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1. Responding to Ontario’s biosimilar switch initiative

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

   Ontario’s provincial biosimilar initiative
   Announced in December 2022, Ontario’s biosimilar switch program ends coverage of eight biologic drugs for Ontario residents covered by the Ontario Drug Benefit (ODB). The transition to biosimilar versions of these drugs began on March 31, 2023. ODB recipients using these drugs will be required to switch to biosimilar versions of these drugs by December 29, 2023, to maintain their provincial coverage

   Equitable Life’s response
   To ensure this provincial change doesn’t result in your clients paying additional and avoidable drug costs, we are changing coverage in Ontario for most biologic drugs included in the provincial initiative.
   
   Beginning October 1, 2023, plan members in Ontario 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. 

   Communicating this change to plan members
   We will inform any affected plan members in early August 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. 

   Will this change impact my clients’ rates?
   Any cost savings associated with the change will be factored in 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 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 Ontario includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
2. [pdf] Application for Fundserv Contract (segregated funds only) - Dealer and Advisor
3. [pdf] Equitable GIF Advisor Guide
4. New web illustration tool for critical illness insurance

   A seamless integration with EZcomplete

   
   At Equitable^®, we’re always looking for new ways to help you manage your business. We are excited to introduce our new web illustration tool for Critical Illness (CI) insurance. 
   
   This simple and intuitive tool integrates with the EZcomplete^® dashboard to create a seamless experience. 
   
   Key features:
   ● Create CI illustrations for clients that easily transition to the application, with most fields auto populated.
   ● Save illustrations on your EZcomplete dashboard. This allows you to return and change or finish the quote at your convenience.
   ● Generate a fully compliant CI illustration PDF without logging into EquiNet^®.
   
   Reminder: You have access to the same web illustration features for term insurance. 
   
   Visit the new web illustration tool here.
   
   
   
   ^® and ^TM denote trademarks of The Equitable Life Insurance Company of Canada.
5. Product at a glance
6. Equitable Life Coronavirus Update – March 13, 2020

   As the coronavirus (COVID-19) continues to spread, it’s important that you, your clients and their plan members have the most up-to-date information. We are providing timely updates on any developments that impact your clients and their plan members or their benefits coverage.

   Please share this information with your clients. You can direct them to EquitableHealth.ca, where we have posted a version of these updates.

   Coronavirus travel coverage*

   For groups with Travel Assist coverage

   The Public Health Agency of Canada has issued several Travel Health Notices advising Canadians to avoid travel to countries and regions where there have been outbreaks of coronavirus (COVID-19).

   A good resource to help your clients and their plan members understand how the spread of the coronavirus may impact their travel plans is the Public Health Agency of Canada’s Coronavirus Travel Advice site. The levels of risk by country and region are regularly updated.

   If your clients’ plan members cannot avoid travelling, Public Health recommends they take steps to prevent illness and seek medical attention if they become sick.

   Where to find the latest information

   The list and level of travel advisories can change at any time. Please check the Government of Canada’s Travel Advisor and Advisory page for the most current information.

   If your clients’ plan members have coronavirus symptoms while travelling, please advise them to contact Travel Assist at the numbers listed below for assistance.

   Advise plan members to call before they travel

   If a plan member is travelling anywhere outside of the province or country and their benefits plan includes Travel Assist, plan administrators should advise them to make sure they’re prepared for a medical emergency by following these steps.

   1. Check the Government of Canada’s Travel Advisor and Advisory page. Note that it is important to click on the country to check whether any specific regions of that country have travel advisories.
   2. If they have questions, they should call Travel Assist before they travel for assistance and benefit information.
   3. Pack their Equitable Life benefits card and provincial health card.
   4. In a medical emergency, call the Travel Assist 24-Hour Hotline:
   • Toll-free Canada/USA: 1.800.321/9998
   • Global call collect: 519.742.3287
   • Allianz Global Assistance ID #9089

   Allianz Global Assistance administers Equitable Life’s Travel Assist benefits. Allianz has an international network of medical facilities, transportation providers, medical correspondents and multilingual administrative agents who aid with medical, legal and most travel-related emergencies 24-hours a day, seven days a week.

   Early prescription refills and drug shortages*

   In response to concerns about COVID-19 TELUS Health, our pharmacy benefits manager, has announced it is maintaining its standard rules for refills of medication. Plan members can refill their medications when at least two-thirds of the last dispensed supply has been used.

   If plan members need more than the maximum supply allowed on their plan, they must pay out-of-pocket for the excess amount. They can then submit a claim to ask for an exception request.

   TELUS is taking this position to help maintain access to medication for all patients. They continue to monitor the situation. We will provide an update if it changes.

   Drug shortages

   TELUS Health monitors for drug shortages and updates their system for any unavailable drugs. This helps to ensure accurate claims payment. If a referenced lowest-cost generic drug is unavailable, claims for drugs in the class will be paid at the next lowest-cost generic alternative available.

   *Indicates content that will be shared with your clients

7. Path to Invest
8. [pdf] First Home Savings Account
9. Submit an Application
10. August 2019 Advisor eNews

    Coming soon:

    Tech updates for plan members

    Technology doesn’t stand still, and neither does your clients' businesses. That’s why we continually invest in technology to make things easier for your clients and their employees.

    Faster claims processing on Equitable EZClaim^® Mobile

    Equitable Life now provides real-time processing of massage therapy, physiotherapy and chiropractor claims submitted via the EZClaim Mobile app.

    That means plan members are able to find out the status of their 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, and the type and amount of the expense, when submitting their claims for these services.

    Equitable Life plan members can submit all types of health and dental claims via EZClaim Mobile, including co-ordination of benefits and Health Care Spending Account claims. Currently, 43% of all claims are submitted through the user-friendly app.

    AS part of our ongoing efforts to improve the mobile claims experience for plan members, we've also added biometric login functionality to allow plan members to sign in to the app using their face or fingerprint. And we've redesigned our landing page on the mobile app to make it easier for plan members to navigate the various features of the app.

    We will be announcing this enhancement to plan members on EquitableHealth.ca

    Introducing InpatProtect:

    Health coverage for employees who are new to Canada

    For a new employee starting to work in Canada, looking after basic health needs can be difficult.

    There’s a waiting period for provincial health coverage, and group benefits plans don’t cover the physician, hospital or emergency services that they or their eligible dependents may need during their initial months in the country. They could end up incurring significant unexpected health expenses.

    That’s why Equitable Life has launched InpatProtect^TM. InpatProtect provides temporary coverage to look after the basic health needs of employees and their eligible dependents during their transition to Canada. Your clients can recruit from outside the country knowing that their employees will have some protection in the event of a medical need, including an emergency.

    For up to 90 days, InpatProtect will cover employees and their eligible dependents for basic services that would normally be reimbursed under provincial health plans, such as:

    • Physician services
      • Prescriptions for medications
      • Diagnosis and treatment for illness or injury
    • Hospital services
      • In-patient services
      • Drugs prescribed and delivered as an inpatient in-hospital
      • Out-patient services
    • Emergency services
      • Ambulance services
    • Emergency dental services

    Contact your Group Marketing Manager or myFlex Sales Manager for more information about this new product from Equitable Life.

    De-listed service providers

    As part of our ongoing initiative to have Group Benefits plans only reimburse eligible claims, we conduct reviews of the billing and administrative practices of service providers, including clinics, facilities and medical suppliers.

    As a result of these reviews we may de-list certain providers.  We will no longer accept, or process claims for services and/or supplies obtained from those providers. The plan member can still choose to obtain services or supplies from these providers, but Equitable Life will not provide reimbursement for the claims.

    Review Equitable Life’s de-listed service providers

    The delisted service provider list is also posted on EquitableHealth.ca for plan members to review to determine if their claim(s) are eligible for reimbursement under their Group Benefits plan.

    For more information about protecting group benefits plans from abuse, check out our articles.

     

     

    ¹ Based on Equitable Life health and dental claims submitted between January 2019 – March 2019
    
    Google Home and Google Assistant are registered trademarks of Google LLC.
    ^® denotes a trademark of The Equitable Life Insurance Company of Canada unless otherwise indicated.