage as a complement to our existing coverage options, including Health Care Spending Accounts (HCSAs), Taxable Spending Accounts (TSAs), Extended Health Care and drug coverage, and Employee and Family Assistance Programs, all of which can provide support to plan members undergoing gender affirmation.

    We regularly review our products to ensure that they’re meeting your clients’ needs, and we’re committed to offering products that support diversity, equity and inclusion.

    We also continue to review our forms, documents and processes to make them more inclusive. This includes reviewing our online plan member enrolment (OPME) tool to allow for more flexibility with the way plan members identify their gender. 

    Gender affirmation and mental well-being

    Gender affirmation procedures can lead to improved mental health outcomes for those with gender dysphoria, as most report an improvement in their quality of life following the procedures. Gender dysphoria may occur when a person’s assigned sex at birth does not match their identity, and people experiencing gender dysphoria typically report psychological and emotional distress, including symptoms of depression or anxiety. By offering coverage where provincial health coverage ends, your clients can support plan members as they seek procedures that align their body presentation with their self-identified gender.
     

    Advantages at a glance

    Advantages for plan members include:
    • Reimbursement for some procedures and expenses, leading to fewer out-of-pocket costs
    • May experience improved mental health outcomes after surgery
    Advantages for plan sponsors include:
    • A benefits plan that promotes a culture of diversity, equity and inclusion, which may build employee loyalty
    • Support for plan member mental health to help those with gender dysphoria thrive
    For more information about how Equitable Life benefits plans can support the needs of those seeking gender affirmation surgery view our resources:  You can also contact your Group Account Executive for more information. If you have clients with myFlex plans who are interested in Gender Affirmation Coverage, please contact your myFlex Sales Manager to determine eligibility. 
     

    The Benefits Canada 2022 Health Care Survey results are in!

    Equitable Life is proud to be a Platinum sponsor for The Benefits Canada 2022 Health Care Survey, Canada’s leading survey on workplace benefits plans. This year’s survey report highlights many fascinating insights across a wide variety of benefits topics, including:
    • A focus on mental health for both plan sponsors and plan members
    • The repercussions of the "shadow" pandemic due to health care delays 
    • Trends in plan members' overall perceptions of their health benefits plans
    • The types of benefits getting more attention from plan members
    • The role of remote work in plan member satisfaction
    By surveying plan members and plan sponsor representatives across Canada each year, Benefits Canada works with its Advisory Board to provide timely insights on the employee benefits issues that are most important to Canadians. This year, our Group Vice-President of Western Sales, Meghan Vallis, has provided her expertise as an Advisory Board member.

    We’re committed to helping you and your clients navigate the evolving landscape of employee benefits in Canada by contributing to this vibrant industry community. To read the full report, visit Benefits Canada.
     

    HCSA and TSA manual allocation reminder

    If your clients’ Health Care Spending Account (HCSA) and/or Taxable Spending Account (TSA) have manual allocations, they need to allocate these amounts to plan members each year. Clients should review their plan members’ profiles on EquitableHealth.ca to ensure they have received their allocation(s) for the current benefit year. Your clients may also order HCSA and TSA forfeiture reports on EquitableHealth.ca. 
     
    If your clients have Plan Administrator update access on EquitableHealth.ca, they can update these amounts online by doing the following:
    • Select View certificate
    • Select Health Care Spending Account or Taxable Spending Account
    • Select Update Allocation in Task Center
    • Enter amount in Revised Allocation Amount
    • Override Reason – Plan Administrator Request
    • Select Save
    If your clients have Plan Administrator reporting access on EquitableHealth.ca, they can determine which plan members have a zero allocation by running the HCSA Totals by Plan Member report online by doing the following:
    • Select Reports
    • Select New
    • Select Next
    • Select HCSA or TSA Totals by Plan Member
    • Select Next
    • Enter end date of 12/31/2022
    • Select Next
    • Select Finish
    • View Report
    To provide us with the amounts to be updated, please have your client contact our Group Benefits Administration Team at GroupBenefitsAdmin@equitable.ca. 

     
  9. January 2023 eNews

    Responding to Saskatchewan’s biosimilar switch initiative*

    We are changing coverage for some biologic drugs in Saskatchewan in response to the province’s biosimilar initiative. These changes will help protect your clients’ plans from additional drug costs that may result from this new government policy while providing access to equally safe and effective lower-cost biosimilars. 

    Saskatchewan’s provincial biosimilar initiative
    Announced in October 2022, the Saskatchewan Biosimilars Initiative ends coverage of ten biologic drugs beginning on April 30, 2023.

    Patients in the province who are using these drugs will be required to switch to biosimilar versions of these drugs by April 30, 2023, in order to maintain their Saskatchewan Drug Plan coverage.
     
    Equitable Life’s response
    To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Saskatchewan for most biologic drugs included in the provincial initiative.

    Beginning April 30, 2023, plan members in the province will no longer be eligible for most originator biologic drugs if they have a condition for which Health Canada has approved a lower cost biosimilar version of the drug.** These plan members will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable Life plan.  

    Communicating this change to plan members
    We will inform any affected plan members in early February of the need to switch their medications so that they have ample time to change their prescriptions and avoid any interruptions in treatment or coverage. 

    What is the difference between biologics and biosimilars?
    Biologics are drugs that are engineered using living organisms like yeast and bacteria. The first version of a biologic developed is known as the “originator” biologic. Biosimilars are highly similar to the drugs they are based on and Health Canada considers them to be equally safe and effective for approved conditions. 

    Questions?
    If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.

    **The list of affected drugs is dynamic and will change as Saskatchewan includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
     

    Ontario announces 2023 biosimilar switch program*

    The government of Ontario recently announced the launch of a biosimilar initiative to switch patients from eight originator biologic drugs to biosimilar versions of the drugs.

    Patients in Ontario using affected originator biologic drugs will have until December 29, 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans.

    We are actively monitoring and investigating the impact of this new policy on private drug plans in Ontario. We plan to implement changes to coverage of biologic drugs in the province in 2023 to help prevent this change from resulting in additional costs for our clients’ drug plans. We will provide more details in the coming months.

    If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
     

    Dental fee guide updates*

    Each year, Provincial and Territorial Dental Associations publish fee guides. Equitable Life® uses these guides to help determine the reimbursement limits for dental procedures. For your reference, below is the list of the average dental fee increases for general practitioners that will be used by Equitable Life for 2023.*** 

    Dental fee guide increases over 2022***



    ***Data for all provinces and territories was not available at the time of publication. This chart will be updated on EquitableHealth.ca as more information becomes available.
     

    Equitable Life ranks high with Canadian group advisors*

    Equitable Life ranked second nationally and first in Ontario among major insurers in a recent survey of Canadian group benefits advisors.
     
    NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 130 leading group consultants, brokers and third-party administrators across the country between May and August 2022 for its annual Canadian Group Benefits Study. Based on these interviews, NMG ranked group insurers in six categories, ranging from operational management to technology.

    Nationally, Equitable Life ranked either first or second in four of the six main categories:

    Advisors in Ontario, in particular, scored Equitable Life very favourably. We ranked #1 overall in the province, finishing first in four of the six overall categories, including: Relationship Management, Operational Management, Underwriting and Claims Management and Technology.
     
    “The fact that advisors regard us so highly in so many categories is a testament to our mutual status and our ability to focus exclusively on our clients and advisors,” said Marc Avaria, Senior Vice President of Group. “We are truly working together to build strong, enduring and aligned partnerships.”
     
    “While we are happy with these results, we won’t rest on our laurels,” added Avaria. “We will continue to dedicate ourselves to providing our clients and advisors with a better benefits experience.”

    Here are more of the highlights from this year’s results:
     
    Nationally, we ranked first in all 10 subcategories in Operational Management, including:
    • Overall service to intermediaries,
    • Overall service to plan sponsors,
    • New quote process,
    • Plan implementation,
    • Renewal process,
    • Information shared at renewal,
    • Accuracy and timeliness of reporting and billing,
    • Administration quality and responsiveness,
    • Taking ownership and
    • Management information quality and availability.
    We also ranked first in Relationship Management, getting top marks in 7 of 10 subcategories, including:
    • Company relationship management,
    • Ease of doing business,
    • Account executive capability,
    • Market knowledge,
    • Visit/call quality,
    • Effective coordination and
    • Advice.
    We ranked second in Underwriting and Claims Management, finishing in the top three for all subcategories, including:
    • Fairness and timeliness of disability claims (1st)
    • Fairness and timeliness of health claims (2nd)
    • Fraud management (2nd)
    • Competitiveness of pooling charges (2nd)
    • Group underwriting flexibility (3rd)
    • Health and dental TLR competitiveness (3rd)
    And we ranked second in Technology, finishing in the top three for:
    • Overall technology – Intermediary (2nd)
    • Member experience (2nd)
    * Indicates content that will be shared with your clients.
     
  10. April 2024 eNews

    In this issue:

    • Competitive – and easy – benefits plans for your small business clients
    • Simplifying benefits enrolment for your clients*
    • NEW time-off tracking tool from HRdownloads*
    • Focus on benefits fraud: Protecting your clients’ plans from abuse*
    *Indicates content that will be shared with your clients who receive these benefits.
     

    Competitive – and easy – benefits plans for your small business clients

    Supporting your small business clients can be a challenge. It’s tough to find a competitively-priced benefits plan with the features they want. Small business owners may also need more of your time – especially if this is their first benefits plan.
     
    That’s why we created Equitable EZBenefits™, a benefits solution designed with the needs of small businesses in mind. With a range of plan design options and valuable embedded services for plan sponsors and plan members, EZBenefits is available for groups with 2 to 25 employees. And to make things simpler for you, we’ve created an Advisor Concierge Service exclusively for EZBenefits. Whether you have a question about submitting a quote request for a new client or an issue with an in-force client, our Concierge Service is your go-to resource for EZBenefits support.  

    Don’t have any EZBenefits clients yet?

    To learn more about EZBenefits, watch our video to learn more or view our brochure.

    Simplifying benefits enrolment for your clients*

    Navigating the benefits enrolment period can be overwhelming – for you, your clients and their employees. It’s difficult to ensure all plan members complete the necessary paperwork before the enrolment deadline. 

    That’s why we offer our secure Online Plan Member Enrolment tool at no extra cost to plan sponsors. The tool simplifies the onboarding process for your clients and their plan members by eliminating the need for paper enrolment forms.
     
    It also makes enrolment faster and easier for your clients by:

    • Reducing errors and rework that can occur due to spelling mistakes or missing information on paper forms; and
    • Sending automatic enrolment reminders to plan members, resulting in fewer late applicants. 
    Our user-friendly interface allows plan members to:
    • Enrol in their benefits plan in just minutes from their computer or mobile device;
    • Easily enter all their enrolment information, including dependent details, banking information for direct deposit of claim payments and details for coordination of benefits; and
    • Designate their beneficiary electronically. 

    Ready to share our Online Plan Enrolment Tool with your clients? Get them started with these helpful resources:

    To learn more about how Online Plan Member Enrolment can simplify benefits enrolment for your clients, contact your Group Account Executive or myFlex Account Executive.

    NEW time-off tracking tool from HRdownloads*

    Through our partnership with HRdownloads®, EZBenefits clients now have complimentary access to Timetastic —a time-off tracking tool that can make it easier to manage employee vacation time, sick days and more.
     
    Timetastic integrates seamlessly with HRdownloads and includes a mobile app to help manage time-off requests from any mobile device.
     
    To see Timetastic in action, check out this demo.
     
    EZBenefits also includes other helpful resources and tools from HRdownloads that can make daily human resources tasks easier, including:
    • A robust, award-winning HR management platform (HRIS);
    • HR documents, templates, compliance resources and articles; and
    • A live HR advice helpline. 
    All of our other Equitable group benefits clients can get a 10% discount on HRdownloads services. Visit the link below or contact your Account Executive for more information.

    Learn more about accessing HRdownloads.

    Focus on benefits fraud: protecting your clients’ plans from abuse*

    According to the Canadian Life and Health Insurance Association (CLHIA), benefits fraud costs insurers and plan sponsors millions of dollars each year, which can lead to increased premium costs.
     

    Resources for your clients

    Both plan administrators and plan members play a role in preventing benefits abuse. So, we’ve compiled some resources you can share with your clients to help them understand what benefits fraud is and how to prevent it: Encourage your clients to educate their plan members about the potential consequences of benefits fraud, including losing their benefits, losing their job and even jail time. 

    How we’re fighting benefits fraud

    Our Investigative Claims Unit (ICU) works to detect and eliminate benefits fraud. We use a variety of investigative techniques, including CLHIA-led industry tools to detect and eliminate benefits fraud: 
    • Joint Provider Fraud Investigation Program: A robust program that allows insurers to collaborate on fraud investigations that affect multiple insurers;
    • Data Pooling Program: An initiative that pools data between insurers and uses advanced artificial intelligence to further identify and reduce benefits fraud; and
    • Provider Alert Registry: A registry that allows insurers to view the results of other insurers’ anti-fraud investigations into specific practitioners. 
    To learn more about benefits fraud and Equitable’s commitment to protecting our benefits plans, please contact your Group Account Executive or myFlex Account Executive.