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1. Investment loans
2. Investment loans
3. Equitable Life Group Benefits Bulletin – May 2021

   In this issue:

   • Graduating dependents losing coverage?*  
   • New Brunswick expands the use of biosimilars*
   • Proposed changes to federal recovery and EI benefits*
   • Removal of plan administrator access to update plan member banking*
   • BioScript recognized as one of Canada’s Best Managed Companies*
   *Indicates content that will be shared with your clients
    

   Graduating dependents losing coverage?

   Let plan members know about Coverage2go

   As we reach the end of spring, some of your clients’ plan members may have dependents who are graduating from university or college and will no longer be eligible for coverage under the benefits plan.
    
   Fortunately, we offer Coverage2go®. It allows individuals who are losing their group coverage to purchase personal month-to-month health and dental coverage that is affordable, reliable and works like their previous group benefits plan. They can choose the level of coverage and protection that suits their personal situation.
   
   There are no medical questions – they simply need to apply within 60 days of losing their health coverage under their group benefits plan.*
    
   Help your plan members and their dependents who are losing coverage by letting them know about Coverage2go. They can visit our website to learn more about Coverage2go and to get a quote.
    
   *Quebec residents are not eligible for Coverage2go

   New Brunswick expands the use of biosimilars

   The New Brunswick government recently announced that it will be implementing a biosimilar transition program.
    
   Patients using originator biologic drugs for diseases such as inflammatory arthritis, inflammatory bowel disease, diabetes and psoriasis, will have until November 30, 2021 to switch to the biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. This process will be completed in consultation with the patients’ physicians.
    
   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.

   Proposed changes to federal recovery and EI benefits

   In its recent 2021 budget, the federal government proposed a variety of changes to its benefit programs.
   
   The proposed changes include providing up to 12 additional weeks of the Canada Recovery Benefit to a maximum of 50 weeks. The first 12 weeks of this benefit would be paid at $500 per week and the remaining eight weeks at $300 per week. 
   
   Multiple changes have also been proposed to make Employment Insurance (EI) more accessible to Canadians. The changes include: maintaining uniform access to EI benefits across all regions, supporting multiple job holders and those who switch jobs by ensuring that all insurable hours and employment count towards their eligibility, and simplifying many rules around EI to ensure Canadians can receive benefits sooner. It has also been proposed that the regular EI benefits be extended to no later than November 20, 2021, if needed.
   
   We are analyzing the impact these changes may have to disability benefits. We will provide more details later in the year. 

   Removal of plan administrator access to update plan member banking

   In early June, plan administrators will no longer be able to update banking information for their plan members on EquitableHealth.ca after their initial enrolment. This change has been made to allow plan members to have full control over where they want their claim payments deposited.

   Plan members can update their banking information online through their plan member web portal or through the EZClaim mobile app. They will continue to be notified via email if and when they make any changes.

   BioScript Solutions recognized as one of Canada’s Best Managed Companies

   Congratulations to our partner, BioScript Solutions, for being recognized as one of Canada’s Best Managed Companies of 2021 by Deloitte.
    
   We have partnered with BioScript since 2016 for our Specialty Drug Preferred Pharmacy Network (PPN). This partnership offers cost savings while providing comprehensive, best-in-class patient care.
    
   BioScript is one of Canada’s leading specialty pharmacies and recently celebrated its 20^th anniversary.
    
4. [pdf] Coverage2go
5. Spring update and dividend scale for 2025/2026
   Good news! The Equitable^® Board of Directors has approved continuing our current dividend scale for the period of July 1, 2025, to June 30, 2026.
   
   • The interest rate* we use to decide the dividend scale will stay at 6.40%.
   • Other factors used to decide the dividend scale will stay the same.
   • The interest rate for policies with dividends on deposit will stay at 3.50%.
   • The interest rate for most policy loans will stay at 6.50%. This applies to both new and existing policy loans, and automatic premium loans. It specifically applies to Equimax^® policies with a 9-digit policy number that starts with either "3" or "8". Older policies may have different loan rates as they are based on the prime interest rate.
   
   *The dividend scale interest rate (DSIR) is different from the participating account (PAR) rate of return. The DSIR smooths out the ups and downs of the participating account experience. The PAR rate of return is the return on the investments in the participating account over the calendar year.
   
   Need more information?
   • 2025 Advisor Dividend Scale Notice
   • 2025 Client Dividend Scale Notice
   • Dividend Information Page
   
   Did you miss our Spring Update & 2025 Dividend Scale Announcement?
   Watch it now:
   
     
6. 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):

   

7. Equitable Life Group Benefits Bulletin – March 2022 In this issue:
   • CLHIA launches industry anti-fraud initiative*
   • Provincial biosimilar update*
   • Quebec decreasing insurance premium tax*
   • Coming soon: A survey to understand how we can better serve your clients’ needs*
   • Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare *
   *Indicates content that will be shared with your clients
    

   CLHIA launches industry anti-fraud initiative*

   In February, the Canadian Life and Health Insurance Association (CLHIA) announced a new anti-fraud initiative that is using advanced artificial intelligence (AI) to further identify and reduce benefits fraud.
    
   Equitable Life is excited to be a part of this important initiative. It will enhance our own fraud detection analytics by using AI to connect the dots across a huge pool of anonymized claims data. This will lead to more investigations and actions to mitigate the impact of fraud on your clients’ plans.
    
   The initiative is being led by the CLHIA and member insurers and is supported by technology provider Shift Technologies. It will be further rolled-out and expanded over the next three years.
    
   Benefits fraud affects more than just insurers. The costs of fraud are felt by employers and their employees as well. We are looking forward to being able to better identify and reduce benefits fraud.
    

   Provincial biosimilar update*

   BC expands its biosimilar initiative
   BC Pharmacare recently announced it is adding two rapid-acting insulins to the list of drugs included in its ongoing initiative to switch patients to biosimilar versions of high-cost biologics. Patients taking Humalog or NovoRapid for Type 1 or Type 2 diabetes will be required to switch to a biosimilar version of the drugs by May 29, 2022 to maintain coverage under the public plan.
   
   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 biologic drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.
   
   How we are responding to protect our clients
   To help prevent this change from resulting in additional costs for our clients’ drug plans while still providing plan members with access to safe and effective medications, we will no longer cover Humalog or NovoRapid for plan members in BC. Effective June 1, 2022, claimants currently taking Humalog or NovoRapid will be required to switch to a biosimilar version of the drugs to maintain coverage under their Equitable Life plan and their BC Pharmacare plan.
   
   We will be communicating this change to plan administrators later this week. And we will be communicating with affected claimants in early April to allow 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 Sales Manager.
   
   Nova Scotia and Northwest Territories introduce biosimilar initiatives
   The governments of Nova Scotia and the Northwest Territories each recently announced they are launching biosimilar initiatives to switch patients from certain originator biologic drugs to biosimilar versions of the drugs.
   
   Patients in Nova Scotia using affected originator biologic drugs will have until February 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. Patients in the Northwest Territories will have until June 20, 2022, to switch.
   
   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.
    

   Quebec decreasing insurance premium tax*

   The Quebec Government has announced that it plans to decrease its Insurance Premium Tax rates effective April 1, 2022. The premium tax rates for group life and accident and sickness insurance are expected to decrease from 3.48% to 3.3%. The new tax rates will be applied to premiums for the billing period beginning on or after April 1, 2022.
    

   Coming soon: A survey to understand how we can better serve your clients’ needs*

   We are committed to providing your clients and their plan members with industry-leading service. We’ve introduced several enhancements over the past year to make it easier to do business with us. And we’re continually looking for ways to improve.
    
   In the coming weeks, we will conduct a survey of your clients to help us understand how we can better serve them. On March 28, we will send plan administrators an email with a link to the survey. The survey will remain open until the end of the day on April 11 and will take between five and 10 minutes to complete. Please encourage your clients to participate. Their feedback will be confidential, and their responses will help us improve our service and ensure we’re meeting their expectations. We may also follow up with plan administrators directly to address any concerns they’ve identified.
    
   We know your clients’ time is valuable. So, each plan administrator who completes the survey will be entered into a random draw for a chance to win one of 25 prepaid gift cards for $25.
    

   Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare*

   If your clients have plan members in British Columbia, Manitoba or Saskatchewan, the provincial government offers a Pharmacare program to support prescription drug costs.  Plan members in these provinces must register for their provincial Pharmacare program to maintain coverage under their Equitable Life drug plan.
    
   Registration is easy! We will send two registration reminder messages directly to plan members’ pharmacists and post them on their Explanation of Benefits. We’ve also created a step-by-step guide that your clients can share with their plan members.
    
   English version
   French version
    
   For more information about the provincial Pharmacare programs, including how plan members can register, please visit:
    
   For British Columbia residents: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents  
    
   For Manitoba residents: https://www.gov.mb.ca/health/pharmacare/apply.html
    
   For Saskatchewan residents: https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/extended-benefits-and%20drug-plan/drug-cost-assistance#eligibility
    
    
8. [pdf] Temporary Life Insurance Agreement (TIA)
9. [pdf] Single Life - Lifetime Enhancement