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  1. [pdf] Online Plan Member Enrolment
  2. February 2020 Advisor eNews

    In this issue:

    Provincial biosimilar update
    Legislative changes for Alberta’s Coverage for Seniors program
    Coming soon: enhancements to Equitable EZClaim® Online
     

    Provincial biosimilar update

    Alberta Biosimilar Initiative

    On December 12, 2019, the Alberta government introduced the launch of the Alberta Biosimilar Initiative. This program will require patients using several originator biologic drugs to switch to a biosimilar, and patients using a non-biologic complex drug (NBCD) to switch to its subsequent entry version before July 1, 2020 in order to maintain coverage.

    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” drug. Biosimilars 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.

    Alberta Health will initially cover both the originator and biosimilar or subsequent entry version of a NBCD  drug as patients start the switching process.

    The following table outlines the affected originator drugs, their biosimilars or subsequent entry, and the conditions affected by the program.

    Biosimilar Drug Originator Biosimilar/Subsequent Entry Indications Affected
    etanercept Enbrel Brenzys Ankylosing Spondylitis
    Rheumatoid Arthritis
    Erelzi Ankylosing Spondylitis
    Psoriatic Arthritis
    Rheumatoid Arthritis
    infliximab Remicade Inflectra
    Renflexis    		 Ankylosing Spondylitis
    Plaque Psoriasis
    Psoriatic Arthritis
    Rheumatoid Arthritis
    Crohn’s Disease
    Ulcerative Colitis
    insulin glargine Lantus Basaglar Diabetes (Type 1 and 2)
    Filgrastim Neupogen Grastofil Neutropenia
    pegfilgrastim Neulasta Lapelga Neutropenia
    glatiramer* Copaxone Glatect Multiple Sclerosis

    *Glatiramer is a non-biologic complex drug where the originator is Copaxone and the subsequent entry is Glatect.

    Equitable Life is actively investigating the benefit, risk and appropriate plan changes associated with this new policy on private drug plans and will keep you informed.

    For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.

    British Columbia

    In 2019, BC Pharmacare introduced a Biosimilars Policy that impacted coverage of three biologic drugs – Remicade, Enbrel and Lantus. As of November 25, 2019, these drugs were no longer eligible in BC for most conditions for which lower cost biosimilar versions are available. Patients in the province with these conditions were required to switch to biosimilar versions of these drugs in order to maintain their coverage.

    The second phase of the BC Biosimilar Policy takes effect March 6, 2020 when Remicade will be delisted for Crohn’s Disease and Ulcerative Colitis. Patients in the province with these conditions will be required to switch to Inflectra or Renflexis in order to maintain their coverage.

    Biosimilar Drug Originator Biosimilar Indications Affected
    infliximab Remicade Inflectra
    Renflexis    		 Crohn’s Disease
    Ulcerative Colitis

    We have communicated with the affected plan members, informing them of the need to switch medications. If plan members have any questions or concerns, our Customer Care team is here to help and support them through the transition.

    If you have any questions about this policy, please contact your Group Account Executive or myFlex Sales Manager.

    Ontario

    In November 2019 Ontario Minister of Health Christine Elliot indicated that the government was planning to launch consultations to explore solutions in managing biologics.

    Equitable Life will continue to monitor these developments and keep you informed of any impact on private drug plans.

     

    Legislative changes for Alberta’s Coverage for Seniors program

    The government of Alberta has announced that as of March 1, 2020, seniors’ family members (such as spouses and dependents) who are younger than 65 will no longer be covered by the provincial Coverage for Seniors program. Albertans 65 years of age and older will continue to be covered under the provincial plan.

    Equitable Life plan members and their dependents will continue to be covered under the parameters of their group benefits plan.

    For more information, please see the Alberta Seniors Health Benefits website.

     

    Coming soon: enhancements to Equitable EZClaim® Online

    Faster vision claims processing and payment

    Equitable Life will soon provide real-time processing of vision claims submitted via EZClaim Online.

    This means plan members will be able to 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 instantaneous processing and faster payment, plan members will be prompted to enter some additional information including the 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 EZClaim, including coordination of benefits and Health Care Spending Account claims.

    This enhancement will be coming to our EZClaim Mobile app in the coming months.

    New printable claims extract

    As part of our ongoing efforts to improve customer experience for plan members, we will also offer a claims extract in a printable format within the plan member site. Plan members will be able to select a date range and claimant, then generate and download a detailed list of health and dental claims. This is a helpful way to keep track of claims, especially when reviewing them in preparation for income tax filing.

    Once these enhancements are live you will be notified in an eNews, and an announcement will be posted on the plan member section of EquitableHealth.ca.

     

    Elimination of Out-of-Country Travellers Program in Ontario

    Effective January 1, 2020, the Ontario government eliminated OHIP coverage for emergency services for Ontarians travelling outside of Canada.

    Previously, the Out-of-Country Travelers Program provided some reimbursement for services required to treat conditions that are acute, unexpected, arose outside Canada and require immediate treatment. The program covered between $200 and $400 per day for inpatient services and $50 per day for outpatient and doctor services.

    For groups who have out-of-country coverage from Allianz, this change will not impact the cost to your plan members, or the process plan members follow in the event of an emergency while travelling.

    Plan members should still call Allianz in the event of an out of country emergency. Allianz will deal with their claim as usual and will now pay for the portion of the claim previously paid by OHIP. Plan members will not have any additional out-of-pocket costs.

    We will be sharing this information with plan members as a news item on our plan member website, equitablehealth.ca.

  3. April 2024 eNews

    In this issue:

    • Competitive – and easy – benefits plans for your small business clients
    • Simplifying benefits enrolment for your clients*
    • NEW time-off tracking tool from HRdownloads*
    • Focus on benefits fraud: Protecting your clients’ plans from abuse*
    *Indicates content that will be shared with your clients who receive these benefits.
     

    Competitive – and easy – benefits plans for your small business clients

    Supporting your small business clients can be a challenge. It’s tough to find a competitively-priced benefits plan with the features they want. Small business owners may also need more of your time – especially if this is their first benefits plan.
     
    That’s why we created Equitable EZBenefits™, a benefits solution designed with the needs of small businesses in mind. With a range of plan design options and valuable embedded services for plan sponsors and plan members, EZBenefits is available for groups with 2 to 25 employees. And to make things simpler for you, we’ve created an Advisor Concierge Service exclusively for EZBenefits. Whether you have a question about submitting a quote request for a new client or an issue with an in-force client, our Concierge Service is your go-to resource for EZBenefits support.  

    Don’t have any EZBenefits clients yet?

    To learn more about EZBenefits, watch our video to learn more or view our brochure.

    Simplifying benefits enrolment for your clients*

    Navigating the benefits enrolment period can be overwhelming – for you, your clients and their employees. It’s difficult to ensure all plan members complete the necessary paperwork before the enrolment deadline. 

    That’s why we offer our secure Online Plan Member Enrolment tool at no extra cost to plan sponsors. The tool simplifies the onboarding process for your clients and their plan members by eliminating the need for paper enrolment forms.
     
    It also makes enrolment faster and easier for your clients by:

    • Reducing errors and rework that can occur due to spelling mistakes or missing information on paper forms; and
    • Sending automatic enrolment reminders to plan members, resulting in fewer late applicants. 
    Our user-friendly interface allows plan members to:
    • Enrol in their benefits plan in just minutes from their computer or mobile device;
    • Easily enter all their enrolment information, including dependent details, banking information for direct deposit of claim payments and details for coordination of benefits; and
    • Designate their beneficiary electronically. 

    Ready to share our Online Plan Enrolment Tool with your clients? Get them started with these helpful resources:

    To learn more about how Online Plan Member Enrolment can simplify benefits enrolment for your clients, contact your Group Account Executive or myFlex Account Executive.

    NEW time-off tracking tool from HRdownloads*

    Through our partnership with HRdownloads®, EZBenefits clients now have complimentary access to Timetastic —a time-off tracking tool that can make it easier to manage employee vacation time, sick days and more.
     
    Timetastic integrates seamlessly with HRdownloads and includes a mobile app to help manage time-off requests from any mobile device.
     
    To see Timetastic in action, check out this demo.
     
    EZBenefits also includes other helpful resources and tools from HRdownloads that can make daily human resources tasks easier, including:
    • A robust, award-winning HR management platform (HRIS);
    • HR documents, templates, compliance resources and articles; and
    • A live HR advice helpline. 
    All of our other Equitable group benefits clients can get a 10% discount on HRdownloads services. Visit the link below or contact your Account Executive for more information.

    Learn more about accessing HRdownloads.

    Focus on benefits fraud: protecting your clients’ plans from abuse*

    According to the Canadian Life and Health Insurance Association (CLHIA), benefits fraud costs insurers and plan sponsors millions of dollars each year, which can lead to increased premium costs.
     

    Resources for your clients

    Both plan administrators and plan members play a role in preventing benefits abuse. So, we’ve compiled some resources you can share with your clients to help them understand what benefits fraud is and how to prevent it: Encourage your clients to educate their plan members about the potential consequences of benefits fraud, including losing their benefits, losing their job and even jail time. 

    How we’re fighting benefits fraud

    Our Investigative Claims Unit (ICU) works to detect and eliminate benefits fraud. We use a variety of investigative techniques, including CLHIA-led industry tools to detect and eliminate benefits fraud: 
    • Joint Provider Fraud Investigation Program: A robust program that allows insurers to collaborate on fraud investigations that affect multiple insurers;
    • Data Pooling Program: An initiative that pools data between insurers and uses advanced artificial intelligence to further identify and reduce benefits fraud; and
    • Provider Alert Registry: A registry that allows insurers to view the results of other insurers’ anti-fraud investigations into specific practitioners. 
    To learn more about benefits fraud and Equitable’s commitment to protecting our benefits plans, please contact your Group Account Executive or myFlex Account Executive.
  4. [pdf] Equitable's Competitive Advantage
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  6. [pdf] Equitable GIF Non-Registered Application
  7. [pdf] Equitable Guaranteed Investment Funds – Estate Class
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  10. [pdf] EquiNet Quick Tips