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Mental health support for all plan members
As the COVID-19 pandemic continues, many Canadians are dealing with increased stress and anxiety. Now, more than ever, plan members need easy to access resources to help them cope with these uncertain times.
Through our partnership with Homewood Health®, the Canadian leader in mental health and addiction services, all of our clients and their plan members have access to tools designed to provide guidance and support, including i-Volve, Homewood’s Online Cognitive Behavioural Therapy tool.
Proven therapy, at your own pace
Included with Homewood Online resources in every Equitable Life® plan, i-Volve can help plan members identify, challenge and overcome anxious thoughts, behaviours and emotions. It encourages incremental changes in behaviour and is proven to be an effective therapeutic approach for dealing with mild to moderate anxiety or depression. Plan members work at their own pace through a series of web-based exercises, ultimately helping to change the ways in which they think, feel and react in various situations.
Free for all Equitable Life plan members
All Equitable Life clients and their plan members have access to i-Volve. It’s available 24 hours a day, seven days a week, wherever you choose to access it.
Contact your Group Account Executive or myFlex Sales Manager to learn more about Homewood Health and i-Volve Online CBT. -
Insights from a pandemic: COVID-19 and group benefits plans
We’ve received numerous questions about the impact of COVID-19 and what it will mean for benefits plans in the months ahead. Below is a summary of what we’re seeing so far. In the coming weeks, we’ll explore each of these topics in greater depth.
Disability
Initially, as COVID-19 started to spread, we saw STD claims ramp up quickly. Since then, we’ve seen the number of COVID-19-related STD claims slow significantly. As for LTD, we believe both the incidence and duration of those claims will increase in both the short term and medium term due to COVID-19.
Health and Dental Claims
We saw an overall spike in the volume and paid amounts for drug claims in March as plan members rushed to stock up on their medications. This was followed by a drop in April after most provinces put 30-day refill limits in place. One exception was claims for asthma drugs which surged in March but had no drop in April. Overall, the April plunge will be short-lived; drug costs have already begun to rise in May.
While paramedical and dental claims are down, we are seeing an increase in claims for virtual treatments and emergency dental services. We expect that claims will spike once the current pandemic restrictions are lifted. We’ve already started to see claims rise in provinces that are allowing health providers to re-open.
Despite the shift to more virtual services, we haven’t seen an increase in fraudulent activity. But we continue to be vigilant. Our investigative practices – verifying with the plan member that they received the treatment and have a valid receipt, and that the practitioner has treatment notes – remain the same whether treatment is provided in person or virtually.
Technology
During this time of physical distancing, people are looking for ways to interact with their providers virtually. Fortunately, our business model is almost entirely electronic, and we have several convenient digital options available for plan members and plan sponsors. Our focus in recent weeks has been to remind clients and plan members about these tools and make it as easy as possible for them to activate and use them. And we are continually adding functionality that will allow us to serve our customers even better.
Mental Health/Wellness
Usage of i-Volve, Homewood’s online cognitive behavioural therapy tool, increased significantly in March before levelling back down in April and May. And while EFAP cases fell in April and early-May, the number of cases has begun to climb in recent weeks, particularly for anxiety. In the coming weeks and months, we expect an eventual increase in marital and family issues, as well as depression. We’ve also seen an increase in mental-health-related prescriptions.
Plan Design
It’s too early to predict how the COVID-19 pandemic will impact benefits plan design and how it will change in the coming months. We would love to get your feedback and insights about how benefit plans will evolve and what new features or provisions they should include.
Please share your thoughts and suggestions with your Group Account Executive or myFlex Marketing Manager. Or, you can email your ideas to GroupCommunications@equitable.ca.
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Paramedicals are Re-opening Shortly
We are pleased to announce that face-to-face insurance testing paramedical services, including the collection of vitals & fluids, are resuming shortly. Our service providers, Dynacare and ExamOne, have been monitoring the public health standards and have established standards they will operate under to protect the health of both the applicant and health professionals.
Our commitment to your client’s safety
It is Equitable Life's commitment that both clients and advisors will be provided clear and thoughtful communication before initiating any testing. Clients should fully understand the potential risks associated with having a paramedical test taken at this time and are always able to choose not to attend the appointment if they do not feel comfortable or safe.
How will paramedical services be conducted?
Dynacare is conducting appointments at fixed site facilities where clients will travel to the health professional for their appointment. The paramedical questions will be covered by video or telephone to minimize the time spent in the fixed site facility. For more information, see Dynacare’s COVID-19 client guide that will be provided to the client directly.
ExamOne examiners will travel to the client’s home for their appointment and the entire paramedical will be conducted at that time. Information about ExamOne’s COVID-19 processes and their Preparing for my exam client guide will also be provided to the client directy.
When are paramedical services re-opening?
In person paramedical services for Equitable Life cases will begin opening gradually. We have worked closely with our service providers, the CLHIA & provincial governments and believe it is prudent to begin re-opening services in the provinces that have a lower incidence of COVID-19. We will expand the schedule as the incidence of COVID-19 lowers or is expected to lower in specific regions.
Please note if you had an order in process prior to services shutting down, the provider will be looking to re-open and complete those orders. If requirements are no longer needed given the non-med limit changes, the order will remain closed.
Schedule for re-opening paramedical services:Province Start Date Saskatchewan June 1-Dynacare, June 11-ExamOne New Brunswick June 8-Dynacare, June 11-ExamOne PEI and Newfoundland June 15, Dynacare and ExamOne Manitoba June 15, Dynacare and ExamOne Alberta June 18, Dynacare and ExamOne British Columbia June 22, Dynacare and ExamOne Nova Scotia June 22, Dynacare and ExamOne Ontario* By June 30, Dynacare and ExamOne Quebec * By June 30, Dynacare and ExamOne
Note: Start dates are subject to change based on the progress of COVID-19.
*Ontario & Quebec to re-open regionally (starting with areas with lower incidence of COVID-19). Specifics for Ontario and Quebec will be communicated closer to the implementation dates for these provinces. Further details can be found in this communication. -
Insights from a pandemic: STD claims during COVID-19
The spread of COVID-19 has had a significant impact on short-term disability (STD) claims. We’re providing an update on what we’ve seen so far in terms of STD experience on our block.
Claim volumes
Initially, as COVID-19 started to spread, STD claims ramped up quickly as plan members tested positive for or developed symptoms associated with the virus and were unable to work. Overall, we saw a 34% increase in the volume of claims on our block in Q1, compared with the first quarter of 2019, primarily due to COVID-19-related claims.
Since then, we’ve seen the number of COVID-19-related STD claims slow. Claims levelled off to a 21% year-over-year increase by the end of May. We haven’t seen any meaningful increase in STD claims related to mental health.
Most of the COVID-19-related STD claims so far have been in the manufacturing, retail and healthcare and social assistance sectors where physical distancing can be challenging.
Somewhat surprisingly, Alberta had for the largest share of STD claims on our block, accounting for 40% of claims, followed by BC with 28% and Ontario with 21%.
Claim durations
While STD claim volumes have increased, we’ve seen a notable decrease in claim durations so far this year. As of the end of May, 59% of closed claims resolved in the first two weeks, compared with only 20% the previous year. This is expected given the nature of COVID-19 and that, for most people, symptoms dissipate within about two weeks./p>
Of the STD claims we’ve approved, approximately 25% were paid for the full 14 days. In most cases, this meant the plan member had tested positive for COVID-19.The remaining 75% of paid claims were paid based on the elimination period in the contract, with the most common elimination period of 7 days accounting for 35% of paid claims.
We will continue to provide timely updates on any development/p>
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Extending premium relief for Dental and Extended Health Care benefits
We know this continues to be a challenging time for Canadian employers and we remain committed to looking for ways to help your clients manage while still supporting their employees.
Although many health practitioners have re-opened as pandemic restrictions are lifted, plan member use of dental benefits and some health benefits still remains lower than normal in June.
We are pleased to announce that we are extending premium relief for all Traditional and myFlex insured non-refund customers for Health and Dental benefits for the month of June, as follows:
- A 25% reduction on Dental premiums; and
- A 5% reduction on Extended Health Care premiums.
These reductions are effective for June 2020 and will appear as a credit on the July bill, or against the next available billing. We will assess the situation monthly and will continue with monthly refunds for as long as the current crisis period continues. The size of the credit may change over time as dentists and other health practitioners gradually reopen their offices. We will confirm premium credits for July (if any) at a later date. Credits for subsequent months will be communicated on a month-by-month basis.
In order to be eligible for the monthly credit calculation and payout, a policy must be in force on the first of the month and remain in force thereafter. The monthly credit calculation is based on employees in force on the June bill. If employees experienced layoffs during the month, that would not affect eligibility for a premium credit as long as the benefit itself is not terminated.
We expect that claims experience and premiums will return to normal once the current pandemic restrictions are lifted.
In the meantime, plan members will continue to have full access to their benefits coverage throughout the pandemic. In many cases, dental offices have remained open for emergency services, and a variety of healthcare providers are available virtually.
Commissions
We know the pandemic has put financial strain on your business as well, so we will continue to pay full compensation. Although your overall commission will be unaffected by these premium reduction adjustments, you may see a temporary reduction in your commission payments if you are on a pay-as-earned basis.
Communication
We will be communicating this premium relief program to your clients later this week.
Questions?
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager. You can also refer to our online COVID-19 Group Benefits FAQ.
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Take emotions out of investing
Taking the emotion out of investing can be easier said then done. Most of us at one time or another have decided upon something strictly because of how we felt at the time, not because it was logical or made good financial sense. I am sure most of us have a good story to tell.
When it comes to financial planning, you always want to encourage your clients to be a rational investor and accept that market fluctuation is part of the investment journey. Over the last few months, even the hardiest rational investor has been challenged to accept the market fluctuations. History shows us that this too, shall pass and markets will rise once more. The biggest question asked is always, when?
While no one has a crystal ball with that answer, the best we can do is help our clients understand that when building portfolios, risk is always at the forefront of any good investment strategy. The level of risk is just one of the building blocks to constructing a financial portfolio that will see the client through good times and bad.
Need more help? Equitable Life has created an emotional investing brochure to help your clients manage through these extraordinary times. To download a copy, click here. We have also included a template letter that you can personalize and use to reach out to your clients. To download an editable copy, click here.
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Insights from a pandemic: Drug trends during COVID-19
We were expecting drug costs to rise this year due to the increase in “specialty” drugs, the shift to more expensive treatments for common conditions, and the introduction of new, costly medications. The COVID-19 pandemic has caused drug costs to rise even more than expected. While this was partly due to increased claims for certain drug categories, the most significant factor was the increase in dispensing fees as the provinces imposed 30-day refill limits.
Costs and claimants surge, drop, then climb again
Initially, as COVID-19 started to spread, we saw an overall spike in the volume and paid amounts for drug claims in March as plan members rushed to stock up on their medications. On our block, the average amount paid per certificate increased 16% in March, compared with the previous year.
This spike was followed by a drop in April after most provinces put 30-day refill limits in place. This led to a decrease in both average paid amounts and quantity per claim as people were limited to smaller refills. But the dispensing fee portion of drug cost tripled for many plan members who had to refill their prescriptions every month instead of every 90 days.
The April plunge was short-lived. Drug claims started to climb again in May as some provinces removed their 30-day refill limits. We’ve seen a continued increase so far in June as all remaining provinces have lifted their 30-day limits.
Claims for “specialty” drugs increase
There were some notable exceptions to this trend. For example, both claimants and paid amounts for high-cost “specialty” drugs increased in March, April and May. Thirty-day refills are the norm for these drugs, so they weren’t impacted by the re-fill limits.Claims for asthma drugs had the largest surge of any common disease category in March but had no subsequent drop in April. Not surprisingly, claims for mental health drugs increased throughout the pandemic, including a 33% increase in the number of claimants in May.
Going forward, we should see the average quantity per prescription stabilize in future months and return to normal, provided pharmacies return most patients to refills of more than 30 days.
The full impact of COVID-19 remains to be determined. We will continue to provide timely updates on any developments that impact our clients and their plan members or their benefits coverage. In the meantime, please contact your Group Account Executive or myFlex Sales Manager if you have questions.
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Did you know that you can generate a report detailing all or some of your client’s investment policy
This can be a great tool when meeting to review your client’s account.
This easy to read PDF gives you and your client some, or all, of the pertinent policy information to discuss overall investment goals. The reporting tool also allows you to exclude any “Advisor only information” sections. With active links to fund pages, you can even review risk ratings, calendar and compound returns.
Generate the report just prior to your meeting to ensure the most up-to-date information is available to your client. Located in the top right corner of your client’s policy page on EquiNet®, it also makes a great takeaway or follow up for your client before or after your meeting. -
An update on Travel Assist coverage
The last several months have been very difficult for plan members. We recognize how important it is for them to get back to a sense of normalcy, including making summer travel plans.
As countries start to reopen their borders, plan members with Travel Assist emergency medical benefits may have questions about whether they will be covered while travelling.
For plan members who want to travel outside of Canada, here’s what they need to know.
Out-of-country travel
Plan members travelling to countries that are popular vacation destinations and have reopened their borders will be covered for eligible expenses, including those related to COVID-19.
Please note: While a country may be open for travel, plan members should contact Allianz before departing to confirm that they are covered for travel to their specific destination.
Plan members travelling to countries for which the Government of Canada has issued a Level 4 travel advisory (“Avoid all travel”) will not be covered.
Please note that every country has different travel restrictions. Travelers could be denied entry to another country, even though their travel may be considered essential. Or they may be forced to self-isolate when they arrive at their destination. Canadians travelling to another country should consult that country’s travel restrictions and guidelines before departure and re-entry into Canada.
Communicating with plan members
Below is a link to a plan member version of this communication. Please encourage your clients to share this with their plan members who have Travel Assist coverage on their benefits plan. It’s important for them to know their coverage details before they make their travel plans. We have also posted this update on the plan member website at EquitableHealth.ca.
An update on Travel Assist coverage PDF
If you have questions, please contact your Group Account Executive or myFlex Sales Manager.
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Insights from a pandemic: Long-term COVID-19 drug risks
For the remainder of 2020 and beyond, COVID-19 will continue to add to the existing pressures driving up drug costs. Examples of contributing factors include:
- Claims for acute drugs will likely increase as elective surgeries resume and plan members address non-emergency health issues that were left unattended during COVID-19.
- Plan members whose employers are facing financial strain due to COVID-19 may stock up on their prescriptions in anticipation of losing their job and/or their benefits.
- An ongoing increase in the prevalence and severity of mental health issues and chronic conditions. In May and June, we saw a dramatic increase in the number of claimants for depression, ulcers, blood pressure and diabetes, and depression was associated with 1 in 5 claimants.
All trends thus far suggest we can expect about a 10% increase in average paid amounts per certificate in 2020 compared with 2019. But the impact won’t be the same for all groups. There will be significant variations, particularly for smaller groups, and some may see much larger cost increases.
Unknown COVID-19-related risks
Another risk exposure may come from the costs associated with drugs used to treat or prevent COVID-19. There are currently numerous vaccines in development, and more than 300 clinical trials are underway for both new and existing drugs to determine their effectiveness in treating the virus.
The cost of any vaccine or whether government or private plans will pay for it is unknown. Regardless, there will likely be other drugs indicated for the treatment or prevention of COVID-19 that private plans will be expected to cover. The cost of this impact for private payers is unknown, but potentially high.
Another unknown is what will happen with dispensing fees. While most provinces have lifted their 30-day prescription refill limits, it remains to be seen whether pharmacies will resume dispensing 60- and 90-day refills at pre-COVID levels for private plans. If not, this would mean the dispensing fees will continue to drive up drug costs.
Advisor opportunity
Despite the increase in drug plan risk in recent years, little has changed in plan design trends. Very few plan sponsors have adopted managed plans or other plan design options that could help manage risk.
This presents an opportunity for advisors to educate their clients about the risks their drug plan may be exposed to and the options available to manage that risk.
A practical starting point for those conversations is our Drug Plan Design Tool. With two simple questions, it can help confirm your client’s objectives and identify some best-fit solutions for their plan. Ask your Group Account Executive or myFlex Sales Manager for a copy of the tool.