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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 -
Responding to Ontario’s biosimilar switch initiative
We are changing coverage for some biologic drugs in Ontario 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 government policy while providing access to equally safe and effective lower-cost biosimilars.
Ontario’s provincial biosimilar initiative
Announced in December 2022, Ontario’s biosimilar switch program ends coverage of eight biologic drugs for Ontario residents covered by the Ontario Drug Benefit (ODB). The transition to biosimilar versions of these drugs began on March 31, 2023. ODB recipients using these drugs will be required to switch to biosimilar versions of these drugs by December 29, 2023, to maintain their provincial coverageEquitable Life’s response
To ensure this provincial change doesn’t result in your clients paying additional and avoidable drug costs, we are changing coverage in Ontario for most biologic drugs included in the provincial initiative.
Beginning October 1, 2023, plan members in Ontario 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.Communicating this change to plan members
We will inform any affected plan members in early August 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.Will this change impact my clients’ rates?
Any cost savings associated with the change will be factored in 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 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 conditionsQuestions?
** The list of affected drugs is dynamic and will change as Ontario includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager. - Dividend Withdrawals and Change and Premium Offset
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Equitable Life Group Benefits Bulletin - September 2020
In this issue:
Enhancements to Equitable EZClaim Mobile
New reports available on EquitableHealth.ca* Indicates content that will be shared with your clients.
Enhancements to Equitable EZClaim® Mobile*
We’ve updated our Equitable EZClaim mobile app to process vision claims faster, to provide a new option for submitting documents and to increase password security.
Faster vision claims processing and payment
Equitable Life now provides faster processing of vision claims submitted via EZClaim Mobile.
This means plan members can find out the status of their vision claim almost instantaneously. And, for approved claims, they will receive payment even sooner – often in as little as 24 hours.
In order to allow for instant processing and faster payment, plan members will be prompted to enter some additional information, including their practitioner’s name, the date of the expense, the type of expense and amount of the expense when submitting their claims for these services.
Equitable Life plan members can submit all vision claims via Equitable EZClaim, including coordination of benefits and Health Care Spending Account claims.
Submit documents from a mobile device
We have added our Document Submission tool to EZClaim Mobile so plan members can conveniently submit documents directly from their mobile device. Applications, change forms, statement of health forms and more can all be easily uploaded whenever and wherever they are.
Improved security with stronger passwords
To help you, your clients and plan members better protect personal information, we have increased the maximum length of passwords for both EZClaim Online and EZClaim Mobile from 12 to 32 characters. This longer character limit makes it easier to create stronger and more secure passwords.
There is no change for plan members, plan administrators or advisors. All existing passwords will continue to function. However, if you choose to update your password you will now be able to choose longer passwords or passphrases.
Why should I change my password?
Changing your password frequently helps keep your information safe. The longer and more random the password, the more secure it is. To improve security even more, a passphrase is recommended.
A passphrase is a series of words or other text used like a password. Because it is much longer, a passphrase is more secure. Although the words in the phrase may be meaningful to you and easy to remember, they can be random enough that the full phrase is difficult for someone else to guess. It’s even better if you use numbers or other characters in your passphrase.
Your passphrase should be:
- Long enough to be hard to guess;
- Not a famous quotation;
- Easy to remember and type; and
- Not used in multiple places.
To change your password:
- Log in to EquitableHealth.ca
- Click on My Information > User Profile
- Click Edit
- Confirm your information and enter your new password
- Click Save
We will be announcing this enhancement to plan members on EquitableHealth.ca.
New reports available on EquitableHealth.ca*
Plan administrators and advisors with reporting access can now download three additional reports any time via the plan administrator and advisor websites on EquitableHealth.ca:
- Premium and Tax – This report provides a breakdown of premiums and taxes paid per plan member for any specific time period for all applicable benefits.
- Occupation and Earnings – This report provides current plan member earnings and occupation information and gives plan administrators an efficient way to report updates to us.
- Employee listing – This report lists all plan members’ information, including name, certificate number, date of birth, province, occupation and salary, as well as benefit coverage currently in place and HCSA allocations.
These reports can be downloaded in Excel format for easy updating, filtering or sorting.
For more information, please contact your Client Relationship Specialist.
*Indicates content that will be shared with your clients
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