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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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October 2019 Advisor eNews
Coverage of Remicade, Enbrel and Lantus in BC
As we announced in August, BC PharmaCare recently introduced a new Biosimilars Initiative that ends coverage of three biologic drugs, including Remicade, Enbrel, and Lantus. These drugs will no longer be eligible in British Columbia for most conditions for which lower-cost biosimilar versions are available. Patients in the province with these conditions will be required to switch to biosimilar versions of these drugs by Nov. 25, 2019 in order to maintain their coverage under BC PharmaCare. Patients taking Remicade for Crohn's Disease or Ulcerative Colitis will not be required to switch to a biosimilar until March 6, 2020.
Biologics are drugs that are engineered using living organisms, such as yeast and bacteria. Biosimilars are highly similar to the originator drugs they are based on and most have been shown to have no clinically meaningful differences in safety or efficacy.
To ensure this provincial change doesn’t result in your clients’ plans paying additional drug costs, we have aligned our drug eligibility for these three biologic drugs with that of BC PharmaCare.
As previously announced, effective Nov. 25, 2019, Remicade and Enbrel will no longer be eligible for BC plan members with conditions for which lower-cost biosimilar versions of the drugs are available. These plan members will be required to switch to the biosimilar versions of these drugs in order to maintain eligibility on the Equitable Life drug plan. We have communicated with Plan Administrators about this change, and we have informed affected claimants of the need to switch medications.
As well, effective Feb. 3, 2020, the drug ingredient cost for Lantus will no longer be eligible for BC plan members; only the dispensing fee may be eligible under their Equitable Life plan. Plan members taking Lantus will be required to switch to Basaglar, the lower-cost biosimilar version of the drug, in order to maintain coverage under their Equitable Life plan. We will be communicating with Lantus claimants in the coming weeks to allow them ample time to change their prescription and avoid any interruptions in their treatment or their coverage.
If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.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.
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EXCITING NEWS! Digital Transactions for Universal Life Plans Now Available
We are happy to announce a major update to our digital systems that makes managing Equitable Universal Life (UL) policies easier than ever. Starting now, you can use digital transactions to submit your clients’ instructions to change their UL deposit allocations and transfer funds between accounts.
This update builds on the recent launch of our digital policy loan request on EquiNet® and is another step towards making your Equitable® experience easier and more convenient.
What's New?
In the past, you had to submit written requests for UL deposit allocation changes and account value transfers using the Universal Life Form 693UL (you can still use this method if you prefer).
Now, you can manage these transactions directly through the secure EquiNet advisor portal. This new process also allows clients to securely approve their requested changes by email.
To get started, simply log into your account on EquiNet and go to the Policy Inquiry tab.
We have provided a brief user guide to help you through the steps.
We trust that this digital upgrade will enhance the way you work with Equitable. Stay tuned for more digital enhancements in the near future!
Thank you for your continued support and partnership.
Questions? For more information, please reach out to your wholesaler or our customer service team.
® or TM denotes a trademark of The Equitable Life Insurance Company of Canada.
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Make Equitable your first choice for insurance – has just been enhanced!
Our popular marketing piece – Make Equitable® your first choice for insurance (1510) – just got an update with the latest life insurance offerings and our new branding.
It is a great conversation starter that can help…
● Encourage clients to discover the benefits of our insurance solutions.
● Start the life insurance needs conversation.
● Help clients understand the Equitable ‘difference’ – that our full focus is on the interests and well-being of our policyholders.
Learn more by visiting our marketing materials page.
Questions?
Please contact your local wholesaler.
® or ™ denotes a trademark of The Equitable Life Insurance Company of Canada.
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