406 results for benefits of seg fund

1. [pdf] Personalized Ads - What does your retirement bucket list include?
2. Equitable Life Group Benefits Bulletin - April 2021

   In this issue:

   • Alberta biosimilar coverage changes*
   • New Humira biosimilars approved*
   • Saskatchewan and Manitoba delist biologics for some conditions*
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   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.
    
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3. Equitable Life Group Benefits Bulletin - November 2022

   The importance of timely plan member eligibility updates*

   Effective Dec. 1, 2022, we are implementing a revised process for managing plan member and dependent health and dental claims that have been incurred and paid after coverage has been terminated. This new process is consistent with industry practices.
    
   If health or dental claims have been incurred and paid after a plan member’s termination date but before we received notice of the termination, we will align the plan member’s or dependent’s termination date with the service date of the last paid claim, retaining premiums up until that date.
    
   If no claims have been incurred and paid after the termination date, Equitable Life will process the termination as requested and refund any excess premium, subject to a maximum premium refund credit of three months.
    
   Currently, we process the termination as requested and attempt to recover any claim overpayments directly from the plan member. We then refund any excess premiums that have been paid, subject to the maximum refund credit amount.
    
   To avoid claims being incurred and paid after a plan member’s termination date, it is important for your clients to update plan member and dependent eligibility dates on or before the effective date of the change.
    
   If you have any questions about the process your clients should follow for updating plan member eligibility, please contact your Group Account Executive or myFlex Sales Manager.

   QuickAssess®: Absence and accommodation request review services*

   It can be difficult to navigate chronic or complex cases of absenteeism or accommodation requests. That’s where QuickAssess® can help.
    
   QuickAssess is an optional, fee-per-use service that can provide your clients with an unbiased, timely assessment of complex plan member absences and workplace accommodation requests. Our disability experts can provide recommendations to help your clients manage:
   • Workplace absences
   • Chronic or patterned absenteeism
   • Requests to modify workplaces or duties
   • Return-to-work coordination
   • Employee Insurance sick leaves
   Based on a thorough review of information provided by the plan sponsor, the plan member, and their physician, our QuickAssess specialists provide a recommendation within two business days on how to manage the absence or accommodation request.** Your clients can then decide how to manage the plan member request and communicate their decision accordingly.
    
   For more information on using QuickAssess, including eligibility requirements, please contact your Group Account Executive or myFlex Sales Manager.
   
   **Within two business days of receiving a completed QuickAssess Absence and Accommodation Review Referral Form and all required information. For more complex referrals, more time will be required.

   Finding a health care provider with TELUS eClaims direct billing*

   By visiting TELUS’s Find a Provider page, your clients’ plan members can now easily search for paramedical and vision providers who are registered on the TELUS Health eClaims network and who can submit claims directly to us on behalf of their patients. Searches can be filtered by postal code to help plan members find the most convenient provider options.
   
   As our direct billing provider for pharmacy, vision and paramedical claims, TELUS Health has an extensive network of 70,000 health care providers that provide direct billing to streamline the claims process.
   
   Please note, plan members should always check Equitable Life’s list of de-listed providers before selecting a health care provider. The list is available for your clients and their plan members on EquitableHealth.ca, and is updated regularly.
   
   For more information about TELUS eClaims, please contact your Group Account Executive or myFlex Sales Manager.

   First phase of the Canada Dental Benefit proposed for Dec. 1, 2022*

   The federal government’s new Canada Dental Benefit is proposed to take effect on Dec. 1, 2022, subject to Parliamentary approval. The program will cover eligible expenses retroactive to Oct. 1, 2022, and this first phase would apply to Canadians under 12 years of age.
   
   If implemented, the Canada Dental Benefit will provide dental care to Canadian families with under $90,000 adjusted net income annually. By 2025, the federal government expects to extend the benefit to children under 18, senior citizens and Canadians with disabilities.
   
   Parents or guardians will be required to apply for this coverage through the Canada Revenue Agency (CRA) and must not have private dental coverage for the child(ren).
   
   This new program will have no impact on your clients’ dental coverage and no action is required on their part.
   
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4. [pdf] Personalized Brochure - What does your retirement bucket list include?
5. New Applications & Transaction Authorization Requirements
6. [pdf] DSC & Transfer Fee Reimbursement Request Form
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9. Equitable Blog
10. Update - Travel Assist Coverage*

    Last Friday, we announced that plan members with Travel Assist on their benefits plan will not be eligible for coverage if they departed the country after the Government of Canada issued its Global Travel Advisory.

    When the Government issued its advisory late Friday afternoon, we felt an obligation to let prospective travellers know as soon as possible so they could make informed choices about their travel. Since then, we have been made aware of a number of situations where plan members were unable to change their travel plans and need our continued support.

    To provide that support, we have revised our position. We will continue to cover plan members for all eligible emergency medical expenses, including those related to COVID-19, for trips outside Canada. Given the global situation is evolving quickly, we will continue to monitor developments and update you accordingly.

    In spite of this, we strongly urge your clients to advise their employees not to travel outside of the country at this time. The risk is high and the options for returning to Canada are becoming limited. Further, we urge your clients to advise their employees who are outside the country to return to Canada earlier than scheduled, if possible.

    If a plan member is currently travelling abroad and is experiencing symptoms or is hospitalized with suspicion of the coronavirus, they should contact Travel Assist at the numbers listed below for assistance and to confirm their coverage.

    • Toll-free Canada/USA: 1.800.321.9998
    • Global call collect: 519.742.3287
    • Allianz Global Assistance ID #9089

    We will continue to update you as the situation develops.

    We will update the announcement on our Plan Member website to reflect this change.

    We apologize for any confusion or inconvenience our earlier announcement may have caused.

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