340 results for mode change request

1. Changes to RRSP to RIF Conversion Form - Pivotal Select (Form #1673)

   Equitable Life^® has recently updated the RRSP to RIF Conversion Form (Form #1673).

   Summary of Change - The changes made to the Spousal section include clarification about beneficiary information and spousal consent.

   The paper version of the updated RRSP TO RIF CONVERSION FORM - PIVOTAL SELECT (Form #1673) is now available on the Forms page of EquiNet^®.

2. [pdf] A Simple Interest Option for Guaranteed Investing
3. Have you heard about Equitable Client Access?
   Equitable Client Access^® allows clients to self-serve on some of the more popular requests. Thousands of clients have already signed up for Equitable Client Access and are enjoying the benefits of accessing their secure information 24/7.
   
   •   Does your client need to change or stop existing Pre-Authorized payment (PAD)? Equitable Client Access can do that.
   •   Does your client need to change a withdrawal date for a PAD? Equitable Client Access can do that too.
   •   Address or banking information changes? Equitable Client Access has your clients covered.
   •   Does your client need to change her beneficiary from Aunt Flora to Uncle Ned? Equitable Client Access can even do that.
   
   Equitable Client Access is a secure online client site that connects clients with policy information, right at their fingertips. In addition to the self-serve features, Equitable Client Access can also provide:
   
   •    Insurance coverage and guarantees
   •    Investment allocation, performance and market values
   •    Transaction history
   •    Statements and letters
   •    Advisor contact information, along with so much more.
   
   
   If your clients have not signed up for Equitable Client Access, direct them to client.equitable.ca - it only takes a few minutes to set up an account, and connects your clients with their policy information online – anytime!
   
   Have a question about Equitable Client Access? Want to tell your client how to go paperless? Check out our updated FAQ or contact your Regional Investment Sales Manager today.
    
4. 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.
5. 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):

   

6. Life Policy Collateral Loans
7. About
8. [pdf] Investment Direction Form - DIA/GIA
9. [pdf] Plan Administrator Guide to EZBenefits
10. 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.