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1. Path to Success Module 2
2. Featured
3. Responding to Alberta's Biosimilar Initiative

   Beginning March 15, 2021, we are changing coverage for some biologic drugs in Alberta in response to the province’s Biosimilar Initiative. These changes will help protect your clients from additional drug costs that may result from this new government policy while still providing access to equally safe and effective biosimilars.

   What is Alberta’s Biosimilar Initiative?

   Alberta’s Biosimilar Initiative will end provincial coverage of several originator biologic drugs for some or all conditions beginning on Jan. 15, 2021. Patients 18 and over 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?

   Industry response to Alberta’s Biosimilar Initiative has the potential to significantly impact your clients’ drug plan costs. 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. (See Case Study below.)

   How is Equitable Life responding?

   To protect your clients’ plans from paying additional and avoidable drug costs, we are changing coverage in Alberta for most biologic drugs included in the provincial initiative.

   As of March 15, 2021, several originator biologic drugs will no longer be covered for plan members of all ages in Alberta. Plan members taking these biologics will be required to switch to the biosimilar versions of these drugs to maintain eligibility under their Equitable Life plan.

   What drugs and conditions are affected?

   The following table outlines the drugs and conditions that will be affected by this change. The list of affected drugs or conditions is dynamic and will change as Alberta includes more biologic drugs in its Biosimilar Initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.

   Drug name	Originator biologic   These drugs will no longer be covered in Alberta for the conditions listed in this table.	Biosimilar   Plan members will need to switch to these medications to maintain coverage under their Equitable Life plan.	Affected health conditions   The changes in coverage apply to these conditions.
   Etanercept	Enbrel	Brenzys Erelzi	Ankylosing Spondylitis Rheumatoid Arthritis Polyarticular juvenile idiopathic arthritis (JIA) Psoriatic Arthritis Plaque Psoriasis (adults and children)
   Infliximab	Remicade	Inflectra Renflexis Avsola	Ankylosing Spondylitis Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Crohn's Disease (adults and children) Ulcerative Colitis (adults and children)
   Insulin glargine	Lantus	Basaglar	Diabetes (Type 1 and 2)
   Filgrastim	Neupogen	Grastofil Nivestym	Neutropenia
   Pegfilgrastim	Neulasta	Lapelga Fulphila Ziextenzo	Neutropenia
   Glatiramer*	Copaxone	Glatect TEVA-Glatiramer Acetate	Multiple Sclerosis

   *Glatiramer is a non-biologic complex drug.

   How will Equitable Life communicate this change to plan members?

   We will be communicating with affected claimants in January 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?

   Traditional groups who wish to opt out of this change and maintain coverage of these originator biologics for Alberta plan members can submit a policy amendment. Amendments must be submitted no later than January 15, 2021. Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Alberta plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.

   Will this change impact my clients’ rates?

   The rate impact of this change in coverage will be relatively insignificant. 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.

   CASE STUDY: The Alberta Biosimilar Initiative and Coordination of Benefits (CoB) risk

   CoB risk is real and can be significant, even if a pharmaceutical savings program exists.

   The industry response to Alberta’s Biosimilar Initiative has the potential to significantly impact your clients’ drug plan costs. Some insurers may follow the province’s lead and delist these originator biologics. Others may cut back coverage to the cost of the biosimilars or maintain coverage of the originators. These differences could expose a plan that doesn’t delist the originator biologics to significant coordination of benefits risk. Here’s how:

   Let’s assume there are two private drug plans – Plan A and Plan B. Both plans are open plans with no deductible. Plan A has 80% co-insurance and Plan B has 100% co-insurance.

   BEFORE Alberta’s Biosimilar Initiative

   Before Alberta’s Biosimilar Initiative, both plans cover the originator biologics listed above.

   Plan A is the first private payer for an Alberta plan member taking an originator biologic drug for Rheumatoid Arthritis. Plan B is the second private payer. The cost of the originator biologic for the plan member is $30,000 annually. Here’s how the coordination of benefits would look before Alberta’s Biosimilar Initiative.

   

   
   AFTER Alberta’s Biosimilar Initiative

   In response to Alberta’s Biosimilar Initiative, the insurer for Plan A delists the originator biologic and requires plan members to switch to the biosimilar. The insurer for Plan B maintains coverage of the originator biologic. Under this scenario, if the plan member doesn’t switch, Plan B essentially becomes the first payer and sees their annual cost increase by 400% (from $6,000 to $30,000).

   

   
   Even if the insurer for Plan B cuts back coverage to the cost of the biosimilar or adjusts the paid amount because they have a savings program in place with the drug manufacturer, the impact could be significant. For example, if the insurer cuts back coverage to 50% (or $15,000 annually), Plan B would see a 150% annual cost increase (from $6,000 to $15,000):

   

4. [pdf] Service is our business
5. 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*
   *Indicates content that will be shared with your clients who receive these benefits.
    

   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. 
   Our user-friendly interface allows plan members to:
   • 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. 
   All of our other Equitable group benefits clients can get a 10% discount on HRdownloads services. Visit the link below or contact your Account Executive for more information.
   
   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 
   Encourage your clients to educate their plan members about the potential consequences of benefits fraud, including losing their benefits, losing their job and even jail time. 

   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. 
   To learn more about benefits fraud and Equitable’s commitment to protecting our benefits plans, please contact your Group Account Executive or myFlex Account Executive.
6. Equitable explains individual life and critical illness insurance with client-focused videos! In today’s busy world, clients need guidance to help them pick the right solutions for their needs. They need quick, easy-to-understand information. With so many options out there, it can get overwhelming to make the right choice.
   
   The same goes for individual life and critical illness insurance. Which type of insurance is right for the client? Advisors can help provide that support and guidance. But perhaps, to get that conversation started, you just need to give clients a little nudge.
   
   We get it. That’s why Equitable has produced a series of client-focused videos to help advisors start those conversations.
   
   Check out our explainer videos below and share them with clients today!
   
   ●  Equimax^® participating whole life for children
   ●  Dividends
   ●  EquiLiving^® critical illness insurance
   ●  Term life insurance
   ●  Equitable Generations^™ universal life insurance
   
   
   
   Want to learn more?
   Contact your Equitable Wholesaler – we’re here to help!
   
    
   ^® or ^™ denote trademarks of The Equitable Life Insurance Company of Canada.
    
7. Simpler juvenile policy approvals

   A win for you and clients 

   
   Get insurance protection in place more quickly for kid’s policies with an enhanced juvenile underwriting model. It’s an industry-leading predictive model that extends existing auto-assess capabilities for your juvenile applications.  
    
   What does this mean for you?   
   You will notice reduced wait times as clients get the protection they need faster. And you will receive your commission quicker as well. This gives both you and your Equitable^® underwriter time to focus on supporting your complex cases to bring you our best offer. The new auto-approval model for juvenile policies is a win for all. 
    
   Give us a try!  
   See for yourself how we can help you get protection in place for clients quickly. 
   
   Contact your Equitable wholesaler for more information.
   
   ^® or ^TM denote trademarks of The Equitable Life Insurance Company of Canada.
8. Get the Straight Talk on Equitable’s par account performance

   Real answers to big questions

   At Equitable, we understand how important it is to make confident decisions when dealing with large cases. When you have questions, you need concise, direct insights from leaders and subject matter experts.

   Introducing the Straight Talk video series

   Today, we are thrilled to share the first episode of Straight Talk. This episode features Mark Arruda, VP of Individual Insurance Pricing and Finance.
   
   Mark talks about how Equitable’s par account is built to perform in all kinds of conditions, with strong governance, disciplined risk management, and prudent capital practices that ensure stability even when large life insurance claims are paid out.
   
   Watch Straight Talk for straight answers to the questions that matter most.
   
   Contact your Equitable Wholesaler to learn more about Equimax.
   
    

    

9. Access more fund performance information faster and easier

   
   
   Welcome to a new and improved Fund Overview & Performance  website for Equitable Life^® segregated funds.
   
   A central location for:

   • fund performance and quartile rankings

   • daily and historical unit prices

   • fund information (available in web and PDF)

   • Fund Facts documents

   • MERs

   
   
   Highlights:

   • Save your favourite funds for easy access.

   • New fund search and filter tools by product, guarantee, asset class and sustainability.

   • Share features allow you to easily share fund information with clients.

   • Ability to compare fund performance of Equitable Life segregated funds.

   • Simulated backcasted returns for funds with less than five years of performance history.

    
   Check out the new Fund Overview & Performance webpage today to see how Equitable Life is making fund information faster and easier to access. Speak to your Regional Investment Sales Manager to learn more!
    
    

    _{® denote a trademark of The Equitable Life Insurance Company of Canada.}

   Posted February 27, 2023

10. Easier group enrolment and more group benefits updates

    Make enrolment easier for your clients with online plan member enrolment (OPME)

    Enrolling new plan members can be overwhelming – for both you, your clients and their employees. It’s time-consuming to manually load new members and challenging to ensure they complete the necessary paperwork before the enrolment deadline.
    
    Our Online Plan Member Enrolment (OPME) tool is available at no extra cost for all your Equitable Life clients and offers a more secure and efficient alternative to traditional paper enrolment. Using their computer or mobile device, employees can enrol in their benefits plan in just minutes.
     
    The user-friendly tool allows plan members to easily enter all their enrolment information, including:
    • Dependent details
    • Banking information for direct deposit of claim payments
    • Details for coordination of benefits
    • Beneficiary designation 
    The online enrolment tool can be used by both new groups and existing clients enrolling new plan members. The tool reduces errors and rework that can occur due to spelling mistakes or missing information on paper forms. 
    
    The days of chasing plan members for their paper enrolment forms are gone. Once plan administrators enter a few employee details, our system automatically sends an email to each plan member, inviting them to enrol in their benefits program. And there will be no need for your clients to send reminders or follow up with employees about their benefits enrolment. It’s all done automatically. 

    Support with using OPME

    To learn more about the benefits of using OPME, check out our Online Plan Member Enrolment Flyer. We also encourage you to share more information with your clients:
    • Online Plan Member Enrolment Overview
    • Quick Reference Guide
    We also have helpful reference guides for plan members, to help them use the tool: 
    • Online Plan Member Enrolment Quick Reference Guide
    • myFlex Online Plan Member Enrolment Quick Reference Guide
    To learn more about accessing OPME, your clients can contact their Equitable Life Client Relationship Specialist or myFlex Benefits Team for support.
    
    Help your clients spend less time administering group benefits. Contact your Group Account Executive or myFlex Sales Manager to learn more about our online plan member enrolment.
     

    Coming soon: A survey to help us serve your clients better*

    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.
     
    This month, we will conduct a survey of your clients to help us understand how we can better serve them. Plan administrators will receive an email with a link to the survey, which 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 will also allow them to provide their name so that we can follow up with them 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 3 prepaid gift cards for $200.
     

    Improved mental assessment features for FeelingBetterNow®*

    Mensante has enhanced its FeelingBetterNow® online platform to make it easier for plan members to assess the state of their mental health and talk to their health care provider about treatment options. FeelingBetterNow is part of our Equitable HealthConnector suite of wellness solutions and is available for an additional cost. It can help plan members easily identify if they are at risk for a number of common mental health issues, including depression, anxiety and substance abuse.  

    Upgrades to the platform include:

    • New features to help plan members better gauge their progress in the assessment.
    • A printable Action Plan that plan members can share with their health care provider to initiate conversations about managing their mental health challenges.
    • A new “follow-up” module to help plan members assess the care they’ve received from their health care provider and identify care gaps.
    • An Assessment Outcome Page, which allows plan members to view their diagnostic risks across mental health disorders for a more holistic picture of their health.
    To learn more about how FeelingBetterNow can help your clients’ plan members take charge of their mental health, view our overview or contact your Group Account Executive or myFlex Sales Manager. 
     

    Over-age dependants losing coverage?*

    Your clients’ plan members may have dependants approaching the maximum age for eligibility under their group benefits plan. If so, members should be aware of their options for dependant coverage. 

    Coverage for full-time students and dependants with disabilities

    The dependants of your clients’ plan members may be eligible to continue their coverage under the current plan if: 
    • The dependant is attending a post-secondary school full-time; or
    • The dependant is disabled. 
    In either case, the plan member can complete the Application for Coverage of Dependent Child Over Age 21 (Form #441) and submit it through our online document submission tool. The tool is available under My Resources in the plan member’s Group Benefits account at EquitableHealth.ca.  

    Coverage2go for over-age dependants

    Dependants who aren’t eligible for continued coverage under the plan can apply for Coverage2go®, a month-to-month health and dental plan for individuals losing their group coverage.**
    
    Coverage2go is affordable, reliable and allows the over-age dependants to choose the level of coverage and protection that suits their personal situation. With no medical questions required as long as they apply within 60 days of losing their coverage, your clients’ plan members can ensure that their over-age dependants have the coverage they need.
    
    Plan members can receive a quote within minutes. Please direct your clients to Coverage2go on Equitable.ca to learn more.  
     
    **Quebec residents are not eligible for Coverage2go.

    Forfeiture reports for HCSAs and TSAs on EquitableHealth.ca*

    As a reminder, your clients can access forfeiture reports for their Health Care Spending Account (HCSA) and Taxable Spending Account (TSA) usage on EquitableHealth.ca.  

    HCSA summary by plan member

    HCSA summary reports provide an overview of each plan member’s account activity and balances. These reports include the total amounts allocated, the amount claimed to date, the net balance, and the amount of funds that will be forfeited based on claims paid to date. Please note that plan members’ claim submissions will remain confidential and will not be viewable by the employer on this summary.
    
    Your clients can provide each plan member with their HCSA summary, if they wish.  

    HCSA account forfeiture by plan member

    HCSA forfeiture reports detail the amount that each member will forfeit if they do not use it. The amount is based on claims that have been paid to date within the benefit year period.  

    HCSA account totals by plan member

    Your clients may wish to access the HCSA account totals reports, which reflect the information in each plan member’s HCSA summary report. For terminated employees, the Funds Available field will display as zero, regardless of the balance in the account when terminated. 
    
    At least three months before the end of the benefits period, your clients should remind their members to use their allocated HCSA and TSA amounts.
    
    If your clients need help accessing these reports, they can reach out to their Regional Office Service team for assistance.
    
    * Indicates content that will be shared with your clients.