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1. Policy endorsement: Long Term Disability pre-existing condition period

   We are updating our contracts to clarify how we handle the Long Term Disability (LTD) pre-existing condition period for employees returning from maternity or paternity leave.

   A new LTD pre-existing condition period will no longer apply when an employee re-enrols in the benefits plan after their maternity or paternity leave ends, provided that they return to work on the date agreed upon with their employer, or in the time period allowed by the Employment Insurance Act, whichever is earlier.

   To facilitate this change, we are amending some of the wording in our contracts and booklets, effective March 1, 2020. Below are links to the Endorsement to the Master Policy and the Summary of Master Booklet Wording Changes for this amendment. Please download and save these policy endorsement documents for your files.

   In addition, please remind your clients to provide all of their plan members with a copy of the Summary of Master Booklet Wording Changes.

   The next time your clients amend their benefits plan, the updated wording will be included in their group benefits plan booklets.
   
   Download Endorsement to the Master Policy
   Download Summary of Master Booklet Wording Changes

2. February 2020 Advisor eNews

   In this issue:

   Provincial biosimilar update
   Legislative changes for Alberta’s Coverage for Seniors program
   Coming soon: enhancements to Equitable EZClaim® Online
    

   Provincial biosimilar update

   

   Alberta Biosimilar Initiative

   On December 12, 2019, the Alberta government introduced the launch of the Alberta Biosimilar Initiative. This program will require patients using several originator biologic drugs to switch to a biosimilar, and patients using a non-biologic complex drug (NBCD) to switch to its subsequent entry version before July 1, 2020 in order to maintain coverage.

   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” drug. Biosimilars are highly similar to the originator drug they are based on and have been shown to have no clinically meaningful differences in safety or efficacy.

   Alberta Health will initially cover both the originator and biosimilar or subsequent entry version of a NBCD  drug as patients start the switching process.

   The following table outlines the affected originator drugs, their biosimilars or subsequent entry, and the conditions affected by the program.

   Biosimilar Drug	Originator	Biosimilar/Subsequent Entry	Indications Affected
   etanercept	Enbrel	Brenzys	Ankylosing Spondylitis Rheumatoid Arthritis
   		Erelzi	Ankylosing Spondylitis Psoriatic Arthritis Rheumatoid Arthritis
   infliximab	Remicade	Inflectra Renflexis	Ankylosing Spondylitis Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Crohn’s Disease Ulcerative Colitis
   insulin glargine	Lantus	Basaglar	Diabetes (Type 1 and 2)
   Filgrastim	Neupogen	Grastofil	Neutropenia
   pegfilgrastim	Neulasta	Lapelga	Neutropenia
   glatiramer*	Copaxone	Glatect	Multiple Sclerosis

   *Glatiramer is a non-biologic complex drug where the originator is Copaxone and the subsequent entry is Glatect.

   Equitable Life is actively investigating the benefit, risk and appropriate plan changes associated with this new policy on private drug plans and will keep you informed.

   For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.

   British Columbia

   In 2019, BC Pharmacare introduced a Biosimilars Policy that impacted coverage of three biologic drugs – Remicade, Enbrel and Lantus. As of November 25, 2019, these drugs were no longer eligible in BC for most conditions for which lower cost biosimilar versions are available. Patients in the province with these conditions were required to switch to biosimilar versions of these drugs in order to maintain their coverage.

   The second phase of the BC Biosimilar Policy takes effect March 6, 2020 when Remicade will be delisted for Crohn’s Disease and Ulcerative Colitis. Patients in the province with these conditions will be required to switch to Inflectra or Renflexis in order to maintain their coverage.

   Biosimilar Drug	Originator	Biosimilar	Indications Affected
   infliximab	Remicade	Inflectra Renflexis	Crohn’s Disease Ulcerative Colitis

   We have communicated with the affected plan members, informing them of the need to switch medications. If plan members have any questions or concerns, our Customer Care team is here to help and support them through the transition.

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

   Ontario

   In November 2019 Ontario Minister of Health Christine Elliot indicated that the government was planning to launch consultations to explore solutions in managing biologics.

   Equitable Life will continue to monitor these developments and keep you informed of any impact on private drug plans.

    

   Legislative changes for Alberta’s Coverage for Seniors program

   

   The government of Alberta has announced that as of March 1, 2020, seniors’ family members (such as spouses and dependents) who are younger than 65 will no longer be covered by the provincial Coverage for Seniors program. Albertans 65 years of age and older will continue to be covered under the provincial plan.

   Equitable Life plan members and their dependents will continue to be covered under the parameters of their group benefits plan.

   For more information, please see the Alberta Seniors Health Benefits website.

    

   Coming soon: enhancements to Equitable EZClaim^® Online

   

   Faster vision claims processing and payment

   Equitable Life will soon provide real-time processing of vision claims submitted via EZClaim Online.

   This means plan members will be able to find out the status of their vision claim almost instantaneously. And, for approved claims, they will receive payment even sooner – often in as little as 24 hours.

   In order to allow for instantaneous processing and faster payment, plan members will be prompted to enter some additional information including the practitioner’s name, the date of the expense, the type of expense and amount of the expense when submitting their claims for these services.

   Equitable Life plan members can submit all vision claims via EZClaim, including coordination of benefits and Health Care Spending Account claims.

   This enhancement will be coming to our EZClaim Mobile app in the coming months.

   New printable claims extract

   As part of our ongoing efforts to improve customer experience for plan members, we will also offer a claims extract in a printable format within the plan member site. Plan members will be able to select a date range and claimant, then generate and download a detailed list of health and dental claims. This is a helpful way to keep track of claims, especially when reviewing them in preparation for income tax filing.

   Once these enhancements are live you will be notified in an eNews, and an announcement will be posted on the plan member section of EquitableHealth.ca.

    

   Elimination of Out-of-Country Travellers Program in Ontario

   

   Effective January 1, 2020, the Ontario government eliminated OHIP coverage for emergency services for Ontarians travelling outside of Canada.

   Previously, the Out-of-Country Travelers Program provided some reimbursement for services required to treat conditions that are acute, unexpected, arose outside Canada and require immediate treatment. The program covered between $200 and $400 per day for inpatient services and $50 per day for outpatient and doctor services.

   For groups who have out-of-country coverage from Allianz, this change will not impact the cost to your plan members, or the process plan members follow in the event of an emergency while travelling.

   Plan members should still call Allianz in the event of an out of country emergency. Allianz will deal with their claim as usual and will now pay for the portion of the claim previously paid by OHIP. Plan members will not have any additional out-of-pocket costs.

   We will be sharing this information with plan members as a news item on our plan member website, equitablehealth.ca.

3. EquiNet Quick Tips

   Need some help navigating your way around EquiNet? We’ve put together the top 5 Quick Tips on the following topics, based on the most frequently mentioned questions from advisors:

   1. Policy Inquiry/New Business Pending Inquiry 
   2. Document Lookup 
   3. Policy Statements & Correspondence 
   4. Username & Email Address Support
   5. Need more help? Submit a request for support using the EquiNet Support Form.

    

   See more details and information about other site tips in this FAQ created to help you find your way around.

4. Coming March 23, 2020 – Equimax enhancements include 60 months of flexibility to make extra deposits

   The following features will be available on Equimax Estate Builder® and Equimax Wealth Accumulator® plans!   
   
   60 months of Excelerator Deposit Option (EDO) flexibility

   • Up to 60 months to make initial EDO payment or resume stopped or reduced payments. No additional underwriting required. 
   • For approved EDO amounts exceeding $150,000 annually ($12,500 monthly), clients have up to 12 months from the date the EDO application was signed or the date of the last EDO payment to make an EDO payment before a contribution cap may apply.
   • Available on all policies with an effective date of March 23, 2020 or later.
   
   
   
   EDO available on case ratings of 300% or less
   • If a policy already in effect has a rating over 200% and up to and including 300%, the owner can apply to add EDO provided the policy was issued under the 2017 tax rules.
   • Additional underwriting and submission of satisfactory evidence may be required.
   
   
   
   Disability Benefit Disbursement at no extra cost
   • If a life insured becomes disabled from a severe mental or physical impairment as defined in the policy contract, the owner may apply for a tax-free,* lump sum payment of up to 100% of the policy’s cash value.
   • Exclusions apply. See sample policy contract for full details, including the qualifications for the disbursement.
   • Available on all policy issued under the 2017 tax rules.

   
   
   * Tax laws are subject to change. The payment of the disability benefit disbursement may affect the adjusted cost basis (ACB) of the policy as it is considered payment of a capital benefit. Changes in ACB can affect the future taxation of the policy.

   Processing your Application
   To make the transition as smooth as possible, please take a moment to review the following transition rules.
    

5. Can’t meet in person? EZcomplete is an EZ way to meet online

   
   Instead of canceling your meeting, why not meet online instead? Our EZcomplete^® application makes it easy to process your non-face-to-face applications and do business with Equitable Life.
    
   EZcomplete is available on Pivotal Select™ segregated funds and all life products – Term, Whole Life, CI and Universal Life – and allows for the signing process to change from in-person to non face-to-face at the end of the application, despite how it was started.  This gives you and your clients the option to easily and efficiently connect remotely.
   
   
   
   How does it work?
    
   EZcomplete gives you the option to conduct your non face-to-face business easily and quickly, enabling your clients to provide their signature remotely on their own device. You simply need to enter their email address and provide them with a secret passcode to securely access the documents to review and sign.
    
   There is no limit on the face amounts or product options and the time to settle is reduced when using the application. It is a flexible, intuitive tool to use, and helps keep business on track now that many clients and advisors are opting for more social distance.

   
   For Life Advisors, please refer to the New Business and Underwriting page on Equinet for details about non-face-to-face delivery.

6. Enhanced flexibility and features make Equimax whole life a great choice for your clients

   WHAT’S NEW ON MARCH 23, 2020?

    
   The following features are available on Equimax Estate Builder^® and Equimax Wealth Accumulator^® plans!   
   
   60 months of EDO payment flexibility¹ that fits your clients’ situation

   • Clients can start EDO payments¹ up to 60 months from the date the application was signed, or resume up to 60 months from the last EDO payment made, without additional evidence of insurability.
   • Applies to Equimax² policies with an effective date of March 23, 2020 or later. 
   
   
   
   
   EDO is available on cases rated 300% or less³ for new and existing clients
   • For existing clients, if approved, the EDO contract provisions that apply will be based on the effective date of the insurance policy, not the date the EDO was added.
   • Applies to Equimax² policies issued under the 2017 tax rules.
   
   
   
   Built-in Disability Benefit Disbursement provides access to cash value in the event of a disability
   • The Disability Benefit Disbursement may provide a tax-free, lump sum payment of up to 100% of the policy’s cash value if the insured becomes disabled.⁴
   • Will be included on Equimax² policies issued under the 2017 tax rules.⁵

   
   
    

   Want more information?

   More information is available on EquiNet^® on the Whole Life Insurance Product page under the Resources tab. 
   
   Ask your Equitable Life^® Regional Sales Manager about Equimax today.

   COVID-19 & social distancing: Strategy for insurance applications   Using our EZcomplete® online application allows you to keep your distance … while keeping your business moving forward.   Learn more

    

   
   ¹ This applies only to policies with an effective date of March 23, 2020 or later. The amount of the EDO payment allowed may be limited to the maximum EDO payment made in previous years depending on the policy year. For approved EDO amounts exceeding $150,000 annually ($12,500 monthly), clients have up to 12 months from the date the EDO application was signed or the date of the last EDO payment to make an EDO payment before a contribution cap may apply. See Admin Guide for full details.  ² Applies to Equimax Estate Builder and Wealth Accumulator; all ages; life pay and 20 pay; single and joint lives. ³ Not available if the policy has a flat extra rating. ⁴ See sample policy contract for full details, including the qualifications for the disbursement. Policy cash value and death benefit will decrease. Tax laws are subject to change. The payment of the disability benefit disbursement may affect the adjusted cost basis (ACB) of the policy as it is considered payment of a capital benefit. Changes in ACB can affect the future taxation of the policy.  ⁵Subject to our administrative rules and guidelines in effect at the time of the disbursement

7. Equitable Life Coronavirus Update – March 13, 2020

   As the coronavirus (COVID-19) continues to spread, it’s important that you, your clients and their plan members have the most up-to-date information. We are providing timely updates on any developments that impact your clients and their plan members or their benefits coverage.

   Please share this information with your clients. You can direct them to EquitableHealth.ca, where we have posted a version of these updates.

   Coronavirus travel coverage*

   For groups with Travel Assist coverage

   The Public Health Agency of Canada has issued several Travel Health Notices advising Canadians to avoid travel to countries and regions where there have been outbreaks of coronavirus (COVID-19).

   A good resource to help your clients and their plan members understand how the spread of the coronavirus may impact their travel plans is the Public Health Agency of Canada’s Coronavirus Travel Advice site. The levels of risk by country and region are regularly updated.

   If your clients’ plan members cannot avoid travelling, Public Health recommends they take steps to prevent illness and seek medical attention if they become sick.

   Where to find the latest information

   The list and level of travel advisories can change at any time. Please check the Government of Canada’s Travel Advisor and Advisory page for the most current information.

   If your clients’ plan members have coronavirus symptoms while travelling, please advise them to contact Travel Assist at the numbers listed below for assistance.

   Advise plan members to call before they travel

   If a plan member is travelling anywhere outside of the province or country and their benefits plan includes Travel Assist, plan administrators should advise them to make sure they’re prepared for a medical emergency by following these steps.

   1. Check the Government of Canada’s Travel Advisor and Advisory page. Note that it is important to click on the country to check whether any specific regions of that country have travel advisories.
   2. If they have questions, they should call Travel Assist before they travel for assistance and benefit information.
   3. Pack their Equitable Life benefits card and provincial health card.
   4. In a medical emergency, call the Travel Assist 24-Hour Hotline:
   • Toll-free Canada/USA: 1.800.321/9998
   • Global call collect: 519.742.3287
   • Allianz Global Assistance ID #9089

   Allianz Global Assistance administers Equitable Life’s Travel Assist benefits. Allianz has an international network of medical facilities, transportation providers, medical correspondents and multilingual administrative agents who aid with medical, legal and most travel-related emergencies 24-hours a day, seven days a week.

   Early prescription refills and drug shortages*

   In response to concerns about COVID-19 TELUS Health, our pharmacy benefits manager, has announced it is maintaining its standard rules for refills of medication. Plan members can refill their medications when at least two-thirds of the last dispensed supply has been used.

   If plan members need more than the maximum supply allowed on their plan, they must pay out-of-pocket for the excess amount. They can then submit a claim to ask for an exception request.

   TELUS is taking this position to help maintain access to medication for all patients. They continue to monitor the situation. We will provide an update if it changes.

   Drug shortages

   TELUS Health monitors for drug shortages and updates their system for any unavailable drugs. This helps to ensure accurate claims payment. If a referenced lowest-cost generic drug is unavailable, claims for drugs in the class will be paid at the next lowest-cost generic alternative available.

   *Indicates content that will be shared with your clients

8. Update - Travel Assist Coverage*

   Last Friday, we announced that plan members with Travel Assist on their benefits plan will not be eligible for coverage if they departed the country after the Government of Canada issued its Global Travel Advisory.

   When the Government issued its advisory late Friday afternoon, we felt an obligation to let prospective travellers know as soon as possible so they could make informed choices about their travel. Since then, we have been made aware of a number of situations where plan members were unable to change their travel plans and need our continued support.

   To provide that support, we have revised our position. We will continue to cover plan members for all eligible emergency medical expenses, including those related to COVID-19, for trips outside Canada. Given the global situation is evolving quickly, we will continue to monitor developments and update you accordingly.

   In spite of this, we strongly urge your clients to advise their employees not to travel outside of the country at this time. The risk is high and the options for returning to Canada are becoming limited. Further, we urge your clients to advise their employees who are outside the country to return to Canada earlier than scheduled, if possible.

   If a plan member is currently travelling abroad and is experiencing symptoms or is hospitalized with suspicion of the coronavirus, they should contact Travel Assist at the numbers listed below for assistance and to confirm their coverage.

   • Toll-free Canada/USA: 1.800.321.9998
   • Global call collect: 519.742.3287
   • Allianz Global Assistance ID #9089

   We will continue to update you as the situation develops.

   We will update the announcement on our Plan Member website to reflect this change.

   We apologize for any confusion or inconvenience our earlier announcement may have caused.

   *Indicates content that will be shared with your clients

9. Short-term disability coverage for plan members in quarantine or self-isolation*

   Please note: This announcement applies only to groups with short-term disability coverage through Equitable Life

   With the spread of COVID-19, many people have been instructed to self-isolate or quarantine themselves or are doing so voluntarily. We realize this is a stressful situation for people and they may be wondering if they are eligible for disability benefits. Short-term disability is designed to replace a plan member’s earnings if they are unable to work due to illness and injury.  As a result, only plan members who meet the following criteria are eligible for benefits:

   • Plan members who have tested positive for COVID-19 and are unable to work from home are eligible for coverage from Day 1 of their self-isolation period.
   • Plan members who have not been tested but have symptoms consistent with COVID-19 and are unable to work from home, are eligible for coverage. Claims will be assessed according to the terms of the plan.

   Plan members who are in quarantine for any other reason, but do not have symptoms consistent with COVID-19, are not eligible for coverage. These plan members should consider applying for Employment Insurance (EI) benefits, if they do not have an option to work from home.

   Submitting COVID-19-related STD claims

   To make things easier for plan members who need to submit claims related to COVID-19, we will not require a physician’s statement. Instead plan members should submit our simplified Short Term Disability Plan Member COVID-19 Claim Form.

   Plan Administrators need to complete their portion of the regular Short Term Disability Form (Form #421).

   This is a temporary process that will remain in effect through the current coronavirus situation. We will update on changes and share them on EquitableHealth.ca.

   Applying for the Employment Insurance sickness benefit

   Canadians quarantined due to COVID-19, who are not receiving Short Term Disability benefits, can apply for Employment Insurance (EI) sickness benefits. The one-week waiting period for EI sickness benefits has been waived. Service Canada’s dedicated toll-free support number is 1-833-381-2725 or (TTY) 1-800-529-3742.

   *Indicates content that will be shared with your clients

10. Supporting you and your group clients during the COVID-19 pandemic

    We know these are challenging times.

    As COVID-19 continues to spread, we want to reassure you that we remain ready and committed to support you, your group clients and their plan members.

    We have a robust and well-tested business continuity plan in place and have taken the necessary steps to maintain the high level of service you have come to expect from us. Our business is near 100% digital, so the vast majority of our employees are now working remotely from home and are fully functional. Our Customer Care Centre remains open to support plan members and can be reached at 1.800.265.4556. And our Client Relationship Specialists are available for Plan Administrator questions and support.

    As the situation continues to develop, we know you will have questions about what it means for your clients and their plan members. We have already issued announcements related to Travel Assist coverage for plan members who are outside of the country, and about short-term disability coverage for plan members who are in quarantine or self-isolation. We will continue to provide timely updates as developments unfold.

    All of us are facing an unprecedented number of urgent situations where there is no established protocol. Our commitment to you and your clients is to respond quickly, and to be flexible where we can, tailoring solutions to specific needs. The global situation is evolving rapidly; we ask for your patience as our solutions also evolve quickly and accordingly. Your Group Account Executive and myFlex Sales Manager are well equipped to navigate Equitable Life’s experts and to resolve difficulties.

    These are extraordinary times and history is in the making. Rest assured that Equitable Life is unwavering in our support, and we will be here to help you when it matters most.