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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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Group - COVID-19 Group Benefits Updates
As the coronavirus (COVID-19) continues to spread, it’s important that you have the most up-to-date information about how it impacts you, your clients and their plan members. To help, we have created a COVID-19 Updates page on EquiNet, our secure advisor site. There you will find links to past editions of our eNews, as well as the most up to date FAQ. Please check back often. We will continue to provide timely updates on any developments that impact our clients and their plan members or their benefits coverage.
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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.
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Equitable Life Group Benefits Bulletin – December 2021
In this issue:
- Supporting plan members affected by the flooding in Nova Scotia and Newfoundland*
- Update: Changing certificate numbers on EquitableHealth.ca*
- Help plan members take advantage of convenient digital options*
- Ontario optometrists and government to restart negotiations*
- QDIPC updates terms and conditions for 2022*
Supporting plan members affected by the flooding in Nova Scotia and Newfoundland*
The recent flooding in Nova Scotia and Newfoundland is having a devastating impact on the province’s residents.
Here are some of the ways we can help support your clients’ plan members who are affected by the flooding.
Prescription refills
Until Dec. 31, our pharmacy benefit manager, TELUS Health, will allow early refills for plan members who have been evacuated and/or lost their medication due to the flooding.
Replacement of medical or dental equipment and appliances
If plan members in Nova Scotia or Newfoundland need to replace any eligible medical or dental equipment or appliances (e.g. prescription eyeglasses, dentures, etc.) due to the flooding, they can call us at 1.800.265.4556 before incurring additional expenses to see how we can support them.
Disability or other benfit cheques
If plan members affected by the flooding are receiving disability benefits or other benefit reimbursements by cheque, they can visit www.equitable.ca/go/digital for easy instructions on how to sign up for direct deposit. It’s easy and takes just a few minutes. They can call us at 1.800.265.4556 if they need help. We can also arrange for a different mailing address or replacement cheques if necessary.
Mental Health Support
A natural disaster can also take a serious toll on people’s mental health. All of our plan members have access to the Homeweb online portal and mobile app, including numerous articles, tools and resources designed to provide guidance and support in difficult times. Homewood has put together some suggestions on how to help employees affected by a natural disaster.
For your clients with an Employee and Family Assistance Program, remind them that their plan members have 24/7 access to confidential counselling through a national network of mental health professionals. Whether it’s face-to-face, by phone, email, chat or video, plan members will receive the most appropriate, most timely support for the issue they’re dealing with.
If a client wishes to add the EFAP to their plan, we can do this quickly – often in just a few days. Simply contact your Group Account Executive or myFlex Sales Manager.
Plan Administrator support
We realize that the flooding may also be having an impact on the regular business operations of your clients in Nova Scotia and Newfoundland. If any of your clients are unable to carry out day-to-day plan administration, they can call us at 1.800.265.4556 to see how we can support them.
We know this is a challenging time for many of your clients and their plan members. We will continue to monitor the situation and provide additional updates as appropriate.
Update: Changing certificate numbers on EquitableHealth.ca*
Effective Dec. 10th, plan administrators will no longer be able to update or change plan members’ certificate numbers on EquitableHealth.ca. This change will ensure we can manage these changes more effectively to provide a smoother plan member experience.
If your clients need to update a plan member’s certificate number, please have them reach out to Group Benefits Administration for assistance at groupbenefitsadmin@equitable.ca.
Help plan members take advantage of convenient digital options*
We have several digital options available to make it easier for your clients to do business with us and for their plan members to access and use their benefits plan.
To help build awareness among plan members, we’ve created two posters that your clients can post on their intranet sites or in their office. The posters provide easy instructions on how to activate our secure, digital options.
Please click on the links below to download the posters.
EquitableHealth.ca posters: EZClaim mobile app posters:
EquitableHealth.ca English EZClaim mobile app English poster
EquitableHealth.ca French poster EZClaim mobile app French poster
Ontario optometrists and government to restart negotiations*
The Ontario Association of Optometrists (OAO) announced it has paused its job action and will restart negotiations with the Ontario Ministry of Health on funding for optometry services.
In September, Ontario optometrists began withholding services from patients covered by OHIP, including children, senior citizens and other patients with certain medical conditions, after negotiations with the Ministry of Health over compensation broke down.
Residents of Ontario between the ages of 20 to 64 who aren’t eligible for coverage of eye services under OHIP were not affected by the job action. They were able to continue to receive eye exams from their optometrist and submit eligible claims to their benefits plan.
QDIPC updates terms and conditions for 2022*
Every year, the Quebec Drug Insurance Pooling Corporation (QDIPC) reviews the terms and conditions for the high-cost pooling system in the province. Based on its latest review, QDIPC is revising its pooling levels and fees for 2022 to reflect trends in the volume of claims submitted to the pool, particularly catastrophic claims.
Size of group (# of certificates) Threshold per certificate 2022 Annual factor (without dependents Annual factor (with dependents) Fewer than 25 $8,000 $276.00 $771.00 25 – 49 $16,500 $188.00 $527.00 50 – 124 $32,500 $97.00 $328.00 125 – 249 $55,000 $66.00 $223.00 250 – 499 $80,000 $51.00 $173.00 500 – 999 $105,000 $39.00 $153.00 1,000 – 3,999 $130,000 $34.00 $133.00 4,000 – 5,999 $300,000 $18.00 $71.00 6,000 and over Free market – Groups not subject to Quebec Industry Pooling
We will apply the new pooling levels and fees to future renewal calculations that involve Quebec plan members. -
Announcing our new Travel Assist provider
We are pleased to announce that we are partnering with Trident Global Assistance as our new Travel Assist provider, effective June 1, 2023.
Based in Etobicoke, Ontario, Trident provides travel assistance for thousands of Group Benefits plan members. Trident has an experienced leadership team with decades of combined industry expertise. They have both the operational know-how and global networks to provide your clients and their plan members with 24/7 support for their travel health assistance needs.
No action is required from plan sponsors or plan members. For clients with Travel Assist included in their plan, the transition to Trident will be seamless. The phone numbers for Travel Assist will remain the same and there is no requirement to download a new benefits card.
As we previously announced, Allianz Global Assistance, our current Travel Assist provider, is exiting the Canadian group travel administration market. Allianz will continue to accept and support claims and inquiries received before June 1, 2023. All claims and inquiries received June 1 or later will be supported by Trident.
In the meantime, we are working closely with Allianz and Trident to help ensure a smooth and seamless transition for our clients and their plan members.
If you have any questions about the transition to Trident as our new Travel Assist provider, please contact your Group Account Executive or myFlex Sales Manager. -
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.
- Convertibility - The Power of Term
- [pdf] Online Plan Member Enrolment
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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