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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. -
Meghan Vallis named head of distribution for myFlex Benefits and other group benefits updates
Meghan Vallis named head of distribution for myFlex Benefits
We are pleased to announce that Meghan Vallis, our Group Sales Vice President for Western Canada, will head national distribution for myFlex Benefits in addition to her existing responsibilities.
As part of her expanded role, Meghan will lead the myFlex Benefits sales team and develop and implement strategies to achieve the growth of this offering. Meghan and the myFlex team will continue to focus on delivering market leading services for our clients and advisors.
Meghan joined Equitable Life in 2020 and brings more than 15 years of experience in the group benefits industry to her expanded role. She is passionate about helping Advisors succeed to transform their clients' employee benefit experience.
myFlex Benefits is one of the most unique and versatile benefits solutions for small businesses in Canada. It is fully pooled, includes a two-year renewal and features a user-friendly portal for plan members to make their benefit selections. And it’s simple to use: Plan sponsors set a budget and choose from a selection of benefit options. Plan members then use flex dollars to select from the options offered by their employer. Any leftover flex dollars are saved in a health care spending account (HCSA).
If you have any questions or are interested in learning more about myFlex Benefits, please contact your Group Account Executive or myFlex Sales Manager.Changes to Short Term Disability (STD) benefit calculations for 2023*
The Canada Employment Insurance Commission and Canada Revenue Agency have announced the 2023 changes to Maximum Insurable Earnings and premiums for employment insurance.
The following changes to Employment Insurance (EI) will come into effect on Jan. 1, 2023:
How does this affect your clients?
Your clients’ STD benefit will be revised with the updated maximums based on the percentage of EI Maximum Weekly Insurable Earnings shown in their policy if:- Their Equitable Life Group Policy includes an STD benefit that is tied to the EI Maximum Weekly Insurable Earnings, and
- At least one classification of employees has a maximum of less than $650.
If their STD maximum is currently higher than $650 or based on a flat amount instead of a percentage or regular earnings, no change will be made to their plan unless otherwise directed.
If your clients wish to provide direction regarding revising their STD maximum, or if they have questions about the process, they can email Kari Gough, Manager, Group Issue and Special Projects.Coming soon: Survey for Plan Administrators with recent disability claims*
We’ve enhanced our communication processes to help your clients with disability plans manage their workplace absences more effectively. In early December, we will distribute a short survey to plan administrators who may have submitted an approved disability claim in the past six months. The survey will ask recipients about their satisfaction with the frequency and detail of our disability management communications.
The email will come from GBClientFeedback@equitable.ca, and the survey will remain open until the end of the day on December 16, 2022. All responses will be confidential. We plan to use the feedback to help ensure that we’re meeting your clients’ expectations and delivering industry-leading service.
We may also follow up with survey respondents directly, to address any concerns they’ve identified.
* Indicates content that will be shared with your clients. - [pdf] Manulife Bank Specialized Lending Contact List
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See more details and information about other site tips in this FAQ created to help you find your way around.
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February 2023 eNews
Responding to Nova Scotia’s biosimilar switch initiative
We are changing coverage for some biologic drugs in Nova Scotia in response to the province’s biosimilar initiative. These changes will help protect your clients’ plans from additional drug costs that may result from this new government policy while providing access to equally safe and effective lower-cost biosimilars.Nova Scotia’s provincial biosimilar initiative
Announced in February 2022, the Nova Scotia Biosimilar Initiative ends coverage of seven biologic drugs for residents enrolled in Pharmacare programs.
Pharmacare patients in the province using these drugs will be required to switch to biosimilar versions of these drugs by February 3, 2023, in order to maintain their Nova Scotia Pharmacare coverage.Equitable Life’s response
To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Nova Scotia for most biologic drugs included in the provincial initiative.
Beginning June 1, 2023, plan members in the province will no longer be eligible for most originator biologic drugs if they have a condition for which Health Canada has approved a lower cost biosimilar version of the drug.** These plan members will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable Life plan.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 Nova Scotia plan members can submit a policy amendment. Amendments must be submitted no later than April 1, 2023. Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Nova Scotia plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.
Groups that choose to maintain coverage of these originator biologics for existing claimants will also maintain coverage for any originator biologics that we subsequently add to our Nova Scotia biosimilar initiative.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.Communicating this change to plan members
We will inform any affected plan members in April of the need to switch their medications so that they have ample time to change their prescriptions and avoid any interruptions in treatment or coverage.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 known as the “originator” biologic. 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.Questions?
If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.
**The list of affected drugs is dynamic and will change as Nova Scotia includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
Changes to New Brunswick drug interchangeability rules
We are introducing changes to help ensure that your clients with voluntary or mandatory generic pricing for their drug plans will benefit more from the cost savings of these two features, regardless of the province where the drugs are dispensed.
Currently, when determining whether a lower-cost alternative is available for a brand-name drug, most insurers only consider drugs that the provincial drug plan identifies as interchangeable.
However, the public drug plan in New Brunswick does not identify a drug as interchangeable if the drug is not listed on its formulary – even if Health Canada has deemed the drug interchangeable.
As a result, plans with mandatory or voluntary generic pricing have continued to reimburse some drugs in New Brunswick based on the cost of the brand-name drug, even if a lower-cost generic alternative is available.
Effective March 20, 2023, if your clients have drug plans with mandatory or voluntary generic pricing, we will adjudicate any drug claims in New Brunswick using the lowest cost alternative that Health Canada approves as bioequivalent. This will occur even if the public drug plan has not identified the drug as interchangeable.
To benefit from this more robust drug plan control, plan sponsors must have mandatory or voluntary generic pricing in place.
For more information about this change or about implementing mandatory or voluntary generic pricing for your clients, please contact your Group Account Executive or myFlex Sales Manager.
New template: plan members eligible for additional coverage
Often, based on salary, some plan members may become eligible to apply for extra Life, Accidental Death & Dismemberment (AD&D), Short Term Disability or Long Term Disability coverage. If this occurs, your clients receive a notification from Group Benefits Administration. We have now developed a template that your clients can provide to applicable plan members if they become eligible for extra coverage. The template makes it simpler for your clients to pass on these details to their plan members efficiently.
The new template is available for download under the Quick Links section of EquitableHealth.ca. It is a fillable PDF form that your clients can complete and provide to their plan members when necessary. The document is called Over the Non-Evidence Limit for Plan Members Notification.
If you have any questions about the template, please contact your Group Account Executive or myFlex Sales Manager. -
Repositioned Wealth Accumulator available
Repositioned Equimax Wealth available now
As we continue to grow to meet the needs of various market segments, our product options for your high net worth (HNW) clients have also been improved. Equimax Wealth Accumulator® has been repositioned to meet the needs of your high net worth clients by providing more deposit room and competitive early cash values.
Equimax Wealth is now repositioned for your high net worth clients
Equimax Wealth Accumulator is now targeted for clients ages 45 to 65 with an insurance need but also looking for tax advantaged growth as an alternative to traditional investments. It allows your clients to achieve both while diversifying their portfolio and saving taxes, particularly for corporations.
Highlights of the repositioned Equimax Wealth Accumulator:
- More deposit room - Allows for significantly more deposit room by reducing the initial death benefit. This means more money can be paid into the policy to promote the tax-advantaged investment growth.
- Higher early cash surrender values - We are more competitive on total cash value in years 1 to 10 in the target market ages of 45-65. The higher extra deposit room and early surrender cash value allows the illustration to show an earlier premium offset, which is key for the HNW market.
- More competitive on life pay - Improvements to life pay more notable than 20 pay. Reduced premiums for most male and female non-smokers in our target market (ages 45-65) as well as 2, 3, and 4 year improvement in illustration of premium offset.
- More competitive at older ages - A shift in the target market means you can support older clients in the HNW market. The Equimax Wealth Accumulator is now more competitive at ages 45-65.
Learn more
For full details on the transition, please see our transition rules.
For more information on this product, please visit the Equimax page on Equinet.
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