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Policy endorsement: Contracts and group benefits plan booklet updates related to BC PharmaCare Biosi
As we announced in the June 2019 issue of eNews, 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.
The following table outlines the affected originator drugs and their biosimilars.
Drug Originator Biosimilar etanercept Enbrel® Brenzys®
Erelzi™infliximab Remicade® Inflectra®
Renflexis®insulin glargine Lantus® Basaglar™
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 are aligning our drug eligibility for these three biologic drugs with that of BC PharmaCare.
To facilitate this change, we are amending some of the wording in our contracts and booklets, effective Oct. 1, 2019. Below are links to the Endorsement to the Master Policy and the Summary of Master Booklet Wording Changes for those amendments. Please download and save these policy endorsement documents for your files.
In addition, please remind your clients to provide their plan members with a copy of the Summary of Master Booklet Wording Changes. The next time your clients amend their benefits plans, the updated wording will be included in their group benefits plan bookletsDOWNLOAD ENDORSEMENT TO THE MASTER POLICY
DOWNLOAD SUMMARY OF MASTER BOOKLET WORDING CHANGES
As of 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 will be communicating with affected claimants in the coming weeks to allow them ample time to change their prescription and avoid any interruptions in their treatment or their coverage.
We intend to take a similar approach to Lantus. However, we are still investigating the options to implement this change. We will be communicating with you in the coming weeks to confirm our approach for this drug.
If you have any questions about this change, please contact your Group Marketing Manager or myFlex Sales Manager.
® and ™ denote trademarks of their respective owners -
Equitable Life Group Benefits Bulletin - Group Advisor Bonus Enhancement
Announcing our Enhanced Group Advisor Bonus Program
We have enhanced our Group Advisor Bonus program to make it more competitive and to help support you in building your business with Equitable Life in 2022. We have updated the structure of the bonus program to make it easier for you to qualify, as well as increased the amounts we pay.
Beginning for sales effective in 2022 we have:- Decreased the minimum premium required to qualify for the Sales Bonus to $35,000 from $150,000.
- Moved away from using Graded Annualized Premium for both the Sales and Persistency Bonus and are using actual Annualized Premium instead, up to a maximum of $500,000 per policy. This simplifies the program and aligns us with the rest of the industry.
- Increased the Sales Bonus payout to up to 5% of Annualized Premium for Traditional Sales and up to 3% of Annualized Premium for myFlex sales.
- Changed the minimum annual premium threshold for the Persistency bonus to $500,000 of capped Annualized Premium from $500,000 of Graded Annualized Premium to make it easier for you to qualify.
These enhancements do not apply to advisors who are not part of our standard Advisor Bonus program and who have special bonus arrangements in place. If you have a special bonus arrangement in place and would like to switch to the standard program, please contact your Group Account Executive or myFlex Sales Manager.
Below is a table comparing the current Sales Bonus structure and payout. For full details, please refer to the Group Advisor Compensation and Recognition brochure.
Enhanced Sales Bonus
For the new Sales Bonus, the Payout Band is based on total combined Traditional and myFlex Benefits new annualized premium (capped at $500,000 per policy). The Sales Bonus Rates for both Traditional sales and myFlex sales are shown in the table below:
New Sales Bonus Rates Payout Band Capped Annualized Premium* Sales Bonus Rate
(from first dollar)Traditional Sales myFlex Sales 1 $34,999 and under 0% 0% 2 $35,000 to $99,999 3.5% 1.5% 3 $100,000 and over 5% 3% *Total Traditional and myFlex new business sales combined, capped at $500,000 per policy.
If you have any questions about the Advisor Bonus enhancements, please contact your Group Account Executive or myFlex Sales Manager.
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Dialogue Virtual Healthcare now available to add to Equitable Life benefits plans
We’re pleased to announce we are partnering with Dialogue, Canada’s leading virtual health provider, to offer unlimited and on-demand virtual access to primary healthcare practitioners.
Virtual Healthcare is the latest addition to our HealthConnector suite of health and wellness services. It is available to add to all Equitable Life benefits plans for an additional cost as of July 1, 2023.Features of Dialogue Virtual Healthcare
Available 24/7, 365 days a year, Dialogue Virtual Healthcare provides access to unlimited non-urgent medical care for a wide range of health concerns. Plan members get fast access to the largest, most experienced and bilingual medical team in Canada for non-urgent medical issues. They also benefit from in-app prescription renewals and refills, personalized follow-ups after every consultation, and concierge-level navigation support for all referrals to in-person specialists when needed.
Dialogue’s industry-leading platform provides an all-in-one patient journey to address health issues, reducing long wait times and time away for doctor appointments. Plan members and their families can access Dialogue Virtual Healthcare through the secure web portal or mobile app. The Dialogue medical team includes doctors, nurse practitioners and nurses. Plan members can use the service even if they’re already receiving care from a family doctor.
For your clients
Benefits of Virtual Healthcare
By providing access to Virtual Healthcare, plan sponsors can help to:-
Drive employee engagement;
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Reduce absenteeism related to in-person medical appointments;
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Manage chronic health issues;
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Attract and retain top talent; and
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Build a healthier workforce.
By providing easier access to primary healthcare practitioners, Virtual Healthcare can offer extra health and wellness support for plan members. It also supports members that may experience barriers to accessing in-person healthcare, such as:-
Living in a remote location;
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Work or family obligations during standard medical clinic hours;
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Mobility challenges related to a disability; and
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Transportation challenges.
Click the link to learn more about Dialogue Virtual Healthcare : Welcome to Dialogue!Questions?
To learn more about how your clients can add Virtual Healthcare to their benefits plan, please contact your Group Account Executive or myFlex Sales Manager. -
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Digital tools for your clients and their plan members
In this issue:
- Digital tools for your clients and their plan members*
- QDIPC updates terms and conditions for 2024*
Digital tools for your clients and their plan members*
Do your clients know how to use all the available digital tools in their Equitable® benefits plans? With useful features for both plan administrators and their members, it’s even easier for your clients to access their plans online.Tools for plan administrators
- Our online plan member enrolment tool lets groups and administrators add new plan members online without completing paper forms
- The EquitableHealth.ca plan administrator portal makes it easy for plan administrators to manage their plan anytime and anywhere. Helpful features include:
- A premium calculator to calculate monthly costs for plan members
- A simple process for updating plan member information
- Digital welcome kits provide personalized information directly to plan members through email
- Easy, automated payment options help plan administrators avoid missed payments by offering pre-authorized debit or electronic funds transfer
Tools for plan members
- Our plan member portal at EquitableHealth.ca provides secure, 24/7 access to claims history and coverage details. It also lets members submit claims, and includes health and wellness resources
- Electronic notifications and claims payments give plan members claim updates via email and deposit payments directly into their bank account
- The Equitable EZClaim® mobile app lets plan members submit claims quickly and securely on-the-go from their mobile device
- Digital benefits cards give plan members the convenience to access their benefits cards easily from a mobile device
Help with digital benefits tools
We’ve created a brochure and video guide to help plan members use digital tools for a smoother, more convenient benefits experience.
Plan members can contact us at 1.800.265.4556 and select the option for Web Support if they need further assistance.
QDIPC updates terms and conditions for 2024*
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 2024 to reflect trends in the volume of claims submitted to the pool, particularly catastrophic claims. These updates take effect January 1, 2024. You can view the updates here.
We will apply the new pooling levels and fees to future renewal calculations that involve Quebec plan members.
If you have any questions, please contact your Group Account Executive or myFlex Account Executive.
- Anti-money Laundering Legislation Requirements Summary
- New Investment Policy
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Equitable Life awarded FundGrade A+ awards for 2021
Equitable Life® is the proud recipient of the Fundata FundGrade A+® in 2021 for Equitable Life Dynamic Power Global Growth Fund and Equitable Life Accumulative Income Fund. These funds are part of our legacy products and no longer available to purchase for new contracts.
Each year, Fundata looks for Canadian investment funds that uphold an outstanding performance rating over the course of the year. Equitable Life invests for the big picture and offers a complete range of investment and annuity products designed to meet the savings, accumulation and income needs of clients. Our strength as a company along with our many investment guarantees can help your clients achieve their financial goals with confidence.
FundGrade A+® is used with permission from Fundata Canada Inc., all rights reserved. The annual FundGrade A+® Awards are presented by Fundata Canada Inc. to recognize the “best of the best” among Canadian investment funds. The FundGrade A+® calculation is supplemental to the monthly FundGrade ratings and is calculated at the end of each calendar year. The FundGrade rating system evaluates funds based on their risk-adjusted performance, measured by Sharpe Ratio, Sortino Ratio, and Information Ratio. The score for each ratio is calculated individually, covering all time periods from 2 to 10 years. The scores are then weighted equally in calculating a monthly FundGrade. The top 10% of funds earn an A Grade; the next 20% of funds earn a B Grade; the next 40% of funds earn a C Grade; the next 20% of funds receive a D Grade; and the lowest 10% of funds receive an E Grade. To be eligible, a fund must have received a FundGrade rating every month in the previous year. The FundGrade A+® uses a GPA-style calculation, where each monthly FundGrade from “A” to “E” receives a score from 4 to 0, respectively. A fund’s average score for the year determines its GPA. Any fund with a GPA of 3.5 or greater is awarded a FundGrade A+® Award. For more information, see www.FundGradeAwards.com. Although Fundata makes every effort to ensure the accuracy and reliability of the data contained herein, the accuracy is not guaranteed by Fundata.® ”Equitable Life” and “Pivotal Select” are trademarks of The Equitable Life Insurance Company of Canada.
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Group Benefits - Premium relief for Dental and Extended Health Care benefits
We know this is a difficult time for Canadian employers and that many of your clients are facing financial hardship as a result of the COVID-19 pandemic. We continue to look for ways to help employers manage while still supporting their employees.
With many health practitioners closing their offices due to the pandemic restrictions, plan member use of dental benefits and some health benefits has declined.
So, we are pleased to announce that we are offering premium relief for all Traditional and myFlex insured non-refund customers for Health and Dental benefits, as follows:
- A 50% reduction on Dental premiums; and
- A 20% reduction on vision and extended healthcare rates (excluding prescription drugs), which equates to an 8% reduction on Health premiums.
These reductions are retroactive to April 1, 2020 and will appear as a credit against the next available billing. We will assess the situation monthly and expect to continue with monthly refunds for as long as the current crisis period continues.
We expect that claims experience and premiums will return to normal once the current pandemic restrictions are lifted.
In the meantime, plan members will continue to have full access to their benefits coverage throughout the pandemic. In many cases, dental offices remain open for emergency services, and a variety of healthcare providers are available virtually.
Commissions
We know the pandemic has put financial strain on your business as well, so we will continue to pay full compensation. Although your overall commission will be unaffected by these premium reduction adjustments, you may see a temporary reduction in your commission payments if you are on a pay-as-earned basis while we put through mass changes. If so, we will then make an additional top-up payment to cover that shortfall as soon as we are able.
Communication
We will be communicating this premium relief program to your clients April 21st at 8:00am EST.
A PDF of the communication is also available here.Questions?
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager. In the meantime, we have provided some Questions and Answers below.
Will the premium reduction on Health and Dental benefits have an impact on the renewals that were deferred?
No. Renewals will proceed as normal, with rate adjustments based only on months where full premium was paid. For most clients, we anticipate “normal” rate adjustments at renewal compared to rates paid prior to refunds taking effect.
Does this adjustment apply equally to clients who have had their renewal deferred?
Yes, these adjustments apply to all Traditional and myFlex insured, non-refund customers for Health and Dental benefits.
How does this affect clients who have terminated or amended a plan?
If a benefit is in-force during the month of April, the adjustment will be credited to the next available billing. For clients who have temporarily terminated all benefits, this will be applied against the first bill once benefits have been reinstated. No cash refunds will be paid.
Will you recover any of the adjustment at a future point in time?
No, we will not recover this adjustment.
Instead of this premium reduction adjustment, can a client cancel or adjust some of the benefits on their plan?
Yes, you and your clients always have the option of changing the coverage on a plan, such as reducing or removing a benefit to help control costs. Please speak to your Group Account Executive or myFlex Sales Manager about the options available.
Are TPAs and self-administered groups eligible for the premium reduction?
Yes. TPAs and self-administered groups are eligible for the premium reduction. However, timing for the credit will be dependent on the billing practices of the TPA or self-administered group. We will apply these credits as soon as we are able. -
Equitable Life Group Benefits COVID-19 Update
The test of a great partner is one who stands tall when you and your clients need to rely on them most. As the COVID-19 pandemic continues, we thought you might find it helpful to have a summary of where we are during this crisis.
You can download this PDF version to refer to when meeting with your clients.
We are here with you and for you
We’ve taken several steps to support you, your clients and their plan members during this crisis, including:
- Providing premium refunds for insured, non-refund Health and Dental benefits;
- Waiving the waiting period for short-term disability claimants who tested positive for COVID-19;
- Extending out-of-country travel coverage for plan members who were unable to return to Canada;
- Providing increased flexibility for premium payments; and
- Keeping you and your clients informed with timely Q&As and announcements, webinars, and insights into the impact of COVID-19 on benefits plans.
As well, to commemorate our 100th Anniversary this year, we donated $4.5 million to purchase and install a new MRI for Grand River Hospital. And we donated $50,000 – $10,000 each – to five charities in British Columbia, Alberta, Manitoba, Ontario and Quebec. For more information about our celebrations, check out our website at www.equitable100.ca.
We have adjusted our business to become digital
Our business is near 100% digital, so the vast majority of our employees are now working remotely from home and are fully functional. Since the pandemic began, our IT and operations teams have digitally enhanced more than 20 different processes and services to make it easier for us to integrate with our distribution partners in this new reality.
We pride ourselves on our customer service
In 2019, our dedication to customer service was recognized with outstanding survey results.
- In a 2019 survey of customers from 15 life insurance companies,1 Equitable Life ranked #1 on the Net Promoter Score, a measure used across industries to gauge the loyalty of a firm's customer relationships; and
- A survey of Group consultants, brokers and third-party administrators 2 ranked Equitable Life in the top two insurers across all categories.
For 2020, we continue to deliver service at the same level with no disruptions during this crisis. Our Customer Care Centre remains open to support plan members and can be reached at 1.800.265.4556. And our Client Relationship Specialists are available for Plan Administrator questions and support.
We are financially strong and stable
We remain financially strong and continue to focus on meeting the needs of Canadians. At the end of the first quarter, our Life Insurance Capital Adequacy Test (LICAT) ratio is at 152.5%, well above our goal and the regulatory requirement.
As the global situation continues to evolve, rest assured that Equitable Life is unwavering in our commitments to you and the communities we serve. We are here with you and for you. Please contact your Group Account Executive or myFlex Sales Manager if you have questions or need assistance.
1 LIMRA CxP Customer Experience Benchmarking Program, Life Insurance In-Force Experience 2019
2 NMG Consulting’s Canadian Group Benefits Survey 2019
- [pdf] Daily/Guaranteed Interest Account Contract