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  1. [pdf] FHSA to RSP/RIF Conversion
  2. Equitable Life Group Benefits Bulletin – December 2021 In this issue: *Indicates content that will be shared with your clients

    Supporting plan members affected by the flooding in Nova Scotia and Newfoundland*

    The recent flooding in Nova Scotia and Newfoundland is having a devastating impact on the province’s residents.

    Here are some of the ways we can help support your clients’ plan members who are affected by the flooding.
     
    Prescription refills
    Until Dec. 31, our pharmacy benefit manager, TELUS Health, will allow early refills for plan members who have been evacuated and/or lost their medication due to the flooding.
     
    Replacement of medical or dental equipment and appliances
    If plan members in Nova Scotia or Newfoundland need to replace any eligible medical or dental equipment or appliances (e.g. prescription eyeglasses, dentures, etc.) due to the flooding, they can call us at 1.800.265.4556 before incurring additional expenses to see how we can support them.

    Disability or other benfit cheques
    If plan members affected by the flooding are receiving disability benefits or other benefit reimbursements by cheque, they can visit www.equitable.ca/go/digital for easy instructions on how to sign up for direct deposit. It’s easy and takes just a few minutes. They can call us at 1.800.265.4556 if they need help. We can also arrange for a different mailing address or replacement cheques if necessary.
     
    Mental Health Support
    A natural disaster can also take a serious toll on people’s mental health. All of our plan members have access to the Homeweb online portal and mobile app, including numerous articles, tools and resources designed to provide guidance and support in difficult times. Homewood has put together some suggestions on how to help employees affected by a natural disaster. 
     
    For your clients with an Employee and Family Assistance Program, remind them that their plan members have 24/7 access to confidential counselling through a national network of mental health professionals. Whether it’s face-to-face, by phone, email, chat or video, plan members will receive the most appropriate, most timely support for the issue they’re dealing with.
     
    If a client wishes to add the EFAP to their plan, we can do this quickly – often in just a few days. Simply contact your Group Account Executive or myFlex Sales Manager.
     
    Plan Administrator support
    We realize that the flooding may also be having an impact on the regular business operations of your clients in Nova Scotia and Newfoundland. If any of your clients are unable to carry out day-to-day plan administration, they can call us at 1.800.265.4556 to see how we can support them.
     
    We know this is a challenging time for many of your clients and their plan members. We will continue to monitor the situation and provide additional updates as appropriate. 
     

    Update: Changing certificate numbers on EquitableHealth.ca*

    Effective Dec. 10th, plan administrators will no longer be able to update or change plan members’ certificate numbers on EquitableHealth.ca. This change will ensure we can manage these changes more effectively to provide a smoother plan member experience.
     
    If your clients need to update a plan member’s certificate number, please have them reach out to Group Benefits Administration for assistance at groupbenefitsadmin@equitable.ca.
     

    Help plan members take advantage of convenient digital options*

    We have several digital options available to make it easier for your clients to do business with us and for their plan members to access and use their benefits plan.
     
    To help build awareness among plan members, we’ve created two posters that your clients can post on their intranet sites or in their office. The posters provide easy instructions on how to activate our secure, digital options.
     
    Please click on the links below to download the posters.
     
    EquitableHealth.ca posters:                                         EZClaim mobile app posters:
    EquitableHealth.ca English                                             EZClaim mobile app English poster                   
    EquitableHealth.ca French poster                                  EZClaim mobile app French poster
     

    Ontario optometrists and government to restart negotiations*

    The Ontario Association of Optometrists (OAO) announced it has paused its job action and will restart negotiations with the Ontario Ministry of Health on funding for optometry services.
     
    In September, Ontario optometrists began withholding services from patients covered by OHIP, including children, senior citizens and other patients with certain medical conditions, after negotiations with the Ministry of Health over compensation broke down.
     
    Residents of Ontario between the ages of 20 to 64 who aren’t eligible for coverage of eye services under OHIP were not affected by the job action. They were able to continue to receive eye exams from their optometrist and submit eligible claims to their benefits plan.
     

    QDIPC updates terms and conditions for 2022*

    Every year, the Quebec Drug Insurance Pooling Corporation (QDIPC) reviews the terms and conditions for the high-cost pooling system in the province. Based on its latest review, QDIPC is revising its pooling levels and fees for 2022 to reflect trends in the volume of claims submitted to the pool, particularly catastrophic claims.
     
    Size of group (# of certificates) Threshold per certificate 2022 Annual factor (without dependents Annual factor (with dependents)
    Fewer than 25 $8,000 $276.00 $771.00
    25 – 49 $16,500 $188.00 $527.00
    50 – 124 $32,500 $97.00 $328.00
    125 – 249 $55,000 $66.00 $223.00
    250 – 499 $80,000 $51.00 $173.00
    500 – 999 $105,000 $39.00 $153.00
    1,000 – 3,999 $130,000 $34.00 $133.00
    4,000 – 5,999 $300,000 $18.00 $71.00
    6,000 and over Free market – Groups not subject to Quebec Industry Pooling
     
    We will apply the new pooling levels and fees to future renewal calculations that involve Quebec plan members.
  3. Equitable Life Group Benefits Bulletin – November 2021 In this issue: *Indicates content that will be shared with your clients

    Reminder: Deadline to opt out of New Brunswick biosimilar program*

    Earlier this year, we announced via eNews that on Feb. 1, 2022, we are ending coverage for some originator biologic drugs in New Brunswick in response to the province’s Biosimilar Initiative.* These changes will help protect your clients’ plans from additional drug costs while still providing access to equally safe and effective biosimilars.
     
    Do my clients need to take any action?
    No action is required if employers want to have the originator biologics excluded from their plan. Plan members taking these targeted originator biologics will be contacted directly to allow them ample time to transition to the biosimilar. Any cost savings associated with the change will be factored in at renewal.
     
    All groups, except myFlex clients, who wish to opt out of this change and maintain coverage of these originator biologics for existing claimants in New Brunswick can submit a policy amendment. Amendments must be submitted no later than Nov. 30, 2021.
     
    Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for New Brunswick plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.
     
    Groups that opt out of this change are also opting out of any future changes to our New Brunswick biosimilar initiative. This means that their drug plans will continue to cover any additional originator biologics for which we subsequently end coverage as part of the biosimilar program.
     
    Questions?
    If you have a question that isn’t answered here, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.
     
    * The list of affected drugs or conditions is dynamic and may change.

    Web Reports Quick Reference Guide now available for plan administrators

    A Web Reports Quick Reference Guide is now available for plan administrators on EquitableHealth.ca. This new guide offers a listing of our newest reports available on the plan administrator web. It also provides instructions for plan administrators outlining how to pull the report using the plan administrator portal.
     
    The guide is available under the Quick Links section on both the advisor and plan administrator portals on EquitableHealth.ca.

    Reminder: Review manual allocations for HCSAs and/or TSAs*

    If your client’s Health Care Spending Account (HCSA) and/or Taxable Spending Account (TSA) has manual allocations, they need to allocate these amounts to plan members each year. Please review all your plan members’ profiles on EquitableHealth.ca to ensure they have received their allocation(s) for the current benefit year.
     
    If your clients have Plan Administrator update access on EquitableHealth.ca, they can update these amounts online by doing the following:
    • Select “View certificate”
    • Select “Health Care Spending Account” or “Taxable Spending Account”
    • Select “Update Allocation” in Task Center
    • Enter amount in “Revised Allocation Amount”
    • Override Reason – “Plan Administrator Request”
    • Select “Save”
    If your clients have Plan Administrator reporting access on EquitableHealth.ca, they can determine which plan members have a zero allocation by running the “HCSA Totals by Plan Member” report online by doing the following:
    • Select “Reports”
    • Select “New”
    • Select “Next”
    • Select “HCSA” or “TSA Totals by Plan Member”
    • Select “Next”
    • Enter end date of “12/31/2020”
    • Select “Next”
    • Select “Finish”
    • View “Report”
    To provide us with the amounts to be updated, please have your client contact our Group Benefits Administration Team at GroupBenefitsAdmin@equitable.ca.

    Help your clients take advantage of our convenient digital options*

    We have several digital options available to make it easier for your clients to do business with us and for their plan members to access and use their benefits plan. Over 71% of plan administrators are managing their plan online and 78% of plan members are already using our digital tools.
     
    For plan administrators:
    • Online Plan Member Enrolment tool – allows all groups to add new plan members without the need for paper forms
    • Plan Administrator Portal (EquitableHealth.ca) – plan administrators can easily manage their plan anytime and anywhere
    • Digital Welcome Kits – personalized welcome kits are delivered to plan members via email
    • Easy automated payments – plan administrators can avoid missed payments by setting up pre-authorized debit or electronic funds transfer
    For plan members:
    • Plan Member Portal (EquitableHealth.ca) – plan members get secure, 24/7 access to their claims history, coverage details and health and wellness resources
    • Electronic Claim Payments and Notifications – plan members can get claim updates sooner in their email inbox and payments right into their bank account
    • EZClaim Mobile App – submitting claims from a mobile device is fast, easy and secure
    • Digital Benefits Cards – plan members no longer have to dig through their wallet – they can download their benefits card on their mobile device
    We can help
    We’ve created a brochure and a video guide to help plan members access and use their digital resources. For further assistance, plan members can visit www.equitable.ca/go/digital. They can also contact our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca.
  4. [pdf] How to access in-force illustrations
  5. Compliance Resources
  6. February 2023 eNews

    Responding to Nova Scotia’s biosimilar switch initiative

    We are changing coverage for some biologic drugs in Nova Scotia 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 new government policy while providing access to equally safe and effective lower-cost biosimilars. 

    Nova Scotia’s provincial biosimilar initiative

    Announced in February 2022, the Nova Scotia Biosimilar Initiative ends coverage of seven biologic drugs for residents enrolled in Pharmacare programs.

    Pharmacare patients in the province using these drugs will be required to switch to biosimilar versions of these drugs by February 3, 2023, in order to maintain their Nova Scotia Pharmacare coverage. 

    Equitable Life’s response

    To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Nova Scotia for most biologic drugs included in the provincial initiative.

    Beginning June 1, 2023, plan members in the province 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.  

    Can my client maintain coverage of these biologic drugs?

    Traditional groups who wish to opt out of this change and maintain coverage of these originator biologics for Nova Scotia plan members can submit a policy amendment. Amendments must be submitted no later than April 1, 2023. Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Nova Scotia plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.

    Groups that choose to maintain coverage of these originator biologics for existing claimants will also maintain coverage for any originator biologics that we subsequently add to our Nova Scotia biosimilar initiative.  

    Will this change impact my clients’ rates?

    The rate impact of this change in coverage will be relatively insignificant. Any cost savings associated with the change will be factored in at renewal.

    If plan sponsors opt out of these changes and maintain coverage for the originator biologics, it may result in a rate increase. Any rate adjustment will be applied at renewal.

    Communicating this change to plan members

    We will inform any affected plan members in April 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. 

    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 conditions. 

    Questions?

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

    **The list of affected drugs is dynamic and will change as Nova Scotia includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
     

    Changes to New Brunswick drug interchangeability rules

    We are introducing changes to help ensure that your clients with voluntary or mandatory generic pricing for their drug plans will benefit more from the cost savings of these two features, regardless of the province where the drugs are dispensed.

    Currently, when determining whether a lower-cost alternative is available for a brand-name drug, most insurers only consider drugs that the provincial drug plan identifies as interchangeable.

    However, the public drug plan in New Brunswick does not identify a drug as interchangeable if the drug is not listed on its formulary – even if Health Canada has deemed the drug interchangeable.

    As a result, plans with mandatory or voluntary generic pricing have continued to reimburse some drugs in New Brunswick based on the cost of the brand-name drug, even if a lower-cost generic alternative is available.

    Effective March 20, 2023, if your clients have drug plans with mandatory or voluntary generic pricing, we will adjudicate any drug claims in New Brunswick using the lowest cost alternative that Health Canada approves as bioequivalent. This will occur even if the public drug plan has not identified the drug as interchangeable.

    To benefit from this more robust drug plan control, plan sponsors must have mandatory or voluntary generic pricing in place.

    For more information about this change or about implementing mandatory or voluntary generic pricing for your clients, please contact your Group Account Executive or myFlex Sales Manager.
     

    New template: plan members eligible for additional coverage

    Often, based on salary, some plan members may become eligible to apply for extra Life, Accidental Death & Dismemberment (AD&D), Short Term Disability or Long Term Disability coverage. If this occurs, your clients receive a notification from Group Benefits Administration. We have now developed a template that your clients can provide to applicable plan members if they become eligible for extra coverage. The template makes it simpler for your clients to pass on these details to their plan members efficiently.

    The new template is available for download under the Quick Links section of EquitableHealth.ca. It is a fillable PDF form that your clients can complete and provide to their plan members when necessary. The document is called Over the Non-Evidence Limit for Plan Members Notification.

    If you have any questions about the template, please contact your Group Account Executive or myFlex Sales Manager.
  7. [pdf] B2B Investment Loan Application Process
  8. Individual Insurance
  9. Equimax Estate Builder® reprice
  10. Additions and Increases