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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*
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.
- 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:
- Online Plan Member Enrolment Flyer for Plan Administrators
- Online Plan Member Enrolment Quick Reference Guide for Plan Administrators
- Quick Reference Guide for Plan Members
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.
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:- CLHIA’s free 15-minute Protect Your Benefits online course for plan administrators and their members
- CLHIA’s Fraud is Fraud program, including their FAQs on benefits fraud
- Our online guide to benefits abuse
- Tips for plan administrators and plan members to protect their plan
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.
- COVID-19 Group Benefits FAQ
- Investment loans
- Investment loans
- [pdf] Advisors Edge Insurance for Children Article
- [pdf] Activate your group benefits account
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Introducing Path to Invest for learning and earning CE credits
Equitable Life is pleased to introduce Path to Invest, our self-serve Continuing Education accredited presentation platform for advisors.
Whether you want to learn more about the financial services industry or how responsible investment solutions can fit into a client’s overall financial well-being, Path to Invest has what you are looking for.
It’s a one stop shop with 15 accredited presentations on a variety of topics. All with a video tutorial, short quiz and resource links for more information.
A few important notes before you get started.
PLEASE USE CHROME to get the best online experience as elements of the platform may not display correctly in other browsers.
To get started on your Path to Invest:- • Click Equitable Life Education site
- • Use the email address that you received this email to login.
- • Your password is Equitable
- • This link is specifically for your use only. Please do not share this link.
- Select a module.
- Watch the entire video presentation.
- Complete the quiz and receive a passing grade.
Check out Path to Invest and start learning and earning CE credits today.
Questions? Contact your Regional Investment Sales Manager to get started on your Path to Invest today!
™ or ® denote registered trademarks of The Equitable Life Insurance Company of Canada.
Posted June 14, 2023 -
Equitable Life Group Benefits Bulletin – September 2021
In this issue:
- Right drug, right dose*
- Responding to New Brunswick’s Biosimilar Initiative*
- Helping plan members access our convenient digital options*
- Reminder: Please access forms on EquitableHealth.ca*
- Over-age dependents losing coverage?*
Right drug, right dose
Equitable Life partners with Personalized Prescribing Inc. to help plan members avoid treatment trial and error
Patients suffering from mental health conditions often need to try several medications before they find one that works for them. This is frustrating and can result in negative side-effects, a longer recovery, lost productivity, or a delayed return to work.
To help plan members avoid this treatment trial and error, we have partnered with Personalized Prescribing Inc. to provide easier access to pharmacogenomic testing for plan members with mental health conditions.
Pharmacogenomics 101
Pharmacogenomics is the study of how an individual’s genes influence their response to medications. Pharmacogenomic testing can help determine how compatible a patient’s body may be to a particular drug, and helps their physician prescribe the most appropriate medication. The goal is to ensure the right drug is prescribed to deliver the most positive outcome with the fewest side effects.
Easier access to pharmacogenomic testing
Through our partnership with Personalized Prescribing Inc., any Equitable Life plan member diagnosed with a mental health condition can purchase a pharmacogenomic test for a discounted price of $399 plus HST – a 20% savings.
We are also introducing the option for plan sponsors to add coverage of pharmacogenomic tests provided by Personalized Prescribing Inc. for mental health conditions.
With this coverage, plan members are eligible for pharmacogenomic testing if:- They have been diagnosed with a mental health condition;
- They are currently taking or have stopped taking a medication for a mental health condition that does not work or has side effects; and
- The pharmacogenomic test is conducted by Personalized Prescribing Inc.
Getting a test is easy. The plan member starts by visiting www.personalizedprescribing.com/equitablelife to request a test kit.
Once they receive their test kit from Personalized Prescribing Inc., they simply provide a saliva sample and send it back (postage is pre-paid). Within 7-10 business days, they receive an Rx Report™ that they can share with their doctor. This report includes details to help their doctor prescribe the right drug and the right dose for them.
Benefits for plan members:- The plan member and their physician receive a full report that is easy to understand;
- The report identifies the most compatible medications for the plan member’s condition and the medications to avoid;
- The physician is able to prescribe the most appropriate medication with the fewest side effects; and
- The plan member avoids medication trial and error.
- Pharmacogenomic testing can be an effective prevention strategy to help employees stay healthy and potentially avoid a mental health-related work absence; and
- Employees suffering from mental health conditions may be more productive when they are on the right medication for them.
Responding to New Brunswick’s Biosimilar Initiative
We are changing coverage for some biologic drugs in New Brunswick in response to the province’s Biosimilar Initiative. These changes will help protect your clients from additional drug costs while still providing access to equally safe and effective biosimilars.
What is New Brunswick’s Biosimilar Initiative?
New Brunswick’s Biosimilar Initiative will end provincial coverage of several originator biologic drugs for some or all conditions beginning on December 1, 2021. Patients who are using these drugs for the affected conditions will be required to switch to biosimilar versions of the drugs to maintain coverage under the province’s government drug plan.
What is the impact on private drug plans?
The most significant risk to plan sponsors who maintain coverage of originator biologics is coordination of benefits (CoB) risk. If other insurance carriers follow suit with the province and delist the originator biologics, it could expose a plan that doesn’t delist them to significant coordination of benefits risk.
For example, consider a patient who is covered under two private plans – their employer plan and a spousal plan. If their employer plan was the first payer for the originator biologic but delists the drug, the spousal plan now becomes the first payor. If the spousal plan continues to cover the cost of the originator, it now pays most or all of the cost of the drug.
How is Equitable Life responding?
To protect your clients’ plans from paying additional and avoidable drug costs, we are changing coverage in New Brunswick for most biologic drugs included in the provincial initiative.
Beginning Feb. 1, 2022, plan members in New Brunswick will no longer be eligible for coverage of Humira, Lantus, Humalog and Copaxone 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 those drugs to maintain coverage under their Equitable Life plan.
How will Equitable Life communicate this change to plan members?
We will be communicating with affected claimants in early-December 2021 to allow them ample time to change their prescriptions and avoid any interruptions in their treatment or their coverage.
Can my client maintain coverage of these biologic drugs?
All groups, except myFlex clients, who wish to opt out of this change and maintain coverage of these originator biologics for New Brunswick plan members 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. Their drug plans will continue to cover any additional originator biologics that we subsequently add to the program.
Will this change impact my clients’ rates?
The rate impact of this change and any cost savings associated with the change will be factored in at renewal.
If plan sponsors opt out of these changes and maintain coverage for the originator biologics, it may result in a rate increase. Any rate adjustment will be applied at renewal.
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 also known as the “originator” biologic. Biosimilars are also biologics. They 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.
Questions?
If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.
Helping plan members access our convenient digital options
Some of your clients’ plan members aren’t benefitting from our secure and convenient digital options to access and use their Group Benefits. They can sign up to submit claims electronically for faster claim payments, get claim payments deposited directly to their bank accounts, easily review their coverage details, quickly access their Group Benefits plan booklet, benefits card and more. We’ve made it easier than ever to sign up, with more resources all conveniently located at Equitable.ca/go/digital.
Your clients’ plan members can visit this link to view:- A brochure with all the high-level instructions they need to get started on EquitableHealth.ca and the EZClaim mobile app
- A full video guide on how to access and navigate EquitableHealth.ca
Reminder: Please access forms on EquitableHealth.ca*
We routinely update our Plan Administrator forms on EquitableHealth.ca based on their feedback and to stay compliant with legal and/or regulatory requirements. If your clients need a form, they should always pull the most recent version from EquitableHealth.ca instead of reusing forms they have saved on their computer. Using an old or outdated form may result in processing delays.
Your clients can access the Plan Administrator forms by following these steps:- Login to EquitableHealth.ca
- Select “Documents”
- Toggle between English and French forms
- Click on the document name to download a PDF copy
Over-age dependents losing coverage?*
Some of your clients’ plan members may have dependents who are reaching the maximum age for eligibility under their group benefits plan.
If they are attending school full-time or are disabled, they may be eligible for continued coverage. Plan members with over-age dependents can simply complete the Application for Coverage of Dependent Child Over Age 21 (Form #441) and submit it through our online document submission tool. They can access the tool by logging into their Group Benefits account at www.equitablehealth.ca and clicking My Resources.
If they are not attending school full-time or disabled, they will no longer be covered under the plan. However, they may be eligible for 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 clients’ 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 Coverage2go -
Easy and convenient digital options for your clients and their members
During this time of physical distancing, people are looking for ways to interact with their providers virtually. We have several convenient digital options available to make it easier for Plan Members and for Plan Administrators. Below is an overview to refer to when you're meeting with your clients. Or you can download this PDF version
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, Plan Administrators 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.
Online Plan Member Enrolment
Our Online Plan Member Enrolment tool simplifies the onboarding process for both Plan Administrators and Plan Members and offers a more secure and efficient alternative to traditional paper enrolment. The user-friendly interface allows Plan Members to easily enrol in their benefits plan in just minutes from their computer or mobile device. That saves work for Plan Administrators by eliminating the need to manage paper forms. And since Plan Members receive automatic reminders, it reduces late applicants and eliminates the need to chase down Plan Members for their paperwork. (This option is currently only available for new clients. It will soon be available for existing clients to add new hires.)
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 their health and wellness resources.
Easy automated payments
Automated payments are a convenient way to avoid missed payments, suspended claims and disruption. Plan Administrators simply need to complete thepre-authorized debit formand send to GroupCollection@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 where they can submit claims, view their claims status and history, and review their coverage details from their computer or mobile device. They can also visit Equitable HealthConnector®, our suite of services to help employees stay healthy and productive. They can simply visit www.equitablehealth.ca to activate their Group Benefits account.
Electronic Claim Payments and Notifications
Once Plan Members have activated their Group Benefits account on EquitableHealth.ca, they can easily get set up to receive their claim payments via direct deposit, and their claim notifications via email. Once logged in they simply click “My Information” and enter the required information.
EZClaim Mobile App
Submitting claims is fast, easy and secure with the Equitable EZClaim® mobile app. Plan Members can submit health and dental claims and receive payments directly to their bank account via direct deposit. Most claims are processed within three business days; some are processed in as little as 24 hours. They simply download the EZClaim app for their iPhone®, or Android™ device, fill out the interactive health or dental claim form, attach their receipt and submit.
Digital Benefits Cards
Instead of digging through their wallets, Plan Members can download a digital version of their benefits card on their mobile device via the Equitable EZClaim® Mobile app to easily provide coverage details to health providers.
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.
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May 2026 eNews
In this issue:
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Save the date: Group benefits advisor roadshow is returning to a city near you
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One-time passcodes will be added to our login experience this week*
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Delisted service providers: What clients need to know*
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Keeping plan member information up to date*
*Indicates content we will share with your clients.
Save the date: Group benefits advisor roadshow is returning to a city near you
Mark your calendars—our annual group benefits advisor roadshow will be travelling across Canada this fall.
Watch your inbox for an invitation with more details soon. In the meantime, here’s our full list of event dates and cities.
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Monday, Sept. 28 – Vancouver, BC
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Tuesday, Sept. 29 – Edmonton, AB
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Wednesday, Sept. 30 – Calgary, AB
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Thursday, Oct. 1 – Saskatoon, SK
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Friday, Oct. 2 – Winnipeg, MB
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Tuesday, Oct. 6 – Halifax, NS
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Wednesday, Oct. 7 – Ottawa, ON
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Thursday, Oct. 8 – Markham, ON
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Tuesday, Oct. 20 – London, ON
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Wednesday, Oct. 21 – Kitchener, ON
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Thursday, Oct. 22 – Oakville, ON
One-time passcodes will be added to our login experience this week
Starting next week, anyone who logs in to EquitableHealth.ca® or the Equitable EZClaim® mobile app with an email address and password may also need to enter a one-time passcode to access their account. The one-time passcode will be provided by email.
Adding this form of multi-factor authentication (MFA) to our login process will further enhance our digital security and help safeguard your account and our clients’ personal data.
Don’t forget—you can create a passkey instead.
Passkeys are another form of MFA. They provide a quick, easy and secure way to access your account, using either biometrics—your face or fingerprint—or a PIN authenticator to confirm your identity.
Anyone who uses a passkey to log in to their account will never be required to enter a one-time passcode.
In case you get questions…
If a client asks you about these changes to our login process, consider sharing this fact sheet with them. The fact sheet highlights the value of adding MFA to the login process and describes the differences between logging in with a one-time passcode versus a passkey.
More information about one-time passcodes and passkeys is included at equitable.ca/effortless. There, you’ll also find short videos that show how easy it is to create a passkey on your mobile device and computer.
Please reach out to your Group Account Executive if you have any questions.
If you use the same email address to log in to your accounts on EquitableHealth.ca, EquiNet® and Equitable Client Access®, you can use the same passkey. Equitable Client Access is our secure site for Individual Insurance and Individual Wealth clients.
Delisted service providers: What clients need to know
Protecting clients’ group benefits plans is our priority. That’s why we regularly assess healthcare service providers, clinics, facilities and medical suppliers in our network. These reviews help ensure the claims plan members submit meet eligibility requirements.
If our review indicates a provider is not meeting those requirements, we may delist them.
Common reasons we delist providers include:
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Billing for services that weren’t provided or aren’t medically required
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Changing information about treatments provided (e.g., service dates or patient names)
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Incomplete records or treatment notes
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Lack of cooperation with an audit
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Suspension of the provider by their licensing college or association
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Criminal convictions
What clients need to know
If a provider is delisted, we will not accept or process claims for services or supplies they provide. However, plan members can still choose to use delisted providers at their own expense.
We provide clients instructions on where to find our current list of delisted providers in each Plan Administrator eNews announcement. We also encourage them to share the list with their plan members.
Whenever we delist a provider, we try to contact plan members, who have recently submitted claims for their services, to inform them of the change and help prevent future claim submissions. However, plan members are responsible for checking our list of delisted providers before purchasing any product or service to avoid having to pay at their expense. The list is available on EquitableHealth.ca.
If you have questions about our list of delisted service providers or our process of reviewing providers, please contact your Group Account Executive.
Keeping plan member information up to date
Keeping plan member information current helps ensure accurate benefits coverage and premium calculations.
When a plan member’s earnings or occupation changes, the plan administrator must update this information as soon as possible. Updates made before a benefits plan renewal helps ensure renewals are based on current data.
If a plan includes short-term disability (STD) or long-term disability (LTD) benefits, outdated earning information can affect disability claim payments for plan members.
We send an annual reminder to plan administrators before renewal. The email includes step-by-step instructions on how to review and update plan members’ earnings and occupation information.
Three ways to update earnings and occupation information
Plan administrators can review and update plan members’ information by either:
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Making updates directly through the plan administrator site (update access required),
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Generating an earnings and occupations worksheet through the plan administrator site (online reporting access required), or
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Requesting a worksheet by emailing groupbenefitsadmin@equitable.ca.
The worksheet includes instructions on how to submit completed updates to us. If you have any questions, please contact your Client Relationship Specialist or email groupbenefitsadmin@equitable.ca.
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