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Faster claims processing on Equitable EZClaim Mobile
Equitable Life now provides real-time processing of massage therapy, physiotherapy and chiropractor claims submitted via the EZClaim® Mobile app.
That means plan members will be able to find out the status of their claim almost instantaneously. And, for approved claims, they will receive payment even sooner – often in as little as 24 hours.
Equitable Life plan members can submit all types of health and dental claims via EZClaim Mobile, including co-ordination of benefits and Health Care Spending Account claims. Currently, 43% of all claims are submitted through the user-friendly app.
“We know plan members love the speed and convenience of EZClaim Mobile,” says Norma Crouse, Assistant Vice-President of Claims and Administration at Equitable Life. “With these enhancements, some claims submitted through the app will be processed and paid even faster.”
We’re also adding biometric login functionality to allow plan members to sign in to the app using their face or fingerprint. And we’ve redesigned our landing page on the mobile app to make it easier for plan members to navigate the various features of the app.
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August 2019 Advisor eNews
Coming soon:
Tech updates for plan members
Technology doesn’t stand still, and neither does your clients' businesses. That’s why we continually invest in technology to make things easier for your clients and their employees.
Faster claims processing on Equitable EZClaim® Mobile
Equitable Life now provides real-time processing of massage therapy, physiotherapy and chiropractor claims submitted via the EZClaim Mobile app.
That means plan members are able to find out the status of their 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, and the type and amount of the expense, when submitting their claims for these services.
Equitable Life plan members can submit all types of health and dental claims via EZClaim Mobile, including co-ordination of benefits and Health Care Spending Account claims. Currently, 43% of all claims are submitted through the user-friendly app.
AS part of our ongoing efforts to improve the mobile claims experience for plan members, we've also added biometric login functionality to allow plan members to sign in to the app using their face or fingerprint. And we've redesigned our landing page on the mobile app to make it easier for plan members to navigate the various features of the app.
We will be announcing this enhancement to plan members on EquitableHealth.ca
Introducing InpatProtect:
Health coverage for employees who are new to Canada
For a new employee starting to work in Canada, looking after basic health needs can be difficult.
There’s a waiting period for provincial health coverage, and group benefits plans don’t cover the physician, hospital or emergency services that they or their eligible dependents may need during their initial months in the country. They could end up incurring significant unexpected health expenses.
That’s why Equitable Life has launched InpatProtectTM. InpatProtect provides temporary coverage to look after the basic health needs of employees and their eligible dependents during their transition to Canada. Your clients can recruit from outside the country knowing that their employees will have some protection in the event of a medical need, including an emergency.
For up to 90 days, InpatProtect will cover employees and their eligible dependents for basic services that would normally be reimbursed under provincial health plans, such as:
- Physician services
- Prescriptions for medications
- Diagnosis and treatment for illness or injury
- Hospital services
- In-patient services
- Drugs prescribed and delivered as an inpatient in-hospital
- Out-patient services
- Emergency services
- Ambulance services
- Emergency dental services
Contact your Group Marketing Manager or myFlex Sales Manager for more information about this new product from Equitable Life.
De-listed service providers
As part of our ongoing initiative to have Group Benefits plans only reimburse eligible claims, we conduct reviews of the billing and administrative practices of service providers, including clinics, facilities and medical suppliers.
As a result of these reviews we may de-list certain providers. We will no longer accept, or process claims for services and/or supplies obtained from those providers. The plan member can still choose to obtain services or supplies from these providers, but Equitable Life will not provide reimbursement for the claims.
Review Equitable Life’s de-listed service providers
The delisted service provider list is also posted on EquitableHealth.ca for plan members to review to determine if their claim(s) are eligible for reimbursement under their Group Benefits plan.
For more information about protecting group benefits plans from abuse, check out our articles.
1 Based on Equitable Life health and dental claims submitted between January 2019 – March 2019
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® denotes a trademark of The Equitable Life Insurance Company of Canada unless otherwise indicated. - Physician services
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Equitable Life Group Benefits Bulletin - September 2020
In this issue:
Enhancements to Equitable EZClaim Mobile
New reports available on EquitableHealth.ca* Indicates content that will be shared with your clients.
Enhancements to Equitable EZClaim® Mobile*
We’ve updated our Equitable EZClaim mobile app to process vision claims faster, to provide a new option for submitting documents and to increase password security.
Faster vision claims processing and payment
Equitable Life now provides faster processing of vision claims submitted via EZClaim Mobile.
This means plan members can 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 instant processing and faster payment, plan members will be prompted to enter some additional information, including their 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 Equitable EZClaim, including coordination of benefits and Health Care Spending Account claims.
Submit documents from a mobile device
We have added our Document Submission tool to EZClaim Mobile so plan members can conveniently submit documents directly from their mobile device. Applications, change forms, statement of health forms and more can all be easily uploaded whenever and wherever they are.
Improved security with stronger passwords
To help you, your clients and plan members better protect personal information, we have increased the maximum length of passwords for both EZClaim Online and EZClaim Mobile from 12 to 32 characters. This longer character limit makes it easier to create stronger and more secure passwords.
There is no change for plan members, plan administrators or advisors. All existing passwords will continue to function. However, if you choose to update your password you will now be able to choose longer passwords or passphrases.
Why should I change my password?
Changing your password frequently helps keep your information safe. The longer and more random the password, the more secure it is. To improve security even more, a passphrase is recommended.
A passphrase is a series of words or other text used like a password. Because it is much longer, a passphrase is more secure. Although the words in the phrase may be meaningful to you and easy to remember, they can be random enough that the full phrase is difficult for someone else to guess. It’s even better if you use numbers or other characters in your passphrase.
Your passphrase should be:
- Long enough to be hard to guess;
- Not a famous quotation;
- Easy to remember and type; and
- Not used in multiple places.
To change your password:
- Log in to EquitableHealth.ca
- Click on My Information > User Profile
- Click Edit
- Confirm your information and enter your new password
- Click Save
We will be announcing this enhancement to plan members on EquitableHealth.ca.
New reports available on EquitableHealth.ca*
Plan administrators and advisors with reporting access can now download three additional reports any time via the plan administrator and advisor websites on EquitableHealth.ca:
- Premium and Tax – This report provides a breakdown of premiums and taxes paid per plan member for any specific time period for all applicable benefits.
- Occupation and Earnings – This report provides current plan member earnings and occupation information and gives plan administrators an efficient way to report updates to us.
- Employee listing – This report lists all plan members’ information, including name, certificate number, date of birth, province, occupation and salary, as well as benefit coverage currently in place and HCSA allocations.
These reports can be downloaded in Excel format for easy updating, filtering or sorting.
For more information, please contact your Client Relationship Specialist.
*Indicates content that will be shared with your clients
- [pdf] Investing in technology to make benefits easier
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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 ArthritisErelzi Ankylosing Spondylitis
Psoriatic Arthritis
Rheumatoid Arthritisinfliximab Remicade Inflectra
RenflexisAnkylosing Spondylitis
Plaque Psoriasis
Psoriatic Arthritis
Rheumatoid Arthritis
Crohn’s Disease
Ulcerative Colitisinsulin 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
RenflexisCrohn’s Disease
Ulcerative ColitisWe 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.
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Equitable Life Group Benefits Bulletin – May 2020
In this issue:
- Digital options for your clients and their plan members*
- Alberta delaying biosimilar initiative*
- Yukon increasing insurance premium tax*
- Manitoba and New Brunswick relaxing drug limits*
- Free guide to accessing virtual healthcare*
- Homeweb for plan members who are losing coverage*
*Indicates content that will be shared with your clients
Easy and convenient digital resources for your clients and their plan membersDuring 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 initiativeAs 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 TaxThe 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 limitsIn 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 healthcareWith 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 coverageWe 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.
- [pdf] Get started online
- [pdf] Health Care Spending Account - Plan members
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Equitable Life Group Benefits Bulletin – May 2021
In this issue:
- Graduating dependents losing coverage?*
- New Brunswick expands the use of biosimilars*
- Proposed changes to federal recovery and EI benefits*
- Removal of plan administrator access to update plan member banking*
- BioScript recognized as one of Canada’s Best Managed Companies*
Graduating dependents losing coverage?
Let plan members know about Coverage2go
As we reach the end of spring, some of your clients’ plan members may have dependents who are graduating from university or college and will no longer be eligible for coverage under the benefits plan.
Fortunately, we offer Coverage2go®. It allows individuals who are losing their group coverage to purchase personal month-to-month health and dental coverage that is affordable, reliable and works like their previous group benefits plan. They can choose the level of coverage and protection that suits their personal situation.
There are no medical questions – they simply need to apply within 60 days of losing their health coverage under their group benefits plan.*
Help your plan members and their dependents who are losing coverage by letting them know about Coverage2go. They can visit our website to learn more about Coverage2go and to get a quote.
*Quebec residents are not eligible for Coverage2goNew Brunswick expands the use of biosimilars
The New Brunswick government recently announced that it will be implementing a biosimilar transition program.
Patients using originator biologic drugs for diseases such as inflammatory arthritis, inflammatory bowel disease, diabetes and psoriasis, will have until November 30, 2021 to switch to the biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. This process will be completed in consultation with the patients’ physicians.
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.
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.Proposed changes to federal recovery and EI benefits
In its recent 2021 budget, the federal government proposed a variety of changes to its benefit programs.
The proposed changes include providing up to 12 additional weeks of the Canada Recovery Benefit to a maximum of 50 weeks. The first 12 weeks of this benefit would be paid at $500 per week and the remaining eight weeks at $300 per week.
Multiple changes have also been proposed to make Employment Insurance (EI) more accessible to Canadians. The changes include: maintaining uniform access to EI benefits across all regions, supporting multiple job holders and those who switch jobs by ensuring that all insurable hours and employment count towards their eligibility, and simplifying many rules around EI to ensure Canadians can receive benefits sooner. It has also been proposed that the regular EI benefits be extended to no later than November 20, 2021, if needed.
We are analyzing the impact these changes may have to disability benefits. We will provide more details later in the year.Removal of plan administrator access to update plan member banking
In early June, plan administrators will no longer be able to update banking information for their plan members on EquitableHealth.ca after their initial enrolment. This change has been made to allow plan members to have full control over where they want their claim payments deposited.
Plan members can update their banking information online through their plan member web portal or through the EZClaim mobile app. They will continue to be notified via email if and when they make any changes.BioScript Solutions recognized as one of Canada’s Best Managed Companies
Congratulations to our partner, BioScript Solutions, for being recognized as one of Canada’s Best Managed Companies of 2021 by Deloitte.
We have partnered with BioScript since 2016 for our Specialty Drug Preferred Pharmacy Network (PPN). This partnership offers cost savings while providing comprehensive, best-in-class patient care.
BioScript is one of Canada’s leading specialty pharmacies and recently celebrated its 20th anniversary.
- [pdf] Your guide to Coverage2go