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1. [pdf] Underwriting cover letter template
2. April 2023 eNews

   Vision care discounts from Bailey Nelson for Equitable Life plan members*

   We are pleased to announce we are partnering with Bailey Nelson to provide Equitable Life plan members with discounts on prescription and non-prescription eyewear. Bailey Nelson is a leading provider of prescription glasses, contact lenses and sunglasses with locations across Canada, as well as an online store.
    
   All Equitable Life plan members will have access to the following discounts from Bailey Nelson:
   
   
   *Includes anti-reflection and anti-scratch treatment. Glasses offers are based on 2 pairs of single vision or 1 pair of premium progressive lenses. Lens add-ons, such as high-index lenses and prescription tinted lens tints may involve additional costs.
   
   **Non-prescription glasses only. Cannot be combined with 2 for $200 discount.
    
   Plan members can provide their Equitable Life discount code in-store or at online checkout. Your clients may wish to distribute this convenient flyer with an overview of the available discounts to their plan members.
    
   Plan members can bring their prescription to a Bailey Nelson location or provide it online to order glasses and contact lenses. Bailey Nelson also provides eye exams in-store for $99.
    
   If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
    

   Equitable Life helps tackle benefits fraud through Joint Provider Fraud Investigation (JPFI) initiative*

   Protecting your clients’ plans is important to us. That’s why Equitable Life is working with other Canadian life and health insurers to conduct joint investigations into health service providers that are suspected of fraudulent activities through the Canadian Life and Health Insurance Association’s (CLHIA’s) Joint Provider Fraud Investigation (JPFI) initiative. This collaborative initiative between major Canadian life and health insurers through the CLHIA is a major step toward reducing benefits fraud in the life and health benefits insurance industry. 

   How the JPFI works

   The JPFI builds on the 2022 launch of a CLHIA-supported industry program. The program uses advanced artificial intelligence to help identify fraudulent activity across an industry pool of anonymized claims data. Joint investigations will examine suspicious patterns across this data.
    
   Through this project, Equitable Life can initiate a request to begin a joint fraud investigation when we: 
   • See suspected provider fraud in our own data or the pooled data, or
   • Receive a substantiated tip about potential provider fraud 
   Other life and health insurers that have joined the JPFI will then have the option to join the investigation if they are also impacted by the provider under investigation. By sharing expertise and resources across insurers, the participating carriers will be able to determine the most appropriate next steps. 

   How Equitable Life protects your clients’ benefits plans from fraud

   Benefits fraud is a crime that affects insurers, employers and employees and puts the sustainability of workplace benefits at risk. CLHIA estimates that employers and insurers lose millions each year to benefits fraud and abuse.
   
   Our Investigative Claims Unit (ICU) consists of security and fraud experts who use data analytics and artificial intelligence to proactively identify and investigate suspicious billing patterns or claims activity to open investigations. We de-list healthcare providers who are engaged in questionable or fraudulent practices, pursue the recovery of improperly obtained funds, and report practitioners to regulatory bodies and law enforcement where appropriate.
   
   Learn more about benefits fraud, or contact your Group Account Executive or myFlex Sales Manager for more information.

   Second phase of TELUS eClaims transition*

   In June 2022, we switched to TELUS Health eClaims as our digital billing provider to give our plan members a faster and more convenient option for submitting paramedical and vision claims. The switch has allowed our plan members to take advantage of TELUS’s extensive network of over 70,000 paramedical and vision providers.
    
   We’ve now begun the second phase of our TELUS Health eClaims implementation. This phase will focus on improving the experience for paramedical and vision providers. We will begin issuing reconciliation statements for the claims they submit on behalf of their patients. These statements will make it easier for them to use the TELUS Health eClaims portal and provide incentive for even more providers to sign up.
    
   Please encourage your clients to remind their plan members about this convenient option. We have created a helpful one-pager that plan members can bring with them next time they have an appointment with their healthcare provider. 
    
   If you have any questions about TELUS Health eClaims, please contact your Group Account Executive or myFlex Sales Manager.
    

   Changes to STD application process for COVID-19 cases*

   As the COVID-19 situation evolves, we continue to adjust our disability management practices to ensure ongoing support and a fair experience for all our plan members.
    
   As of May 1, 2023, we will begin managing COVID-19-related short-term disability (STD) claims the same way that we manage disability claims for any other illness or condition. If a plan member is unable to work due to COVID-19 symptoms or a positive COVID-19 test, they must now use the standard STD application, including the Attending Physician Statement portion.
    
   Once we receive the claim, we will adjudicate it according to our standard process.
    
   If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
   
   * Indicates content that will be shared with your clients.
   
   
    
3. Insights from a pandemic: Long-term COVID-19 drug risks

   For the remainder of 2020 and beyond, COVID-19 will continue to add to the existing pressures driving up drug costs. Examples of contributing factors include:

   • Claims for acute drugs will likely increase as elective surgeries resume and plan members address non-emergency health issues that were left unattended during COVID-19.
   • Plan members whose employers are facing financial strain due to COVID-19 may stock up on their prescriptions in anticipation of losing their job and/or their benefits.
   • An ongoing increase in the prevalence and severity of mental health issues and chronic conditions. In May and June, we saw a dramatic increase in the number of claimants for depression, ulcers, blood pressure and diabetes, and depression was associated with 1 in 5 claimants.

   All trends thus far suggest we can expect about a 10% increase in average paid amounts per certificate in 2020 compared with 2019. But the impact won’t be the same for all groups. There will be significant variations, particularly for smaller groups, and some may see much larger cost increases.

   Unknown COVID-19-related risks

   Another risk exposure may come from the costs associated with drugs used to treat or prevent COVID-19. There are currently numerous vaccines in development, and more than 300 clinical trials are underway for both new and existing drugs to determine their effectiveness in treating the virus.

   The cost of any vaccine or whether government or private plans will pay for it is unknown. Regardless, there will likely be other drugs indicated for the treatment or prevention of COVID-19 that private plans will be expected to cover. The cost of this impact for private payers is unknown, but potentially high.

   Another unknown is what will happen with dispensing fees. While most provinces have lifted their 30-day prescription refill limits, it remains to be seen whether pharmacies will resume dispensing 60- and 90-day refills at pre-COVID levels for private plans. If not, this would mean the dispensing fees will continue to drive up drug costs.
   
   

   Advisor opportunity

   Despite the increase in drug plan risk in recent years, little has changed in plan design trends. Very few plan sponsors have adopted managed plans or other plan design options that could help manage risk.

   This presents an opportunity for advisors to educate their clients about the risks their drug plan may be exposed to and the options available to manage that risk.

   A practical starting point for those conversations is our Drug Plan Design Tool. With two simple questions, it can help confirm your client’s objectives and identify some best-fit solutions for their plan.  Ask your Group Account Executive or myFlex Sales Manager for a copy of the tool.

4. Equitable Life Group Benefits Bulletin - Group Advisor Bonus Enhancement Announcing our Enhanced Group Advisor Bonus Program
    
   We have enhanced our Group Advisor Bonus program to make it more competitive and to help support you in building your business with Equitable Life in 2022. We have updated the structure of the bonus program to make it easier for you to qualify, as well as increased the amounts we pay.
    
   Beginning for sales effective in 2022 we have:
   • Decreased the minimum premium required to qualify for the Sales Bonus to $35,000 from $150,000.
   • Moved away from using Graded Annualized Premium for both the Sales and Persistency Bonus and are using actual Annualized Premium instead, up to a maximum of $500,000 per policy. This simplifies the program and aligns us with the rest of the industry.
   • Increased the Sales Bonus payout to up to 5% of Annualized Premium for Traditional Sales and up to 3% of Annualized Premium for myFlex sales. 
   • Changed the minimum annual premium threshold for the Persistency bonus to $500,000 of capped Annualized Premium from $500,000 of Graded Annualized Premium to make it easier for you to qualify.
   Premiums associated with benefits on retention accounting or Administrative Services Only (ASO), Equitable HealthConnector® services, Group Critical Illness and Health Care Spending Accounts will no longer be counted towards the Sales Bonus.
    
   These enhancements do not apply to advisors who are not part of our standard Advisor Bonus program and who have special bonus arrangements in place. If you have a special bonus arrangement in place and would like to switch to the standard program, please contact your Group Account Executive or myFlex Sales Manager.
    
   Below is a table comparing the current Sales Bonus structure and payout. For full details, please refer to the Group Advisor Compensation and Recognition brochure.
    
   Enhanced Sales Bonus
   For the new Sales Bonus, the Payout Band is based on total combined Traditional and myFlex Benefits new annualized premium (capped at $500,000 per policy). The Sales Bonus Rates for both Traditional sales and myFlex sales are shown in the table below:
    

   New Sales Bonus Rates
   Payout Band	Capped Annualized Premium*	Sales Bonus Rate (from first dollar)
   		Traditional Sales	myFlex Sales
   1	$34,999 and under	0%	0%
   2	$35,000 to $99,999	3.5%	1.5%
   3	$100,000 and over	5%	3%
   *Total Traditional and myFlex new business sales combined, capped at $500,000 per policy.

    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
   If you have any questions about the Advisor Bonus enhancements, please contact your Group Account Executive or myFlex Sales Manager.
    
5. Update: Employment Insurance (EI) Sickness Benefit Extension As it proposed in its 2022 Budget, the federal government has confirmed it is extending the Employment Insurance (EI) Sickness Benefits period from 15 weeks to 26 weeks later this year. The official implementation date and details have not yet been confirmed by the government and we will share further details once they are available. In the meantime, here’s what you need to know.
    
   We will not require or implement any changes to our disability plan designs based on this extension. However, plan sponsors may wish to amend their short-term disability (STD) and long-term disability (LTD) plans and policies to align with the new 26-week EI period. 

   Impact to short-term disability (STD) benefits integrated with EI

   Plan sponsors with EI-integrated STD may wish to adjust their benefits to line up with the new 26-week extension. 

   Impact to plans with no STD benefits

   For plan sponsors who do not offer STD, they have the option of adjusting their LTD plans to the new 26-week elimination period if members claim EI prior to LTD. This adjustment would help to avoid the plan member receiving disability and EI payments at the same time and potentially being required to return funds due to overpayment. 

   Considerations for plan sponsors

   Plan sponsors who amend their STD or LTD policies to align with the new 26-week EI period should note that there may be inadvertent delays to their employees’ return to work. While collecting EI, injured or ill employees do not benefit from our early intervention services or rigorous claims management practices that could help them get back to work sooner. So, by delaying the availability of STD or LTD coverage, the advantages that these programs are intended to provide could also be delayed. 

   Impact to Premium Reduction Program (PRP)

   The Premium Reduction Program (PRP) allows employers with eligible short-term disability plans to pay lower EI premiums. The eligibility criteria have not changed at this time. The government plans to review the PRP in 2024.

   Questions

   If you have questions about these changes or what they mean for your clients’ disability plans, please contact your Group Account Executive or myFlex Sales Manager.
    
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