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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
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Easier group enrolment and more group benefits updates
Make enrolment easier for your clients with online plan member enrolment (OPME)
Enrolling new plan members can be overwhelming – for both you, your clients and their employees. It’s time-consuming to manually load new members and challenging to ensure they complete the necessary paperwork before the enrolment deadline.
Our Online Plan Member Enrolment (OPME) tool is available at no extra cost for all your Equitable Life clients and offers a more secure and efficient alternative to traditional paper enrolment. Using their computer or mobile device, employees can enrol in their benefits plan in just minutes.
The user-friendly tool allows plan members to easily enter all their enrolment information, including:- Dependent details
- Banking information for direct deposit of claim payments
- Details for coordination of benefits
- Beneficiary designation
The days of chasing plan members for their paper enrolment forms are gone. Once plan administrators enter a few employee details, our system automatically sends an email to each plan member, inviting them to enrol in their benefits program. And there will be no need for your clients to send reminders or follow up with employees about their benefits enrolment. It’s all done automatically.Support with using OPME
To learn more about the benefits of using OPME, check out our Online Plan Member Enrolment Flyer. We also encourage you to share more information with your clients: We also have helpful reference guides for plan members, to help them use the tool:- Online Plan Member Enrolment Quick Reference Guide
- myFlex Online Plan Member Enrolment Quick Reference Guide
Help your clients spend less time administering group benefits. Contact your Group Account Executive or myFlex Sales Manager to learn more about our online plan member enrolment.
Coming soon: A survey to help us serve your clients better*
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.
This month, we will conduct a survey of your clients to help us understand how we can better serve them. Plan administrators will receive an email with a link to the survey, which 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 will also allow them to provide their name so that we can follow up with them 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 3 prepaid gift cards for $200.
Improved mental assessment features for FeelingBetterNow®*
Mensante has enhanced its FeelingBetterNow® online platform to make it easier for plan members to assess the state of their mental health and talk to their health care provider about treatment options. FeelingBetterNow is part of our Equitable HealthConnector suite of wellness solutions and is available for an additional cost. It can help plan members easily identify if they are at risk for a number of common mental health issues, including depression, anxiety and substance abuse.Upgrades to the platform include:
- New features to help plan members better gauge their progress in the assessment.
- A printable Action Plan that plan members can share with their health care provider to initiate conversations about managing their mental health challenges.
- A new “follow-up” module to help plan members assess the care they’ve received from their health care provider and identify care gaps.
- An Assessment Outcome Page, which allows plan members to view their diagnostic risks across mental health disorders for a more holistic picture of their health.
Over-age dependants losing coverage?*
Your clients’ plan members may have dependants approaching the maximum age for eligibility under their group benefits plan. If so, members should be aware of their options for dependant coverage.Coverage for full-time students and dependants with disabilities
The dependants of your clients’ plan members may be eligible to continue their coverage under the current plan if:- The dependant is attending a post-secondary school full-time; or
- The dependant is disabled.
Coverage2go for over-age dependants
Dependants who aren’t eligible for continued coverage under the plan can apply for Coverage2go®, a month-to-month health and dental plan for individuals losing their group coverage.**
Coverage2go is affordable, reliable and allows the over-age dependants to choose the level of coverage and protection that suits their personal situation. With no medical questions required as long as they apply within 60 days of losing their coverage, your clients’ plan members can ensure that their over-age dependants have the coverage they need.
Plan members can receive a quote within minutes. Please direct your clients to Coverage2go on Equitable.ca to learn more.
**Quebec residents are not eligible for Coverage2go.Forfeiture reports for HCSAs and TSAs on EquitableHealth.ca*
As a reminder, your clients can access forfeiture reports for their Health Care Spending Account (HCSA) and Taxable Spending Account (TSA) usage on EquitableHealth.ca.HCSA summary by plan member
HCSA summary reports provide an overview of each plan member’s account activity and balances. These reports include the total amounts allocated, the amount claimed to date, the net balance, and the amount of funds that will be forfeited based on claims paid to date. Please note that plan members’ claim submissions will remain confidential and will not be viewable by the employer on this summary.
Your clients can provide each plan member with their HCSA summary, if they wish.HCSA account forfeiture by plan member
HCSA forfeiture reports detail the amount that each member will forfeit if they do not use it. The amount is based on claims that have been paid to date within the benefit year period.HCSA account totals by plan member
Your clients may wish to access the HCSA account totals reports, which reflect the information in each plan member’s HCSA summary report. For terminated employees, the Funds Available field will display as zero, regardless of the balance in the account when terminated.
At least three months before the end of the benefits period, your clients should remind their members to use their allocated HCSA and TSA amounts.
If your clients need help accessing these reports, they can reach out to their Regional Office Service team for assistance.
* Indicates content that will be shared with your clients.
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Joe Galbraith recognized as Wealth Professional Magazine 2025 5-Star Wholesaler of the Year
Joe Galbraith, Director, Investment Sales at Equitable®, has been named one of Wealth Professional Magazine’s 2025 5-Star wholesalers. This award highlights his significant contributions to the financial services industry. The 50 individuals, chosen from a large pool of nominees, represent some of the best in the wholesaling business.
Encouraged by his wife to pursue his passion for helping people, Joe transitioned into financial services, spending 12 years as an advisor. He began his current role as Director, Investment Sales with Equitable six years ago. Known for his empathetic service mindset, Joe is deeply committed to understanding and addressing the unique needs of everyone he works with. His collaborative approach and knack for problem-solving make him a valued team member.
Joe's recognition as one of Wealth Professional's top 50 wholesalers underscores his commitment to clients and the industry. In response to this recognition, Joe expressed he is “humbled that advisors value our relationship enough to take the time to nominate me for this recognition. Their support and belief in me mean a great deal, and I’m grateful for the trust and collaboration we share.”
Join us in congratulating Joe on this achievement!
Date posted: May 1, 2025