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Equitable Life Group Benefits Bulletin - September 2022
Homewood Health launches Sentio, an upgraded iCBT platform
Equitable Life’s mental health partner, Homewood Health, has launched Sentio, an upgraded platform for Internet-based cognitive behavioural therapy (iCBT). This self-directed platform is now available to all Equitable Life clients, and it replaces Homewood’s previous iCBT platform, i-Volve.
Sentio Self-Directed iCBT is a comprehensive digital cognitive behavioural therapy platform. Developed by Homewood’s mental health experts, it is an action-oriented solution for plan members, giving them practical resources and activities to help with their depression, anxiety and overall mental health challenges.
Available as a standalone app, on mobile, tablet and desktop, Sentio contains over 20 unique treatment goals for issues like stress management, improving sleep, managing depressive thoughts, and coping with panic. Users can work through treatment goals in any order, at their own pace. It also includes tools and resources to help plan members build skills and change their thought patterns.Sentio iCBT benefits
Sentio integrates seamlessly with Homewood Pathfinder so that users can easily locate and take advantage of the iCBT activities available. Sentio also includes a number of unique features:- More interactive features and activities to help plan members build valuable mental health skills
- Integrated symptom measurement and progress tracking
- Interactive multimedia learning and cognitive exercises to enhance learning
- Progress, learnings, and exercises that have been accessed are available to be re-accessed for 12 months
Please contact your Group Account Executive or myFlex Sales Manager if you have any questions.
Streamlining disability claims with Opifiny
Equitable Life is partnering with Opifiny to provide a quicker and more seamless disability claims experience.
Opifiny is an online platform that streamlines the disability claims process for consulting physicians, benefits plan sponsors, and disability plan members. Equitable Life will be using Opifiny for ongoing disability claims management, modernizing the process of gathering medical assessments and information.
Disability claims frequently involve several instances of correspondence between Equitable Life and the plan member’s medical team. By using the secure platform, health care professionals can access, respond to and process medical insurance requests easily from any device. They can typically complete administrative tasks associated with disability claims in a quarter of the time. The platform is secure and protects the privacy of their patients’ confidential information.
By digitizing and modernizing the claims management process for doctors, Equitable Life will have faster access to higher quality claims information. For some claims, using Opifiny may enable Equitable Life to help plan members safely return to work sooner.
Reminder: Obtaining plan member signatures on all administration forms
Please remind your clients that plan members must sign all administration forms, including enrolment forms, benefits change forms, and beneficiary designation forms. Once completed, a plan administrator can keep the form or send it to us. We are not able to accept a beneficiary designation that has not been signed by the plan member. Having appropriately signed forms helps to ensure that any life insurance claims are paid to the intended recipients.
For your clients’ convenience, forms can be signed electronically using one of our approved vendors, which include DocuSign, BambooHR, Adobe Sign, and many more.
If you have questions about providing signed forms, please contact your Group Account Executive or myFlex Sales Manager.
Correction: Coverage for full-time students and dependents with disabilities
In our August edition of eNews, we provided incorrect information about benefits coverage options for over-age dependents. We indicated that over-age dependents who are full-time students may continue to be eligible under the plan member’s benefits plan if they are studying in their home province. However, attending a post-secondary institution in their home province is not a requirement for continued eligibility. Dependents who are full-time students may continue to be eligible for coverage regardless of where in Canada they are attending post-secondary education.
If your clients have any questions about extending coverage for over-age dependents that are full-time students, please notify them of this error.
We apologize for any inconvenience or confusion this may have caused.
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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 InpatProtectTM. 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
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® denotes a trademark of The Equitable Life Insurance Company of Canada unless otherwise indicated. - Physician services
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Announcing Equitable Life's National Biosimilar Program
Beginning March 1, 2024, we are expanding our biosimilar switch program nationally** to protect all our clients and to make our coverage consistent across Canada.
Our national biosimilar initiative will simplify drug plan coverage, replacing our provincial programs with one program across the country.
Why now?
Over the past few years, most provinces have introduced policies to delist some originator biologic drugs. They require most patients to switch to biosimilar versions of those drugs to be eligible for coverage under their public drug plans. Soon, it is expected that all provincial drug plans will cover only biosimilars.
In response, we have implemented biosimilar switch initiatives in BC, Alberta, Saskatchewan, Ontario, Quebec, New Brunswick and Nova Scotia to align with these provincial changes. Our initiatives are designed to protect our clients from additional drug costs that may result from these government policies while providing access to equally safe and effective lower cost biosimilars.
How will this affect clients’ drug plans?
Because we have already introduced biosimilar switch initiatives in most provinces, the impact of this change will be minimal. It will primarily affect plan members in provinces or territories where we haven’t already required the switch to biosimilars, and plan members who are taking biosimilars that were not originally included in the switch initiative for their province.
Regardless of where they live, plan members across Canada 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. Plan members already taking the originator biologic will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable plan. We will support their transition with education, personalized communication, and resources.
Will this change affect clients' rates?
Any cost savings associated with the change will be factored in at renewal.
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.
What is the difference between biologics and biosimilars?
Advance notice
We will be communicating with affected claimants in early December to allow them 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 Account Executive.
**Excludes plan members in Quebec who participate in a separate provincial program. - [pdf] Build Your Business - Fully funding a client’s First Home Savings Account
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