Site Search
231 results for PROBLEMGO.COM Looking to hire a bagman to bribe the DA Tor proceed fast experts in this field
- Individual Wealth Marketing Materials
-
Equitable Life Group Benefits Bulletin – March 2022
In this issue:
- CLHIA launches industry anti-fraud initiative*
- Provincial biosimilar update*
- Quebec decreasing insurance premium tax*
- Coming soon: A survey to understand how we can better serve your clients’ needs*
- Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare *
CLHIA launches industry anti-fraud initiative*
In February, the Canadian Life and Health Insurance Association (CLHIA) announced a new anti-fraud initiative that is using advanced artificial intelligence (AI) to further identify and reduce benefits fraud.
Equitable Life is excited to be a part of this important initiative. It will enhance our own fraud detection analytics by using AI to connect the dots across a huge pool of anonymized claims data. This will lead to more investigations and actions to mitigate the impact of fraud on your clients’ plans.
The initiative is being led by the CLHIA and member insurers and is supported by technology provider Shift Technologies. It will be further rolled-out and expanded over the next three years.
Benefits fraud affects more than just insurers. The costs of fraud are felt by employers and their employees as well. We are looking forward to being able to better identify and reduce benefits fraud.
Provincial biosimilar update*
BC expands its biosimilar initiative
BC Pharmacare recently announced it is adding two rapid-acting insulins to the list of drugs included in its ongoing initiative to switch patients to biosimilar versions of high-cost biologics. Patients taking Humalog or NovoRapid for Type 1 or Type 2 diabetes will be required to switch to a biosimilar version of the drugs by May 29, 2022 to maintain coverage under the public plan.
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 biologic drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.
How we are responding to protect our clients
To help prevent this change from resulting in additional costs for our clients’ drug plans while still providing plan members with access to safe and effective medications, we will no longer cover Humalog or NovoRapid for plan members in BC. Effective June 1, 2022, claimants currently taking Humalog or NovoRapid will be required to switch to a biosimilar version of the drugs to maintain coverage under their Equitable Life plan and their BC Pharmacare plan.
We will be communicating this change to plan administrators later this week. And we will be communicating with affected claimants in early April to allow 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.
Nova Scotia and Northwest Territories introduce biosimilar initiatives
The governments of Nova Scotia and the Northwest Territories each recently announced they are launching biosimilar initiatives to switch patients from certain originator biologic drugs to biosimilar versions of the drugs.
Patients in Nova Scotia using affected originator biologic drugs will have until February 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. Patients in the Northwest Territories will have until June 20, 2022, to switch.
Equitable Life® actively monitors and investigates all biosimilar policy changes and the ongoing evolution of biosimilar drugs entering Canada. We will keep you informed of any impact on private drug plans and how we are responding.
Quebec decreasing insurance premium tax*
The Quebec Government has announced that it plans to decrease its Insurance Premium Tax rates effective April 1, 2022. The premium tax rates for group life and accident and sickness insurance are expected to decrease from 3.48% to 3.3%. The new tax rates will be applied to premiums for the billing period beginning on or after April 1, 2022.
Coming soon: A survey to understand how we can better serve your clients’ needs*
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.
In the coming weeks, we will conduct a survey of your clients to help us understand how we can better serve them. On March 28, we will send plan administrators an email with a link to the survey. The survey will remain open until the end of the day on April 11 and 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 may also follow up with plan administrators directly 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 25 prepaid gift cards for $25.
Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare*
If your clients have plan members in British Columbia, Manitoba or Saskatchewan, the provincial government offers a Pharmacare program to support prescription drug costs. Plan members in these provinces must register for their provincial Pharmacare program to maintain coverage under their Equitable Life drug plan.
Registration is easy! We will send two registration reminder messages directly to plan members’ pharmacists and post them on their Explanation of Benefits. We’ve also created a step-by-step guide that your clients can share with their plan members.
English version
French version
For more information about the provincial Pharmacare programs, including how plan members can register, please visit:
For British Columbia residents: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents
For Manitoba residents: https://www.gov.mb.ca/health/pharmacare/apply.html
For Saskatchewan residents: https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/extended-benefits-and%20drug-plan/drug-cost-assistance#eligibility
- [pdf] Benefits of segregated funds in a TFSA
-
Equitable Life Group Benefits Bulletin - September 2022
Homewood Health launches Sentio, an upgraded iCBT platform
Equitable Life’s mental health partner, Homewood Health, has launched Sentio, an upgraded platform for Internet-based cognitive behavioural therapy (iCBT). This self-directed platform is now available to all Equitable Life clients, and it replaces Homewood’s previous iCBT platform, i-Volve.
Sentio Self-Directed iCBT is a comprehensive digital cognitive behavioural therapy platform. Developed by Homewood’s mental health experts, it is an action-oriented solution for plan members, giving them practical resources and activities to help with their depression, anxiety and overall mental health challenges.
Available as a standalone app, on mobile, tablet and desktop, Sentio contains over 20 unique treatment goals for issues like stress management, improving sleep, managing depressive thoughts, and coping with panic. Users can work through treatment goals in any order, at their own pace. It also includes tools and resources to help plan members build skills and change their thought patterns.Sentio iCBT benefits
Sentio integrates seamlessly with Homewood Pathfinder so that users can easily locate and take advantage of the iCBT activities available. Sentio also includes a number of unique features:- More interactive features and activities to help plan members build valuable mental health skills
- Integrated symptom measurement and progress tracking
- Interactive multimedia learning and cognitive exercises to enhance learning
- Progress, learnings, and exercises that have been accessed are available to be re-accessed for 12 months
Please contact your Group Account Executive or myFlex Sales Manager if you have any questions.
Streamlining disability claims with Opifiny
Equitable Life is partnering with Opifiny to provide a quicker and more seamless disability claims experience.
Opifiny is an online platform that streamlines the disability claims process for consulting physicians, benefits plan sponsors, and disability plan members. Equitable Life will be using Opifiny for ongoing disability claims management, modernizing the process of gathering medical assessments and information.
Disability claims frequently involve several instances of correspondence between Equitable Life and the plan member’s medical team. By using the secure platform, health care professionals can access, respond to and process medical insurance requests easily from any device. They can typically complete administrative tasks associated with disability claims in a quarter of the time. The platform is secure and protects the privacy of their patients’ confidential information.
By digitizing and modernizing the claims management process for doctors, Equitable Life will have faster access to higher quality claims information. For some claims, using Opifiny may enable Equitable Life to help plan members safely return to work sooner.
Reminder: Obtaining plan member signatures on all administration forms
Please remind your clients that plan members must sign all administration forms, including enrolment forms, benefits change forms, and beneficiary designation forms. Once completed, a plan administrator can keep the form or send it to us. We are not able to accept a beneficiary designation that has not been signed by the plan member. Having appropriately signed forms helps to ensure that any life insurance claims are paid to the intended recipients.
For your clients’ convenience, forms can be signed electronically using one of our approved vendors, which include DocuSign, BambooHR, Adobe Sign, and many more.
If you have questions about providing signed forms, please contact your Group Account Executive or myFlex Sales Manager.
Correction: Coverage for full-time students and dependents with disabilities
In our August edition of eNews, we provided incorrect information about benefits coverage options for over-age dependents. We indicated that over-age dependents who are full-time students may continue to be eligible under the plan member’s benefits plan if they are studying in their home province. However, attending a post-secondary institution in their home province is not a requirement for continued eligibility. Dependents who are full-time students may continue to be eligible for coverage regardless of where in Canada they are attending post-secondary education.
If your clients have any questions about extending coverage for over-age dependents that are full-time students, please notify them of this error.
We apologize for any inconvenience or confusion this may have caused.
-
Equitable Life Group Benefits Bulletin - November 2022
The importance of timely plan member eligibility updates*
Effective Dec. 1, 2022, we are implementing a revised process for managing plan member and dependent health and dental claims that have been incurred and paid after coverage has been terminated. This new process is consistent with industry practices.
If health or dental claims have been incurred and paid after a plan member’s termination date but before we received notice of the termination, we will align the plan member’s or dependent’s termination date with the service date of the last paid claim, retaining premiums up until that date.
If no claims have been incurred and paid after the termination date, Equitable Life will process the termination as requested and refund any excess premium, subject to a maximum premium refund credit of three months.
Currently, we process the termination as requested and attempt to recover any claim overpayments directly from the plan member. We then refund any excess premiums that have been paid, subject to the maximum refund credit amount.
To avoid claims being incurred and paid after a plan member’s termination date, it is important for your clients to update plan member and dependent eligibility dates on or before the effective date of the change.
If you have any questions about the process your clients should follow for updating plan member eligibility, please contact your Group Account Executive or myFlex Sales Manager.QuickAssess®: Absence and accommodation request review services*
It can be difficult to navigate chronic or complex cases of absenteeism or accommodation requests. That’s where QuickAssess® can help.
QuickAssess is an optional, fee-per-use service that can provide your clients with an unbiased, timely assessment of complex plan member absences and workplace accommodation requests. Our disability experts can provide recommendations to help your clients manage:- Workplace absences
- Chronic or patterned absenteeism
- Requests to modify workplaces or duties
- Return-to-work coordination
- Employee Insurance sick leaves
For more information on using QuickAssess, including eligibility requirements, please contact your Group Account Executive or myFlex Sales Manager.
**Within two business days of receiving a completed QuickAssess Absence and Accommodation Review Referral Form and all required information. For more complex referrals, more time will be required.Finding a health care provider with TELUS eClaims direct billing*
By visiting TELUS’s Find a Provider page, your clients’ plan members can now easily search for paramedical and vision providers who are registered on the TELUS Health eClaims network and who can submit claims directly to us on behalf of their patients. Searches can be filtered by postal code to help plan members find the most convenient provider options.
As our direct billing provider for pharmacy, vision and paramedical claims, TELUS Health has an extensive network of 70,000 health care providers that provide direct billing to streamline the claims process.
Please note, plan members should always check Equitable Life’s list of de-listed providers before selecting a health care provider. The list is available for your clients and their plan members on EquitableHealth.ca, and is updated regularly.
For more information about TELUS eClaims, please contact your Group Account Executive or myFlex Sales Manager.First phase of the Canada Dental Benefit proposed for Dec. 1, 2022*
The federal government’s new Canada Dental Benefit is proposed to take effect on Dec. 1, 2022, subject to Parliamentary approval. The program will cover eligible expenses retroactive to Oct. 1, 2022, and this first phase would apply to Canadians under 12 years of age.
If implemented, the Canada Dental Benefit will provide dental care to Canadian families with under $90,000 adjusted net income annually. By 2025, the federal government expects to extend the benefit to children under 18, senior citizens and Canadians with disabilities.
Parents or guardians will be required to apply for this coverage through the Canada Revenue Agency (CRA) and must not have private dental coverage for the child(ren).
This new program will have no impact on your clients’ dental coverage and no action is required on their part.
* Indicates content that will be shared with your clients.
-
April 2023 eNews
Vision care discounts from Bailey Nelson for Equitable Life plan members*
We are pleased to announce we are partnering with Bailey Nelson to provide Equitable Life plan members with discounts on prescription and non-prescription eyewear. Bailey Nelson is a leading provider of prescription glasses, contact lenses and sunglasses with locations across Canada, as well as an online store.
All Equitable Life plan members will have access to the following discounts from Bailey Nelson:
*Includes anti-reflection and anti-scratch treatment. Glasses offers are based on 2 pairs of single vision or 1 pair of premium progressive lenses. Lens add-ons, such as high-index lenses and prescription tinted lens tints may involve additional costs.
**Non-prescription glasses only. Cannot be combined with 2 for $200 discount.
Plan members can provide their Equitable Life discount code in-store or at online checkout. Your clients may wish to distribute this convenient flyer with an overview of the available discounts to their plan members.
Plan members can bring their prescription to a Bailey Nelson location or provide it online to order glasses and contact lenses. Bailey Nelson also provides eye exams in-store for $99.
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
Equitable Life helps tackle benefits fraud through Joint Provider Fraud Investigation (JPFI) initiative*
Protecting your clients’ plans is important to us. That’s why Equitable Life is working with other Canadian life and health insurers to conduct joint investigations into health service providers that are suspected of fraudulent activities through the Canadian Life and Health Insurance Association’s (CLHIA’s) Joint Provider Fraud Investigation (JPFI) initiative. This collaborative initiative between major Canadian life and health insurers through the CLHIA is a major step toward reducing benefits fraud in the life and health benefits insurance industry.How the JPFI works
The JPFI builds on the 2022 launch of a CLHIA-supported industry program. The program uses advanced artificial intelligence to help identify fraudulent activity across an industry pool of anonymized claims data. Joint investigations will examine suspicious patterns across this data.
Through this project, Equitable Life can initiate a request to begin a joint fraud investigation when we:- See suspected provider fraud in our own data or the pooled data, or
- Receive a substantiated tip about potential provider fraud
How Equitable Life protects your clients’ benefits plans from fraud
Benefits fraud is a crime that affects insurers, employers and employees and puts the sustainability of workplace benefits at risk. CLHIA estimates that employers and insurers lose millions each year to benefits fraud and abuse.
Our Investigative Claims Unit (ICU) consists of security and fraud experts who use data analytics and artificial intelligence to proactively identify and investigate suspicious billing patterns or claims activity to open investigations. We de-list healthcare providers who are engaged in questionable or fraudulent practices, pursue the recovery of improperly obtained funds, and report practitioners to regulatory bodies and law enforcement where appropriate.
Learn more about benefits fraud, or contact your Group Account Executive or myFlex Sales Manager for more information.Second phase of TELUS eClaims transition*
In June 2022, we switched to TELUS Health eClaims as our digital billing provider to give our plan members a faster and more convenient option for submitting paramedical and vision claims. The switch has allowed our plan members to take advantage of TELUS’s extensive network of over 70,000 paramedical and vision providers.
We’ve now begun the second phase of our TELUS Health eClaims implementation. This phase will focus on improving the experience for paramedical and vision providers. We will begin issuing reconciliation statements for the claims they submit on behalf of their patients. These statements will make it easier for them to use the TELUS Health eClaims portal and provide incentive for even more providers to sign up.
Please encourage your clients to remind their plan members about this convenient option. We have created a helpful one-pager that plan members can bring with them next time they have an appointment with their healthcare provider.
If you have any questions about TELUS Health eClaims, please contact your Group Account Executive or myFlex Sales Manager.
Changes to STD application process for COVID-19 cases*
As the COVID-19 situation evolves, we continue to adjust our disability management practices to ensure ongoing support and a fair experience for all our plan members.
As of May 1, 2023, we will begin managing COVID-19-related short-term disability (STD) claims the same way that we manage disability claims for any other illness or condition. If a plan member is unable to work due to COVID-19 symptoms or a positive COVID-19 test, they must now use the standard STD application, including the Attending Physician Statement portion.
Once we receive the claim, we will adjudicate it according to our standard process.
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
* Indicates content that will be shared with your clients.
- [pdf] Sales Illustration System FAQ
- Frequently Asked Questions
- [pdf] Daily/Guaranteed Interest Account Application - TFSA
- [pdf] Equitable GIF Product at a glance