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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. - [pdf] Borrowing money to save money
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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.