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Equitable Life Group Benefits Bulletin – September 2021
In this issue:
- Right drug, right dose*
- Responding to New Brunswick’s Biosimilar Initiative*
- Helping plan members access our convenient digital options*
- Reminder: Please access forms on EquitableHealth.ca*
- Over-age dependents losing coverage?*
Right drug, right dose
Equitable Life partners with Personalized Prescribing Inc. to help plan members avoid treatment trial and error
Patients suffering from mental health conditions often need to try several medications before they find one that works for them. This is frustrating and can result in negative side-effects, a longer recovery, lost productivity, or a delayed return to work.
To help plan members avoid this treatment trial and error, we have partnered with Personalized Prescribing Inc. to provide easier access to pharmacogenomic testing for plan members with mental health conditions.
Pharmacogenomics 101
Pharmacogenomics is the study of how an individual’s genes influence their response to medications. Pharmacogenomic testing can help determine how compatible a patient’s body may be to a particular drug, and helps their physician prescribe the most appropriate medication. The goal is to ensure the right drug is prescribed to deliver the most positive outcome with the fewest side effects.
Easier access to pharmacogenomic testing
Through our partnership with Personalized Prescribing Inc., any Equitable Life plan member diagnosed with a mental health condition can purchase a pharmacogenomic test for a discounted price of $399 plus HST – a 20% savings.
We are also introducing the option for plan sponsors to add coverage of pharmacogenomic tests provided by Personalized Prescribing Inc. for mental health conditions.
With this coverage, plan members are eligible for pharmacogenomic testing if:- They have been diagnosed with a mental health condition;
- They are currently taking or have stopped taking a medication for a mental health condition that does not work or has side effects; and
- The pharmacogenomic test is conducted by Personalized Prescribing Inc.
Getting a test is easy. The plan member starts by visiting www.personalizedprescribing.com/equitablelife to request a test kit.
Once they receive their test kit from Personalized Prescribing Inc., they simply provide a saliva sample and send it back (postage is pre-paid). Within 7-10 business days, they receive an Rx Report™ that they can share with their doctor. This report includes details to help their doctor prescribe the right drug and the right dose for them.
Benefits for plan members:- The plan member and their physician receive a full report that is easy to understand;
- The report identifies the most compatible medications for the plan member’s condition and the medications to avoid;
- The physician is able to prescribe the most appropriate medication with the fewest side effects; and
- The plan member avoids medication trial and error.
- Pharmacogenomic testing can be an effective prevention strategy to help employees stay healthy and potentially avoid a mental health-related work absence; and
- Employees suffering from mental health conditions may be more productive when they are on the right medication for them.
Responding to New Brunswick’s Biosimilar Initiative
We are changing coverage for some biologic drugs in New Brunswick in response to the province’s Biosimilar Initiative. These changes will help protect your clients from additional drug costs while still providing access to equally safe and effective biosimilars.
What is New Brunswick’s Biosimilar Initiative?
New Brunswick’s Biosimilar Initiative will end provincial coverage of several originator biologic drugs for some or all conditions beginning on December 1, 2021. Patients who are using these drugs for the affected conditions will be required to switch to biosimilar versions of the drugs to maintain coverage under the province’s government drug plan.
What is the impact on private drug plans?
The most significant risk to plan sponsors who maintain coverage of originator biologics is coordination of benefits (CoB) risk. If other insurance carriers follow suit with the province and delist the originator biologics, it could expose a plan that doesn’t delist them to significant coordination of benefits risk.
For example, consider a patient who is covered under two private plans – their employer plan and a spousal plan. If their employer plan was the first payer for the originator biologic but delists the drug, the spousal plan now becomes the first payor. If the spousal plan continues to cover the cost of the originator, it now pays most or all of the cost of the drug.
How is Equitable Life responding?
To protect your clients’ plans from paying additional and avoidable drug costs, we are changing coverage in New Brunswick for most biologic drugs included in the provincial initiative.
Beginning Feb. 1, 2022, plan members in New Brunswick will no longer be eligible for coverage of Humira, Lantus, Humalog and Copaxone 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 those drugs to maintain coverage under their Equitable Life plan.
How will Equitable Life communicate this change to plan members?
We will be communicating with affected claimants in early-December 2021 to allow them ample time to change their prescriptions and avoid any interruptions in their treatment or their coverage.
Can my client maintain coverage of these biologic drugs?
All groups, except myFlex clients, who wish to opt out of this change and maintain coverage of these originator biologics for New Brunswick plan members 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. Their drug plans will continue to cover any additional originator biologics that we subsequently add to the program.
Will this change impact my clients’ rates?
The rate impact of this change and 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.
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 also known as the “originator” biologic. Biosimilars are also biologics. They 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.
Questions?
If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.
Helping plan members access our convenient digital options
Some of your clients’ plan members aren’t benefitting from our secure and convenient digital options to access and use their Group Benefits. They can sign up to submit claims electronically for faster claim payments, get claim payments deposited directly to their bank accounts, easily review their coverage details, quickly access their Group Benefits plan booklet, benefits card and more. We’ve made it easier than ever to sign up, with more resources all conveniently located at Equitable.ca/go/digital.
Your clients’ plan members can visit this link to view:- A brochure with all the high-level instructions they need to get started on EquitableHealth.ca and the EZClaim mobile app
- A full video guide on how to access and navigate EquitableHealth.ca
Reminder: Please access forms on EquitableHealth.ca*
We routinely update our Plan Administrator forms on EquitableHealth.ca based on their feedback and to stay compliant with legal and/or regulatory requirements. If your clients need a form, they should always pull the most recent version from EquitableHealth.ca instead of reusing forms they have saved on their computer. Using an old or outdated form may result in processing delays.
Your clients can access the Plan Administrator forms by following these steps:- Login to EquitableHealth.ca
- Select “Documents”
- Toggle between English and French forms
- Click on the document name to download a PDF copy
Over-age dependents losing coverage?*
Some of your clients’ plan members may have dependents who are reaching the maximum age for eligibility under their group benefits plan.
If they are attending school full-time or are disabled, they may be eligible for continued coverage. Plan members with over-age dependents can simply complete the Application for Coverage of Dependent Child Over Age 21 (Form #441) and submit it through our online document submission tool. They can access the tool by logging into their Group Benefits account at www.equitablehealth.ca and clicking My Resources.
If they are not attending school full-time or disabled, they will no longer be covered under the plan. However, they may be eligible for Coverage2go®. It allows individuals who are losing their group coverage to purchase personal month-to-month health and dental coverage that is affordable, reliable and works like their previous group benefits plan. They can choose the level of coverage and protection that suits their personal situation.
There are no medical questions – they simply need to apply within 60 days of losing their health coverage under their group benefits plan.*
Help your clients’ plan members and their dependents who are losing coverage by letting them know about Coverage2go. They can visit our website to learn more about Coverage2go and to get a quote.
*Quebec residents are not eligible for Coverage2go -
Manage your business virtually with Equitable Life
As an advisor, we know that physical distancing and self-isolation are proving to challenge the business as usual practise. The good news is that Equitable Life® is here to help. Our self-serve and online tools and resources for Savings and Retirement advisors can assist in maintaining a certain degree of daily activity.
Online Banking
Help your clients during this time of isolation and self-distancing by letting them know about banking online. Online banking is an easy and convenient way for your clients to make additional contributions to non-registered savings plans, Tax-Free Savings Accounts or even last-minute contributions to a Retirement Savings Plan.
Deposits will be made according to the instructions on file. Advisors will receive the regular commissions for any deposits made. Please note that all deposits must originate from the policy owner's bank account.
For more information on using online banking including financial institutions currently registered for direct deposit with Equitable Life, click here.
EZcomplete for non face to face
We know that business still needs to happen, even in times of uncertainty. EZcomplete® can help with that. With our non face-to-face functionality, EZcomplete allows you to remotely connect with your clients. Once the online application is complete, EZcomplete sends your client a passcode that gives secure access to review documents and allows your client to provide an electronic signature. You only need to provide your client’s email address.
EZcomplete makes the process of completing non face-to-face applications more convenient and doing business with Equitable Life EZ. For more information on EZcomplete, click here.
Limited Trading Authorization
Need to make some fund adjustments for your client? Limited Trading Authorization (LTA) is built into the Pivotal SelectTM and Guaranteed Interest Account applications to simplify the process of submitting client requests. Alternatively, the Limited Trading Authorization Form # 14 can be completed. Discretionary trading is not permitted. The advisor must have documented the client’s instructions in the client file. To learn more, click here.
Client Access
Does your client need to make changes to a pre-authorized deposit or beneficiary information, address or banking information? Does your client have a Client Access® account? Client Access is Equitable’s secure online client site that connects clients to tools and policy information. To create a new Equitable Client Access account, your client will need to reference the policy number(s). By registering for Equitable Client Access, policyholders and annuitants can make changes and view information such as:
Details of investment holdings including:-
Up-to-date market value of investments;
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Guaranteed Interest Account (GIA) maturity dates and values;
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Premium amounts, death and maturity guarantees and beneficiary information; and
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Recent account activity.
Details of Payout Annuities including:
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Next payment date;
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Annual income and payment guarantee details; and
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Beneficiary and Annuitant information.
There is also a secure inbox where copies of statements and other correspondence are available. To learn more, click here.
Need help with any of these resources? Contact our Advisor Services team Monday to Friday 8:30 a.m. – 7:30 p.m. ET at 1.866.884.7427 or email savingsretirement@equitable.ca, or your local Regional Investment Sales Manager. -
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NEW MARKETING MATERIAL! Flexibility for supplemental income with Equimax
Equitable has created a new piece to help you understand our new Equimax® illustration feature, Paid-Up Additions (PUA) to Cash Dividends, now available!
Did you know Equimax clients can switch from the PUA dividend option to the cash dividend option by simply requesting a dividend option change?1,2
You can illustrate this for paid-up 10 pay and 20 pay Equimax plans! Show clients how they can build in added flexibility and use their policy to create a source of future supplemental income by simply changing the dividend option to cash.3
Illustration Considerations:
● Works with Equimax Estate Builder® or Equimax Wealth Accumulator®.
● Illustrate the Excelerator Deposit Option (EDO) to help build the policy values while the PUA dividend option is in effect. EDO payments can’t be made once the policy is switched to the cash dividend option.
● If a client needs temporary insurance coverage – like mortgage protection - illustrate term riders for how long they are needed to meet the specific goal.3
● If critical illness coverage is needed our competitively priced 20 pay critical illness riders are a great fit to provide paid-up critical illness coverage.3
Clients should apply for the coverage they need. This concept is about flexibility to create a future source of supplemental income.
Want to learn more? Check out our new marketing piece: Flexibility for supplemental income with Equimax (2077).
For more information, reach out to your local wholesaler.
® and TM denote trademarks of The Equitable Life Insurance Company of Canada.
1 Dividends are not guaranteed and are paid at the sole discretion of the Board of Directors. Dividends may be subject to taxation. Dividends will vary based on the actual investment returns in the participating account as well as mortality, expenses, lapse, claims experience, taxes, and other experience of the participating block of policies.
2 To request a change to the dividend option complete and submit form 558 (Request for Withdrawal of Dividends, Change in Option, or Premium Offset). A client can request a change to the cash dividend option from any other dividend option regardless of the premium type or whether premiums continue to be payable, subject to our current administration rules and guidelines. Some dividend option changes are subject to underwriting. Underwriting is not required to change from the PUA to cash dividend option, however, underwriting is required to change from the cash dividend option to the PUA dividend option.
3 This concept is intended to illustrate a one-time switch to cash dividends once premiums are no longer payable for the policy (including premiums for riders). Premiums are paid with after-tax dollars and dividends paid in cash are subject to taxation. If premiums are payable there will be tax savings for the client to use the before-tax cash dividend to reduce the premium instead of taking it entirely as a cash payment. This concept is intended for longer term planning, not to meet short term cash needs by switching back and forth between the PUA and cash options. Clients should consider a policy loan or a cash withdrawal to meet short-term cash needs; policy loans and cash withdrawals may be subject to taxation.
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