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1. Claims payments and notifications will go fully digital on July 1, 2023 We are committed to providing a better benefits experience. We have secure and convenient digital options to make it easier for plan members to access and use their benefits plan, including EquitableHealth.ca and the EZClaim Mobile app.
   
   Most plan members are already using these tools to set up email claim notifications and direct deposit. They get their claim updates faster and their claims paid more quickly, right into their bank account.
   
   To help ensure that all plan members benefit from faster claim payments and notifications, we are making these services fully digital as of July 1, 2023. That means, in most cases, we will no longer mail paper claim cheques or explanation of benefits (EOB) notifications.**
   
   Plan members who haven’t already activated direct deposit and email notifications will need to activate these services via their plan member account on EquitableHealth.ca. 

   How we’ll help plan members get set up

   Fortunately, it’s simple for plan members to set up these features. And it only takes a few minutes. To make it even easier, we’ve created a Plan Member Guide to Getting Started Online. It includes simple instructions to help plan members use our digital features and get the most from their benefits plan. 
   
   We have also created a toolkit that plan administrators can email to their plan members to walk them through the simple steps. Access the toolkit here.
   
   And we’re available to guide plan members who may need help. They can call us at 1.800.265.4556 and select “Plan Member Web Support”. Our Client Care Centre Team is happy to help them activate these services. 

   How we’ll communicate with plan members

   We will start communicating this change to plan members in April. For plan members who aren’t taking advantage of these convenient features, we will send them an email to let them know about the change, with instructions and support on getting set up.
   
   We will also include an insert with all mailings of paper cheques and EOB notifications sent out. And we will post an announcement and banner on EquitableHealth.ca to let plan members know about the change.
    

   How we’ll support plan members who need extra help or accommodations

   After July 1, 2023, we will follow up with plan members who have not yet activated direct deposit or email notifications for their claims and provide any extra help and support they may need. And, of course, we’ll make exceptions for plan members who aren’t willing or reasonably able to use these features. 

   Questions?

   If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
   
   ** Disability claimants will continue to receive paper Explanation of Benefits notifications in the mail. Some pay-direct drug claims will also continue to be paid by cheque.
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4. 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.

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