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  1. New Investment Contract
  2. EquiNet Quick Tips

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  3. January 2023 eNews

    Responding to Saskatchewan’s biosimilar switch initiative*

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

    Saskatchewan’s provincial biosimilar initiative
    Announced in October 2022, the Saskatchewan Biosimilars Initiative ends coverage of ten biologic drugs beginning on April 30, 2023.

    Patients in the province who are using these drugs will be required to switch to biosimilar versions of these drugs by April 30, 2023, in order to maintain their Saskatchewan Drug Plan coverage.
     
    Equitable Life’s response
    To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Saskatchewan for most biologic drugs included in the provincial initiative.

    Beginning April 30, 2023, plan members in the province 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 February 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. 

    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 Saskatchewan includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
     

    Ontario announces 2023 biosimilar switch program*

    The government of Ontario recently announced the launch of a biosimilar initiative to switch patients from eight originator biologic drugs to biosimilar versions of the drugs.

    Patients in Ontario using affected originator biologic drugs will have until December 29, 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans.

    We are actively monitoring and investigating the impact of this new policy on private drug plans in Ontario. We plan to implement changes to coverage of biologic drugs in the province in 2023 to help prevent this change from resulting in additional costs for our clients’ drug plans. We will provide more details in the coming months.

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

    Dental fee guide updates*

    Each year, Provincial and Territorial Dental Associations publish fee guides. Equitable Life® uses these guides to help determine the reimbursement limits for dental procedures. For your reference, below is the list of the average dental fee increases for general practitioners that will be used by Equitable Life for 2023.*** 

    Dental fee guide increases over 2022***



    ***Data for all provinces and territories was not available at the time of publication. This chart will be updated on EquitableHealth.ca as more information becomes available.
     

    Equitable Life ranks high with Canadian group advisors*

    Equitable Life ranked second nationally and first in Ontario among major insurers in a recent survey of Canadian group benefits advisors.
     
    NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 130 leading group consultants, brokers and third-party administrators across the country between May and August 2022 for its annual Canadian Group Benefits Study. Based on these interviews, NMG ranked group insurers in six categories, ranging from operational management to technology.

    Nationally, Equitable Life ranked either first or second in four of the six main categories:

    Advisors in Ontario, in particular, scored Equitable Life very favourably. We ranked #1 overall in the province, finishing first in four of the six overall categories, including: Relationship Management, Operational Management, Underwriting and Claims Management and Technology.
     
    “The fact that advisors regard us so highly in so many categories is a testament to our mutual status and our ability to focus exclusively on our clients and advisors,” said Marc Avaria, Senior Vice President of Group. “We are truly working together to build strong, enduring and aligned partnerships.”
     
    “While we are happy with these results, we won’t rest on our laurels,” added Avaria. “We will continue to dedicate ourselves to providing our clients and advisors with a better benefits experience.”

    Here are more of the highlights from this year’s results:
     
    Nationally, we ranked first in all 10 subcategories in Operational Management, including:
    • Overall service to intermediaries,
    • Overall service to plan sponsors,
    • New quote process,
    • Plan implementation,
    • Renewal process,
    • Information shared at renewal,
    • Accuracy and timeliness of reporting and billing,
    • Administration quality and responsiveness,
    • Taking ownership and
    • Management information quality and availability.
    We also ranked first in Relationship Management, getting top marks in 7 of 10 subcategories, including:
    • Company relationship management,
    • Ease of doing business,
    • Account executive capability,
    • Market knowledge,
    • Visit/call quality,
    • Effective coordination and
    • Advice.
    We ranked second in Underwriting and Claims Management, finishing in the top three for all subcategories, including:
    • Fairness and timeliness of disability claims (1st)
    • Fairness and timeliness of health claims (2nd)
    • Fraud management (2nd)
    • Competitiveness of pooling charges (2nd)
    • Group underwriting flexibility (3rd)
    • Health and dental TLR competitiveness (3rd)
    And we ranked second in Technology, finishing in the top three for:
    • Overall technology – Intermediary (2nd)
    • Member experience (2nd)
    * Indicates content that will be shared with your clients.
     
  4. Disability Waiver of Premium Requirements
  5. [pdf] G3 - Application for Change
  6. [pdf] G2 - Application for Change
  7. Equitable Life Group Benefits Bulletin - April 2021

    In this issue:

      *Indicates content that will be shared with your clients

    Update: Alberta biosimilar coverage changes take effect*

     
    In our November 2020 edition of eNews, we announced we are changing coverage for some biologic drugs in Alberta in response to the province’s Biosimilar Initiative.
     
    As of March 15, 2021, several originator biologic drugs are no longer covered for plan members in Alberta. Plan members taking these biologics are required to switch to the biosimilar versions of these drugs to maintain eligibility under their Equitable Life plan.
     
    Affected drugs and conditions – Remicade remains eligible
    We initially announced that Remicade would be among the biologic drugs no longer covered in Alberta.
    We have since determined a method to maintain ongoing eligibility of Remicade while reducing or eliminating any Coordination of Benefit risk associated with the provincial change. As such, Remicade will continue to be eligible for coverage. 
     
    Communication to plan members and plan sponsors
    We communicated directly 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. The transition to biosimilars, when required, has been smooth and continues to be successful.
     
    Plan sponsors were notified even earlier to allow ample time to opt-out of this change. The vast majority have accepted the changes and are benefiting from a smooth plan member transition. 
     
    Looking ahead
    We are one of the few insurers taking a comprehensive and proactive response to the Alberta Biosimilars Initiative. We will continue to monitor developments related to the coverage of biologics in Alberta and other provinces and will continue to take steps to protect your clients’ drug plans.
     
    Questions?
    If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.
     
     

    New Humira biosimilars approved*

    Beginning in February, Health Canada approved seven new biosimilars for Humira, a biologic drug for the treatment of rheumatoid arthritis, psoriatic arthritis, Crohn's disease and many other conditions. Most of these biosimilars have already been launched and are available in pharmacies.
     
    Humira is one of the highest ranked drugs in terms of total annual cost. All the Humira biosimilars are priced 40% lower than Humira and represent a savings opportunity for private drug plans.
     
    BC Pharmacare has already announced that, effective October 7, 2021, all claimants for most conditions will only be eligible for Humira biosimilars.
     
    We have implemented national controls to ensure the use of Humira biosimilars for new claimants. As with all biosimilar programs at Equitable Life, they will continuously evolve such that our clients are provided appropriate risk protection. 
     
     
     

    Saskatchewan and Manitoba change coverage for some biologics*

    The Saskatchewan government recently announced that, effective March 1, 2021, new patients will no longer be eligible for coverage of Enbrel under its public plan. New patients will only be eligible for biosimilar versions of Enbrel.
     
    Similarly, the Manitoba government announced changes to its tiered biologics program. Currently, claimants are expected to try biosimilars listed under Tier 1 of the program before they can be considered for coverage under the public plan for either Enbrel or Remicade, which are Tier 2 drugs. Effective April 1, 2021, Brenzys, an Enbrel biosimilar, has been added to Tier 1 for some additional medical conditions. As well, Avsola has been added as another Tier 1 biosimilar for Remicade. These changes further expand the Manitoba government’s utilization of biosimilars as preferred therapies over originator biologics.
     
    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.
     
    Equitable Life actively monitors and investigates  all biosimilar policy changes and the ongoing evolution of biosimilar drugs entering Canada.  We will keep you informed of any impact on private drug plans and how we are responding.
     
     *Indicates content that will be shared with your clients
     
  8. [pdf] New Forms to Comply with AML & CRS Changes
  9. Invesco
  10. Critical Illness - More Covered Conditions