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Reminder: Deadline to opt out of Alberta biosimilar coverage changes
In November 2020, we announced via eNews that on 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 client’s plans from additional drug costs while still providing access to equally safe and effective biosimilars.
Do my clients need to take any action?
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.
Otherwise, no action is required on their part. Plan members taking these biologics will be contacted directly to allow them ample time to change their prescription. Any cost savings associated with the change will be factored in at renewal.
Questions?
We have compiled a list of frequently asked questions to help you understand Alberta’s Biosimilar Initiative. If you have a question that isn’t answered here, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.
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An important announcement about our Travel Assist provider
Allianz Global Assistance, our Travel Assist emergency medical assistance provider, has informed us that it is exiting the Canadian group travel insurance market.
Allianz will continue to accept and support new claims up to June 30, 2023, and they will support ongoing claims until Dec. 31, 2023.
We are already meeting with potential new Travel Assist partners and plan to have a provider in place before June 30, 2023.
In the meantime, we are working closely with Allianz to help ensure a smooth and seamless transition for your clients and their plan members. Allianz is committed to maintaining its staff to meet and exceed service levels throughout the transition, as follows:
Before July 1, 2023:
Allianz will continue to accept calls and open new claims up to June 30, 2023. Any claims opened on or prior to June 30, 2023, will continue to be processed by Allianz until Dec. 31, 2023.
After July 1, 2023:
New cases will be directed to our new service provider. Allianz will work alongside us and our new provider to make this transition as simple as possible.
After Dec. 31, 2023:
For any cases still open as of Dec. 31, 2023, Allianz will work with our new service provider to responsibly transfer these cases while ensuring a seamless client experience.
We will communicate this news next week to your clients who have Travel Assist coverage on their plan. And we will continue to communicate more details to you about this transition in the coming weeks.
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager. -
Introducing Equitable EZBenefits: A better group benefits solution for your small business clients
If you serve small business owners, chances are they’re looking for a group benefits solution that’s affordable, sustainable and easy to manage. That’s why we introduced Equitable EZBenefits™. It’s a unique group benefits solution designed with you and your small business clients in mind.
Options to fit every need
Available to organizations with between 2 and 25 employees, EZBenefits offers a range of plan design options to match different needs and budgets. * Whether your client owns start-up or a growing company, we’ve got them covered. Plan options include a mix of Life, Health and Dental coverage. ** Clients can also add Long-Term Disability (LTD) coverage or a Health Care Spending Account (HCSA).
Embedded services to support health and wellness
To provide employees with added support for both their physical and mental wellbeing, all our plan design options include:- Anytime, online access to medical professionals through our Virtual Healthcare solution from Dialogue,
- Access to professional counselors – via the telephone, the web or in-person – through our Employee and Family Assistance Program from Homewood Health®, and
- Online resources to help manage health, financial and family challenges through Homeweb, Homewood Health’s online wellness portal.
EZBenefits also comes with built-in HR support through Equitable Life’s partnership with HRdownloads® This takes the heavy lifting out of common human resource tasks with HR support tools and services, including:- HR Technology: An award-winning cloud-based human resource information system to provide help from onboarding to offboarding and everything in between.
- HR Content: Access to a library of over 3,000 HR documents, templates, compliance resources and articles, with 25 free document downloads.
- HR Training: A free Workplace Diversity and Inclusion online training course.
- HR Support: One free Live HR Advice call with a seasoned HR expert.
We know that advising small business clients can be challenging. We’ve created a streamlined benefits process that provides rapid quotes, hassle-free plan implementation, simplified renewals and that is easy to administer. That way, you can spend more time advising your clients and building your business – and less time with administrative back and forth.
Pricing stability for long-term stability
When it comes to attracting and retaining talent, we know your small business clients are competing with larger organizations that have big budgets and lots of resources. That’s why we’ve designed EZBenefits to provide long-term pricing stability for health and dental benefits.
Find out more
Watch this video to learn how EZBenefits can help you and your clients. You can also visit info.equitable.ca/ezbenefits for more details or to request a quote. If you have questions, contact your Equitable Life Group Account Executive. If you don't have an Equitable Life Group Account Executive, email us at EZBenefits@equitable.ca.
* Not available in Quebec.
** Dental coverage is not included with the Bronze plan design option. - [pdf] Life Quick Reference Guide
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An update on Travel Assist coverage
The last several months have been very difficult for plan members. We recognize how important it is for them to get back to a sense of normalcy, including making summer travel plans.
As countries start to reopen their borders, plan members with Travel Assist emergency medical benefits may have questions about whether they will be covered while travelling.
For plan members who want to travel outside of Canada, here’s what they need to know.
Out-of-country travel
Plan members travelling to countries that are popular vacation destinations and have reopened their borders will be covered for eligible expenses, including those related to COVID-19.
Please note: While a country may be open for travel, plan members should contact Allianz before departing to confirm that they are covered for travel to their specific destination.
Plan members travelling to countries for which the Government of Canada has issued a Level 4 travel advisory (“Avoid all travel”) will not be covered.
Please note that every country has different travel restrictions. Travelers could be denied entry to another country, even though their travel may be considered essential. Or they may be forced to self-isolate when they arrive at their destination. Canadians travelling to another country should consult that country’s travel restrictions and guidelines before departure and re-entry into Canada.
Communicating with plan members
Below is a link to a plan member version of this communication. Please encourage your clients to share this with their plan members who have Travel Assist coverage on their benefits plan. It’s important for them to know their coverage details before they make their travel plans. We have also posted this update on the plan member website at EquitableHealth.ca.
An update on Travel Assist coverage PDF
If you have questions, please contact your Group Account Executive or myFlex Sales Manager.
- [pdf] Now it’s even easier to grow your savings online!
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Insights from a pandemic: Drug trends during COVID-19
We were expecting drug costs to rise this year due to the increase in “specialty” drugs, the shift to more expensive treatments for common conditions, and the introduction of new, costly medications. The COVID-19 pandemic has caused drug costs to rise even more than expected. While this was partly due to increased claims for certain drug categories, the most significant factor was the increase in dispensing fees as the provinces imposed 30-day refill limits.
Costs and claimants surge, drop, then climb again
Initially, as COVID-19 started to spread, we saw an overall spike in the volume and paid amounts for drug claims in March as plan members rushed to stock up on their medications. On our block, the average amount paid per certificate increased 16% in March, compared with the previous year.
This spike was followed by a drop in April after most provinces put 30-day refill limits in place. This led to a decrease in both average paid amounts and quantity per claim as people were limited to smaller refills. But the dispensing fee portion of drug cost tripled for many plan members who had to refill their prescriptions every month instead of every 90 days.
The April plunge was short-lived. Drug claims started to climb again in May as some provinces removed their 30-day refill limits. We’ve seen a continued increase so far in June as all remaining provinces have lifted their 30-day limits.
Claims for “specialty” drugs increase
There were some notable exceptions to this trend. For example, both claimants and paid amounts for high-cost “specialty” drugs increased in March, April and May. Thirty-day refills are the norm for these drugs, so they weren’t impacted by the re-fill limits.Claims for asthma drugs had the largest surge of any common disease category in March but had no subsequent drop in April. Not surprisingly, claims for mental health drugs increased throughout the pandemic, including a 33% increase in the number of claimants in May.
Going forward, we should see the average quantity per prescription stabilize in future months and return to normal, provided pharmacies return most patients to refills of more than 30 days.
The full impact of COVID-19 remains to be determined. We will continue to provide timely updates on any developments that impact our clients and their plan members or their benefits coverage. In the meantime, please contact your Group Account Executive or myFlex Sales Manager if you have questions.
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