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Equitable Life Group Benefits Bulletin – March 2022
In this issue:
- CLHIA launches industry anti-fraud initiative*
- Provincial biosimilar update*
- Quebec decreasing insurance premium tax*
- Coming soon: A survey to understand how we can better serve your clients’ needs*
- Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare *
CLHIA launches industry anti-fraud initiative*
In February, the Canadian Life and Health Insurance Association (CLHIA) announced a new anti-fraud initiative that is using advanced artificial intelligence (AI) to further identify and reduce benefits fraud.
Equitable Life is excited to be a part of this important initiative. It will enhance our own fraud detection analytics by using AI to connect the dots across a huge pool of anonymized claims data. This will lead to more investigations and actions to mitigate the impact of fraud on your clients’ plans.
The initiative is being led by the CLHIA and member insurers and is supported by technology provider Shift Technologies. It will be further rolled-out and expanded over the next three years.
Benefits fraud affects more than just insurers. The costs of fraud are felt by employers and their employees as well. We are looking forward to being able to better identify and reduce benefits fraud.
Provincial biosimilar update*
BC expands its biosimilar initiative
BC Pharmacare recently announced it is adding two rapid-acting insulins to the list of drugs included in its ongoing initiative to switch patients to biosimilar versions of high-cost biologics. Patients taking Humalog or NovoRapid for Type 1 or Type 2 diabetes will be required to switch to a biosimilar version of the drugs by May 29, 2022 to maintain coverage under the public plan.
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 biologic drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.
How we are responding to protect our clients
To help prevent this change from resulting in additional costs for our clients’ drug plans while still providing plan members with access to safe and effective medications, we will no longer cover Humalog or NovoRapid for plan members in BC. Effective June 1, 2022, claimants currently taking Humalog or NovoRapid will be required to switch to a biosimilar version of the drugs to maintain coverage under their Equitable Life plan and their BC Pharmacare plan.
We will be communicating this change to plan administrators later this week. And we will be communicating with affected claimants in early April to allow 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.
Nova Scotia and Northwest Territories introduce biosimilar initiatives
The governments of Nova Scotia and the Northwest Territories each recently announced they are launching biosimilar initiatives to switch patients from certain originator biologic drugs to biosimilar versions of the drugs.
Patients in Nova Scotia using affected originator biologic drugs will have until February 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. Patients in the Northwest Territories will have until June 20, 2022, to switch.
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.
Quebec decreasing insurance premium tax*
The Quebec Government has announced that it plans to decrease its Insurance Premium Tax rates effective April 1, 2022. The premium tax rates for group life and accident and sickness insurance are expected to decrease from 3.48% to 3.3%. The new tax rates will be applied to premiums for the billing period beginning on or after April 1, 2022.
Coming soon: A survey to understand how we can better serve your clients’ needs*
We are committed to providing your clients and their plan members with industry-leading service. We’ve introduced several enhancements over the past year to make it easier to do business with us. And we’re continually looking for ways to improve.
In the coming weeks, we will conduct a survey of your clients to help us understand how we can better serve them. On March 28, we will send plan administrators an email with a link to the survey. The survey will remain open until the end of the day on April 11 and will take between five and 10 minutes to complete. Please encourage your clients to participate. Their feedback will be confidential, and their responses will help us improve our service and ensure we’re meeting their expectations. We may also follow up with plan administrators directly to address any concerns they’ve identified.
We know your clients’ time is valuable. So, each plan administrator who completes the survey will be entered into a random draw for a chance to win one of 25 prepaid gift cards for $25.
Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare*
If your clients have plan members in British Columbia, Manitoba or Saskatchewan, the provincial government offers a Pharmacare program to support prescription drug costs. Plan members in these provinces must register for their provincial Pharmacare program to maintain coverage under their Equitable Life drug plan.
Registration is easy! We will send two registration reminder messages directly to plan members’ pharmacists and post them on their Explanation of Benefits. We’ve also created a step-by-step guide that your clients can share with their plan members.
English version
French version
For more information about the provincial Pharmacare programs, including how plan members can register, please visit:
For British Columbia residents: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents
For Manitoba residents: https://www.gov.mb.ca/health/pharmacare/apply.html
For Saskatchewan residents: https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/extended-benefits-and%20drug-plan/drug-cost-assistance#eligibility
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Equitable Life Group Benefits Bulletin – November 2021
In this issue:
- Deadline to opt out of New Brunswick biosimilar program*
- Web Reports Quick Reference Guide now available for plan administrators*
- Reminder: Review manual allocations for HCSAs and/or TSAs*
- Help your clients take advantage of our convenient digital options*
Reminder: Deadline to opt out of New Brunswick biosimilar program*
Earlier this year, we announced via eNews that on Feb. 1, 2022, we are ending coverage for some originator biologic drugs in New Brunswick in response to the province’s Biosimilar Initiative.* These changes will help protect your clients’ plans from additional drug costs while still providing access to equally safe and effective biosimilars.
Do my clients need to take any action?
No action is required if employers want to have the originator biologics excluded from their plan. Plan members taking these targeted originator biologics will be contacted directly to allow them ample time to transition to the biosimilar. Any cost savings associated with the change will be factored in at renewal.
All groups, except myFlex clients, who wish to opt out of this change and maintain coverage of these originator biologics for existing claimants in New Brunswick 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. This means that their drug plans will continue to cover any additional originator biologics for which we subsequently end coverage as part of the biosimilar program.
Questions?
If you have a question that isn’t answered here, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.
* The list of affected drugs or conditions is dynamic and may change.Web Reports Quick Reference Guide now available for plan administrators
A Web Reports Quick Reference Guide is now available for plan administrators on EquitableHealth.ca. This new guide offers a listing of our newest reports available on the plan administrator web. It also provides instructions for plan administrators outlining how to pull the report using the plan administrator portal.
The guide is available under the Quick Links section on both the advisor and plan administrator portals on EquitableHealth.ca.Reminder: Review manual allocations for HCSAs and/or TSAs*
If your client’s Health Care Spending Account (HCSA) and/or Taxable Spending Account (TSA) has manual allocations, they need to allocate these amounts to plan members each year. Please review all your plan members’ profiles on EquitableHealth.ca to ensure they have received their allocation(s) for the current benefit year.
If your clients have Plan Administrator update access on EquitableHealth.ca, they can update these amounts online by doing the following:- Select “View certificate”
- Select “Health Care Spending Account” or “Taxable Spending Account”
- Select “Update Allocation” in Task Center
- Enter amount in “Revised Allocation Amount”
- Override Reason – “Plan Administrator Request”
- Select “Save”
- Select “Reports”
- Select “New”
- Select “Next”
- Select “HCSA” or “TSA Totals by Plan Member”
- Select “Next”
- Enter end date of “12/31/2020”
- Select “Next”
- Select “Finish”
- View “Report”
Help your clients take advantage of our 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. Over 71% of plan administrators are managing their plan online and 78% of plan members are already using our digital tools.
For plan administrators:- Online Plan Member Enrolment tool – allows all groups to add new plan members without the need for paper forms
- Plan Administrator Portal (EquitableHealth.ca) – plan administrators can easily manage their plan anytime and anywhere
- Digital Welcome Kits – personalized welcome kits are delivered to plan members via email
- Easy automated payments – plan administrators can avoid missed payments by setting up pre-authorized debit or electronic funds transfer
- Plan Member Portal (EquitableHealth.ca) – plan members get secure, 24/7 access to their claims history, coverage details and health and wellness resources
- Electronic Claim Payments and Notifications – plan members can get claim updates sooner in their email inbox and payments right into their bank account
- EZClaim Mobile App – submitting claims from a mobile device is fast, easy and secure
- Digital Benefits Cards – plan members no longer have to dig through their wallet – they can download their benefits card on their mobile device
We’ve created a brochure and a video guide to help plan members access and use their digital resources. For further assistance, plan members can visit www.equitable.ca/go/digital. They can also contact our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca. - [pdf] Why EquiLiving Critical Illness Insurance
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Revised Witness Signature Process during COVID-19 for Individual Life and Critical Illness Insurance
Revised Witness Signature Process during COVID-19 for Individual Life and Critical Insurance Business
We are temporarily revising our policy around witness signatures during COVID-19. While the preference is to have a witness when one is available, we understand that may be difficult given our current environment.
Please follow the options below for witness signature with the first option being most preferable, and the last option being the least preferable:
1. Signature from a witness who is a disinterested party
2. Signature from a witness who is a party with an interest
3. No witness
If we receive a form that doesn’t have a witness signature, we will still process the form. Just a reminder this is only temporary during COVID-19.
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Online sales illustrations
Providing you flexibility while on the go.
We know how important it is to have tools that provide flexibility and convenience when managing your business. That’s why we created web-based sales illustration tools for easy access. You can create a Term, Critical Illness, Whole Life or Universal Life client illustrations from anywhere, anytime!
Useful Features:
• Save illustrations directly to your dashboard. You can revisit, edit, or complete them whenever you want.
• Our Term and Critical Illness illustrations integrate with EZcomplete®. This means you can move from illustration to application easily, with most fields in the first step filled in automatically.
Our web-based tools put everything at your fingertips, so you can keep your business moving while on the go. This is just one of many ways we’ve made it easier to do business with Equitable®.
Try running an illustration today!
If you have any questions, please reach out to your Equitable Wholesaler. - [pdf] Dollar Cost Averaging
- [pdf] Critical Illness PreQualifying Questionnaire
- [pdf] Equitable GIF Advisor FAQ
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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. - Path to Success Module 5