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Responding to Alberta's Biosimilar Initiative

Beginning 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 clients from additional drug costs that may result from this new government policy while still providing access to equally safe and effective biosimilars.

What is Alberta’s Biosimilar Initiative?

Alberta’s Biosimilar Initiative will end provincial coverage of several originator biologic drugs for some or all conditions beginning on Jan. 15, 2021. Patients 18 and over 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?

Industry response to Alberta’s Biosimilar Initiative has the potential to significantly impact your clients’ drug plan costs. 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. (See Case Study below.)

How is Equitable Life responding?

To protect your clients’ plans from paying additional and avoidable drug costs, we are changing coverage in Alberta for most biologic drugs included in the provincial initiative.

As of March 15, 2021, several originator biologic drugs will no longer be covered for plan members of all ages in Alberta. Plan members taking these biologics will be required to switch to the biosimilar versions of these drugs to maintain eligibility under their Equitable Life plan.

What drugs and conditions are affected?

The following table outlines the drugs and conditions that will be affected by this change. The list of affected drugs or conditions is dynamic and will change as Alberta includes more biologic drugs in its Biosimilar Initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.

Drug name	Originator biologic These drugs will no longer be covered in Alberta for the conditions listed in this table.	Biosimilar Plan members will need to switch to these medications to maintain coverage under their Equitable Life plan.	Affected health conditions The changes in coverage apply to these conditions.
Etanercept	Enbrel	Brenzys Erelzi	Ankylosing Spondylitis Rheumatoid Arthritis Polyarticular juvenile idiopathic arthritis (JIA) Psoriatic Arthritis Plaque Psoriasis (adults and children)
Infliximab	Remicade	Inflectra Renflexis Avsola	Ankylosing Spondylitis Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Crohn's Disease (adults and children) Ulcerative Colitis (adults and children)
Insulin glargine	Lantus	Basaglar	Diabetes (Type 1 and 2)
Filgrastim	Neupogen	Grastofil Nivestym	Neutropenia
Pegfilgrastim	Neulasta	Lapelga Fulphila Ziextenzo	Neutropenia
Glatiramer*	Copaxone	Glatect TEVA-Glatiramer Acetate	Multiple Sclerosis

*Glatiramer is a non-biologic complex drug.

How will Equitable Life communicate this change to plan members?

We will be communicating with affected claimants in January 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?

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.

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.

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.

CASE STUDY: The Alberta Biosimilar Initiative and Coordination of Benefits (CoB) risk

CoB risk is real and can be significant, even if a pharmaceutical savings program exists.

The industry response to Alberta’s Biosimilar Initiative has the potential to significantly impact your clients’ drug plan costs. Some insurers may follow the province’s lead and delist these originator biologics. Others may cut back coverage to the cost of the biosimilars or maintain coverage of the originators. These differences could expose a plan that doesn’t delist the originator biologics to significant coordination of benefits risk. Here’s how:

Let’s assume there are two private drug plans – Plan A and Plan B. Both plans are open plans with no deductible. Plan A has 80% co-insurance and Plan B has 100% co-insurance.

BEFORE Alberta’s Biosimilar Initiative

Before Alberta’s Biosimilar Initiative, both plans cover the originator biologics listed above.

Plan A is the first private payer for an Alberta plan member taking an originator biologic drug for Rheumatoid Arthritis. Plan B is the second private payer. The cost of the originator biologic for the plan member is $30,000 annually. Here’s how the coordination of benefits would look before Alberta’s Biosimilar Initiative.

AFTER Alberta’s Biosimilar Initiative

In response to Alberta’s Biosimilar Initiative, the insurer for Plan A delists the originator biologic and requires plan members to switch to the biosimilar. The insurer for Plan B maintains coverage of the originator biologic. Under this scenario, if the plan member doesn’t switch, Plan B essentially becomes the first payer and sees their annual cost increase by 400% (from $6,000 to $30,000).

Even if the insurer for Plan B cuts back coverage to the cost of the biosimilar or adjusts the paid amount because they have a savings program in place with the drug manufacturer, the impact could be significant. For example, if the insurer cuts back coverage to 50% (or $15,000 annually), Plan B would see a 150% annual cost increase (from $6,000 to $15,000):

Get Client Focused: Turning Compliance into Your Advantage
Join Equitable Life and guest speaker, April-Lynn Levitt, CFP, Business Coach, The Personal Coach, to learn how to be compliant in today’s environment and create client-focused review meetings:

• Understand the new requirements and the best practices for implementing the new requirements into your practice.

• Go beyond “ticking the boxes” to build an exceptional client experience.

• Learn to use your review process to stimulate referrals and update compliance documents seamlessly.

We are pleased to provide you with a recorded version of April-Lynn Levitt’s presentation, “Get Client Focused: Turning Compliance into Your Advantage” click here

This webinar is available in English only.
® denote trademarks of The Equitable Life Insurance Company of Canada.

Posted June 6, 2023
On June 26, 2021 make room for more EDO room Effective June 26, 2021, a term rider added to an Equimax Estate Builder® or Equimax Wealth Accumulator® policy may allow for an increase to the maximum Excelerator Deposit Option (EDO) payment limit.

Your clients who have a temporary insurance need and add a term rider to their Equimax plan may be able to take advantage of the additional exempt room and higher EDO payment limits to build the policy values. Make Equimax® your first choice for your clients’ whole life insurance needs.

Want more information?
Learn more about the changes and transition rules.

Contact your Regional Sales Manager for more information on these changes and other sales ideas.
EAMG Market Commentary July 2023

July 17, 2023

Rates & Credit - The rates market was volatile in Q2 as investors focused on inflation, central bank interest rate decisions, and recession probabilities. Persistent strength in U.S. consumer spending and labour markets have surprised investors and prompted further interest rate tightening from central banks. In Canada, corporate bonds outperformed government bonds and the broader FTSE Canada Universe Index during the quarter, with a total return of 0.2%, versus a loss of 1.0% for government bonds and 0.7% for the overall Index. The corporate bond outperformance was driven by a broad risk-on tone to the market, most notably in April as the market recovered from the banking sector liquidity crisis that developed during March. That said, the market tone remained cautious, with the improved risk premium on corporate bonds tempered by lingering concerns around sticky inflation, high interest rates, and the potential for slower economic growth into the latter half of the year.

Dominance of U.S. Equities – U.S. equity markets posted another strong quarter with the S&P 500 returning 8.7%, outperforming Canada and other major international equity markets. The S&P/TSX Composite, returned 1.2% in CAD. Major developed economies from Europe, Australasia, and Far East (EAFE) returned 3.2% in local currency terms. The highly anticipated re-opening of the Chinese economy has failed to materialize with economic data indicating less strength than previously forecasted. Amid sluggish Chinese growth, closely interconnected economic partners such as the European Union, as well as commodity-driven markets like Canada, have all underperformed the U.S. on a relative basis.

U.S. Fundamentals – Earnings continued to contract versus prior year, albeit at a slower pace than forecasted. Forward earnings guidance improved quarter-over-quarter with corporate sentiment returning to neutral levels. Based on our analysis, we observed that 31% of major companies expect deteriorating financial performance, while 33% expect improved performance, with the remaining expecting no material change. Overall, major U.S. companies remain well capitalized with strong operating margins. However, company guidance indicates a prioritization of cost controls amid increased consumer indebtedness and concerns about the health of the consumer.

Artificial Intelligence (AI) Mania – Despite concerns that the U.S. economy is at a late stage in its economic cycle, that monetary tightening by central banks could go too far, and the fact that earnings contracted on a year-over-year basis, equity markets became more expensive during the quarter with price-to-earnings multiples expanding. This expansion was driven by investors crowding into AI focused technology companies, with the seven largest AI/technology themed companies averaging a 26% return while the other 493 members gained only 3%. Investors rewarded businesses with contributions to AI development (hardware and software components), as well as those with the ability to implement synergies from leveraging the technology. A crowded market surge is not uncommon at this point in the economic cycle, where positive economic surprises, in this instance, strong employment and consumer spending can lead to an upswelling in investor confidence.

U.S. Quant Factors – Using our investment framework, we currently favour exposures to large cash-rich companies with innovative product offerings, which we believe offer the strongest risk-adjusted returns in the current market environment. While the valuation of AI companies seems to defy traditional rationales, the momentum has continued to push the group higher. Consequently, the Quality factor (companies with higher return-on-equity, strong operating performance, and healthy leverage levels) participated in the AI trend and consistently outperformed throughout the quarter. The Low Volatility factor (stocks with lower sensitivity to broad market movement, and lower price volatility) underperformed through the quarter. While the Low Volatility factor typically performs well at this stage of the economic cycle, the fact that a small number of stocks were responsible for much of the market’s return hurt this factor. Lastly, the Momentum factor (stocks with a recent history of price appreciation) initially underperformed during the quarter before rebounding in June. This factor’s recent outperformance suggests that the market is becoming complacent and possibly signals that rotations within the market are slowing as current trends remain in favour.

Canadian Fundamentals – Top line revenue missed forecasts while bottom line earnings were consistent with expectations. Softer-than-expected results out of Canadian financials, as well as underwhelming results from the materials sector, dragged on the aggregate index performance. Earnings forecasts for the rest of the year have been revised downward with analyst expecting index aggregate earnings to detract 2% to 3%. Meanwhile, the Bank of Canada raised its overnight interest rate by 25 basis points, bringing it to 4.75% on the backdrop of robust economic data releases including Q1 GDP and April CPI.

Canadian Quant Factors – The most notable dislocation in Canada was the convergence of the dividend yield of High-Dividend ETFs and Equal-Weight Bank ETFs. We believe that the drag from Canadian banks following the U.S. regional banking concerns in March resulted in a discount of the Quality factor as the performance of the group is sensitive to the movements of banks. While banks did recover around 35% of their SVB-induced underperformance, the nature of banking has attracted investor scrutiny given the view that we are in the late-stage of the economic cycle. That said, this environment is an attractive environment to add variants of the Quality factor, which would gain exposure to a rebounding industry that offers a similar dividend yield to the high dividend stocks.

Views From the Frontline

Rates – On an outright basis, bond yields across the curve continue to look attractive. Economic data remains strong however we are beginning to see the first signs of weakness in spending, jobs and inflation. Slower growth, a more balanced labour market, declining inflation, and tighter credit conditions will likely drive interest rates lower throughout 2023. Market participants remain focused on the extent of interest rate hikes and the duration of a pause required to bring inflation back to the 2% target. With inflation remaining more persistent than previously expected forecasts around the timing, pace and extent of the removal of monetary policy have been pushed into 2024.

Credit – The uncertain economic outlook and risks around slower economic growth later this year merit caution about corporate bonds and a bias towards higher-quality, shorter-dated credit where we think the risk / reward dynamic are more favourable. That said, the “soft-landing” narrative, now more pervasive in the market, could continue to provide support to risk assets, which we view as an opportunity to further pare down higher beta exposure.

Equities – Given the direction of the current economic and company fundamental data, we continue to favour high quality growth segments of the market with strong operating margins. As such, the late cycle conditions in the market reinforce our preference for large cap stocks over smaller, more U.S. domestically focused businesses. The U.S. Low Volatility factor’s underperformance is unlikely to reverse in the short term given the resilience of the U.S. economy. Furthermore, after a steep decline last quarter, we expect that cyclical value will find support in the near term, echoing the increased chance of slowing inflation without stalling economic growth. In Canada, equities are typically more cyclical in nature, which coupled with the potential for an earnings contraction, makes us view the Low Volatility factor as more likely to outperform. Like the U.S., we prefer Canadian high-quality companies to navigate through the late cycle environment. On the heels of poor Chinese economic data and underwhelming stimulus, we are maintaining our overweight to the U.S. relative to Canada and EAFE.

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ADVISOR USE ONLY
Any statements contained herein that are not based on historical fact are forward-looking statements. Any forward-looking statements represent the portfolio manager’s best judgment as of the present date as to what may occur in the future. However, forward-looking statements are subject to many risks, uncertainties and assumptions, and are based on the portfolio manager’s present opinions and views. For this reason, the actual outcome of the events or results predicted may differ materially from what is expressed. Furthermore, the portfolio manager’s views, opinions or assumptions may subsequently change based on previously unknown information, or for other reasons. Equitable Life of Canada® assumes no obligation to update any forward-looking information contained herein. The reader is cautioned to consider these and other factors carefully and not to place undue reliance on forward-looking statements. Investments may increase or decrease in value and are invested at the risk of the investor. Investment values change frequently, and past performance does not guarantee future results. Professional advice should be sought before an investor embarks on any investment strategy.
Posted July 27, 2023
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New Dividend Scale Effective July 1, 2023! Equitable Life’s Board of Directors has approved a change to the dividend scale* for the period July 1, 2023, to June 30, 2024.

- The interest rate we use for the dividend scale will go from 6.05% to 6.25% on July 1, 2023.
- Other factors used to decide the dividend scale will stay the same.
- The interest rate for participating whole life policies with dividends on deposit will stay the same at 2.25%.
- The policy loan interest rate** will go from 6.20% to 6.50% on June 30, 2023

More good news!
Once the next dividend scale year starts, we expect policyholder dividends to be close to $105 million until the end of June 2024.

Learn more
- Advisor Dividend Scale Notice
- Client Dividend Scale Notice
- Dividend Information Page

Did you miss our virtual Spring Update & 2023 Dividend Scale Announcement? Watch it now:

(*The French and Chinese events will be partially in English, with sub-titles on screen).

TOGETHER – Protecting Today – Preparing Tomorrow™
As a MUTUAL we provide financial security DIFFERENTLY by focusing exclusively on our CLIENTS.

*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, expense, lapse, claims experience, taxes, and other experience of the participating block of policies. Changes in the dividend scale do not affect the guaranteed premium, guaranteed cash values, or guaranteed death benefit amount. A copy of Equitable Life’s Dividend Policy and Participating Account Management Policy can be found on our website at www.equitable.ca.

** This applies to all new and active policy loans, including automatic premium loans. This change is for Equimax^_® policies that have a 9-digit policy number beginning with a “3” or an “8”. Some older policies may have other loan rates as they are based on the prime interest rate.