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February 2020 Advisor eNews

In this issue:

Provincial biosimilar update
Legislative changes for Alberta’s Coverage for Seniors program
Coming soon: enhancements to Equitable EZClaim® Online

Provincial biosimilar update

Alberta Biosimilar Initiative

On December 12, 2019, the Alberta government introduced the launch of the Alberta Biosimilar Initiative. This program will require patients using several originator biologic drugs to switch to a biosimilar, and patients using a non-biologic complex drug (NBCD) to switch to its subsequent entry version before July 1, 2020 in order to maintain coverage.

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” drug. Biosimilars 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.

Alberta Health will initially cover both the originator and biosimilar or subsequent entry version of a NBCD drug as patients start the switching process.

The following table outlines the affected originator drugs, their biosimilars or subsequent entry, and the conditions affected by the program.

Biosimilar Drug	Originator	Biosimilar/Subsequent Entry	Indications Affected
etanercept	Enbrel	Brenzys	Ankylosing Spondylitis Rheumatoid Arthritis
etanercept	Enbrel	Erelzi	Ankylosing Spondylitis Psoriatic Arthritis Rheumatoid Arthritis
infliximab	Remicade	Inflectra Renflexis	Ankylosing Spondylitis Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Crohn’s Disease Ulcerative Colitis
insulin glargine	Lantus	Basaglar	Diabetes (Type 1 and 2)
Filgrastim	Neupogen	Grastofil	Neutropenia
pegfilgrastim	Neulasta	Lapelga	Neutropenia
glatiramer*	Copaxone	Glatect	Multiple Sclerosis

*Glatiramer is a non-biologic complex drug where the originator is Copaxone and the subsequent entry is Glatect.

Equitable Life is actively investigating the benefit, risk and appropriate plan changes associated with this new policy on private drug plans and will keep you informed.

For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.

British Columbia

In 2019, BC Pharmacare introduced a Biosimilars Policy that impacted coverage of three biologic drugs – Remicade, Enbrel and Lantus. As of November 25, 2019, these drugs were no longer eligible in BC for most conditions for which lower cost biosimilar versions are available. Patients in the province with these conditions were required to switch to biosimilar versions of these drugs in order to maintain their coverage.

The second phase of the BC Biosimilar Policy takes effect March 6, 2020 when Remicade will be delisted for Crohn’s Disease and Ulcerative Colitis. Patients in the province with these conditions will be required to switch to Inflectra or Renflexis in order to maintain their coverage.

Biosimilar Drug	Originator	Biosimilar	Indications Affected
infliximab	Remicade	Inflectra Renflexis	Crohn’s Disease Ulcerative Colitis

We have communicated with the affected plan members, informing them of the need to switch medications. If plan members have any questions or concerns, our Customer Care team is here to help and support them through the transition.

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

Ontario

In November 2019 Ontario Minister of Health Christine Elliot indicated that the government was planning to launch consultations to explore solutions in managing biologics.

Equitable Life will continue to monitor these developments and keep you informed of any impact on private drug plans.

Legislative changes for Alberta’s Coverage for Seniors program

The government of Alberta has announced that as of March 1, 2020, seniors’ family members (such as spouses and dependents) who are younger than 65 will no longer be covered by the provincial Coverage for Seniors program. Albertans 65 years of age and older will continue to be covered under the provincial plan.

Equitable Life plan members and their dependents will continue to be covered under the parameters of their group benefits plan.

For more information, please see the Alberta Seniors Health Benefits website.

Coming soon: enhancements to Equitable EZClaim^® Online

Faster vision claims processing and payment

Equitable Life will soon provide real-time processing of vision claims submitted via EZClaim Online.

This means plan members will be able to find out the status of their vision 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, the type of expense and amount of the expense when submitting their claims for these services.

Equitable Life plan members can submit all vision claims via EZClaim, including coordination of benefits and Health Care Spending Account claims.

This enhancement will be coming to our EZClaim Mobile app in the coming months.

New printable claims extract

As part of our ongoing efforts to improve customer experience for plan members, we will also offer a claims extract in a printable format within the plan member site. Plan members will be able to select a date range and claimant, then generate and download a detailed list of health and dental claims. This is a helpful way to keep track of claims, especially when reviewing them in preparation for income tax filing.

Once these enhancements are live you will be notified in an eNews, and an announcement will be posted on the plan member section of EquitableHealth.ca.

Elimination of Out-of-Country Travellers Program in Ontario

Effective January 1, 2020, the Ontario government eliminated OHIP coverage for emergency services for Ontarians travelling outside of Canada.

Previously, the Out-of-Country Travelers Program provided some reimbursement for services required to treat conditions that are acute, unexpected, arose outside Canada and require immediate treatment. The program covered between $200 and $400 per day for inpatient services and $50 per day for outpatient and doctor services.

For groups who have out-of-country coverage from Allianz, this change will not impact the cost to your plan members, or the process plan members follow in the event of an emergency while travelling.

Plan members should still call Allianz in the event of an out of country emergency. Allianz will deal with their claim as usual and will now pay for the portion of the claim previously paid by OHIP. Plan members will not have any additional out-of-pocket costs.

We will be sharing this information with plan members as a news item on our plan member website, equitablehealth.ca.

Policy Change and Conversions eDelivery - Quick Tips and Tricks
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Reminder: Deadline to opt out of Alberta biosimilar coverage changes
In November 2020, we announced via eNews that on March 15, 2021, we are changing coverage for some biologic drugs in Alberta in response to the province’s Biosimilar Initiative. These changes will help protect your client’s plans from additional drug costs while still providing access to equally safe and effective biosimilars.

Do my clients need to take any action?

Traditional groups who wish to opt out of this change and maintain coverage of these originator biologics for Alberta plan members can submit a policy amendment. Amendments must be submitted no later than January 15, 2021.

Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Alberta plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.

Otherwise, no action is required on their part. Plan members taking these biologics will be contacted directly to allow them ample time to change their prescription. Any cost savings associated with the change will be factored in at renewal.

Questions?

We have compiled a list of frequently asked questions to help you understand Alberta’s Biosimilar Initiative. If you have a question that isn’t answered here, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.
Saving time with our fully digital group benefits application On May 1, 2023, we are launching Equitable BenefitsApply™, our fully digital group benefits application.

This enhancement to the benefits application process will help both you and your clients save time when applying for an Equitable Life group benefits policy. We designed and developed BenefitsApply with input and feedback from several advisors and clients, who tested the tool for themselves.

In most cases, BenefitsApply will replace our traditional paper implementation process.*

BenefitsApply eliminates the need for clients to complete and sign multiple, lengthy paper forms. Time-saving features for you and your clients include:
- A fully digital online application that you can access wherever and whenever you need it,
- Pre-filled standard fields,
- Only one signature required from plan sponsors,
- A smart application that only includes the sections relevant to the client and the plan design they have chosen, and
- Automatic notifications of any missing fields.
Your Client Relationship Specialist is available to support you, provide a demo and provide training on how to use BenefitsApply.

We will continue improving BenefitsApply’s features based on feedback from the people who use it—you and your clients. We encourage you to share any feedback you have with your Group Account Executive or your Client Relationship Specialist.

*BenefitsApply is currently available for groups with up to four divisions and up to four classes. It is not available for myFlex Benefits plans, or for clients with a customized master application.
Clients could win $5,000 in Equitable’s New Year’s Resolution, New Year’s Contribution Contest!
Equitable® wants to help clients achieve their financial goals in 2024.

Clients could win $5,000 and you could win $1,000 in Equitable’s New Year’s Resolution, New Year’s Contribution Contest.

How it works:
The client makes a contribution between January 1 and February 29, 2024 to one or more of these accounts:
- • First Home Savings Account
- • Registered Retirement Savings Plan
- • Tax-Free Savings Account
If they win, you win! The draw will be held March 20, 2024.

Equitable is dedicated to offering clients the products, the services, and the choices that best suit their needs. We provide multiple sales charge options, three distinct guarantee classes, and a diverse selection of investment funds.

Speak to your Regional Investment Sales Manager to learn more.

Posted: December 14, 2023

® denotes a registered trademark of The Equitable Life Insurance Company of Canada.

Equitable’s New Year’s Resolution, New Year’s Contribution Contest: No purchase necessary. Contest period January 1, 2024, to February 29, 2024.  Enter by making a deposit to an Equitable FHSA, TFSA or RRSP during the contest period or by submitting a no-purchase entry. One prize for a total value of $5,000 CAD to be drawn on March 8, 2024, will be awarded. The servicing advisor for the policy to which the selected entrant made the deposit is also an eligible winner and will receive a $1,000 CAD prize. For example, if an Equitable client is a winner of the $5,000 prize, the client’s servicing advisor wins a $1,000 prize.  Open to legal residents of Canada of the age of majority. Odds of winning depend on number of eligible Entries received during the Contest Period.  For full contest rules, including no-purchase method of entry, see the full contest rules. 
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