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  1. [pdf] Equitable GIF Non-Registered Application
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  7. February 2020 Advisor eNews

    In this issue:

    Provincial biosimilar update
    Legislative changes for Alberta’s Coverage for Seniors program
    Coming soon: enhancements to Equitable EZClaim® Online
     

    Provincial biosimilar update

    Alberta Biosimilar Initiative

    On December 12, 2019, the Alberta government introduced the launch of the Alberta Biosimilar Initiative. This program will require patients using several originator biologic drugs to switch to a biosimilar, and patients using a non-biologic complex drug (NBCD) to switch to its subsequent entry version before July 1, 2020 in order to maintain coverage.

    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” drug. Biosimilars 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.

    Alberta Health will initially cover both the originator and biosimilar or subsequent entry version of a NBCD  drug as patients start the switching process.

    The following table outlines the affected originator drugs, their biosimilars or subsequent entry, and the conditions affected by the program.

    Biosimilar Drug Originator Biosimilar/Subsequent Entry Indications Affected
    etanercept Enbrel Brenzys Ankylosing Spondylitis
    Rheumatoid Arthritis
    Erelzi Ankylosing Spondylitis
    Psoriatic Arthritis
    Rheumatoid Arthritis
    infliximab Remicade Inflectra
    Renflexis
    Ankylosing Spondylitis
    Plaque Psoriasis
    Psoriatic Arthritis
    Rheumatoid Arthritis
    Crohn’s Disease
    Ulcerative Colitis
    insulin glargine Lantus Basaglar Diabetes (Type 1 and 2)
    Filgrastim Neupogen Grastofil Neutropenia
    pegfilgrastim Neulasta Lapelga Neutropenia
    glatiramer* Copaxone Glatect Multiple Sclerosis

    *Glatiramer is a non-biologic complex drug where the originator is Copaxone and the subsequent entry is Glatect.

    Equitable Life is actively investigating the benefit, risk and appropriate plan changes associated with this new policy on private drug plans and will keep you informed.

    For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.

    British Columbia

    In 2019, BC Pharmacare introduced a Biosimilars Policy that impacted coverage of three biologic drugs – Remicade, Enbrel and Lantus. As of November 25, 2019, these drugs were no longer eligible in BC for most conditions for which lower cost biosimilar versions are available. Patients in the province with these conditions were required to switch to biosimilar versions of these drugs in order to maintain their coverage.

    The second phase of the BC Biosimilar Policy takes effect March 6, 2020 when Remicade will be delisted for Crohn’s Disease and Ulcerative Colitis. Patients in the province with these conditions will be required to switch to Inflectra or Renflexis in order to maintain their coverage.

    Biosimilar Drug Originator Biosimilar Indications Affected
    infliximab Remicade Inflectra
    Renflexis
    Crohn’s Disease
    Ulcerative Colitis

    We have communicated with the affected plan members, informing them of the need to switch medications. If plan members have any questions or concerns, our Customer Care team is here to help and support them through the transition.

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

    Ontario

    In November 2019 Ontario Minister of Health Christine Elliot indicated that the government was planning to launch consultations to explore solutions in managing biologics.

    Equitable Life will continue to monitor these developments and keep you informed of any impact on private drug plans.

     

    Legislative changes for Alberta’s Coverage for Seniors program

    The government of Alberta has announced that as of March 1, 2020, seniors’ family members (such as spouses and dependents) who are younger than 65 will no longer be covered by the provincial Coverage for Seniors program. Albertans 65 years of age and older will continue to be covered under the provincial plan.

    Equitable Life plan members and their dependents will continue to be covered under the parameters of their group benefits plan.

    For more information, please see the Alberta Seniors Health Benefits website.

     

    Coming soon: enhancements to Equitable EZClaim® Online

    Faster vision claims processing and payment

    Equitable Life will soon provide real-time processing of vision claims submitted via EZClaim Online.

    This means plan members will be able to find out the status of their vision claim almost instantaneously. And, for approved claims, they will receive payment even sooner – often in as little as 24 hours.

    In order to allow for instantaneous processing and faster payment, plan members will be prompted to enter some additional information including the practitioner’s name, the date of the expense, the type of expense and amount of the expense when submitting their claims for these services.

    Equitable Life plan members can submit all vision claims via EZClaim, including coordination of benefits and Health Care Spending Account claims.

    This enhancement will be coming to our EZClaim Mobile app in the coming months.

    New printable claims extract

    As part of our ongoing efforts to improve customer experience for plan members, we will also offer a claims extract in a printable format within the plan member site. Plan members will be able to select a date range and claimant, then generate and download a detailed list of health and dental claims. This is a helpful way to keep track of claims, especially when reviewing them in preparation for income tax filing.

    Once these enhancements are live you will be notified in an eNews, and an announcement will be posted on the plan member section of EquitableHealth.ca.

     

    Elimination of Out-of-Country Travellers Program in Ontario

    Effective January 1, 2020, the Ontario government eliminated OHIP coverage for emergency services for Ontarians travelling outside of Canada.

    Previously, the Out-of-Country Travelers Program provided some reimbursement for services required to treat conditions that are acute, unexpected, arose outside Canada and require immediate treatment. The program covered between $200 and $400 per day for inpatient services and $50 per day for outpatient and doctor services.

    For groups who have out-of-country coverage from Allianz, this change will not impact the cost to your plan members, or the process plan members follow in the event of an emergency while travelling.

    Plan members should still call Allianz in the event of an out of country emergency. Allianz will deal with their claim as usual and will now pay for the portion of the claim previously paid by OHIP. Plan members will not have any additional out-of-pocket costs.

    We will be sharing this information with plan members as a news item on our plan member website, equitablehealth.ca.

  8. Critical Illness - More Covered Conditions
  9. Update: Improved Employee Assistance from Homewood Health

    As we announced in June, we are expanding our relationship with Homewood Health to help you meet the mental health and wellness needs of your employees and their families. Beginning Oct. 1, 2019, Homewood will be the new provider of both our Employee and Family Assistance Program (EFAP) and our online health and wellness services.

    Following the transition to Homewood, plan members will benefit from added features:

    • Signing in to Homewood Health online allows the platform to customize content unique to your interests.
    • All plan members will have access to a Health Risk Assessment to help identify health and wellness barriers.
    • i-Volve, Homewood's online cognitive behavioural therapy program is available for all plan members to help them manage anxiety and depression.

    Learn more about Homewood Health and how they will be providing your plan members with exceptional EFAP and online health and wellness resources.

    What does the transition to Homewood mean for you and your plan members?

    We will be working with you in the coming months to facilitate the transition and support your employees. Most importantly, there will be no disruption of service delivery to employees who are currently in short-term counselling with our current EFAP provider.

    The transition timeline

    Groups without an EFAP

    Online health and wellness resources will be available through EquitableHealth.ca just as they are now. Here's what you can expect in the coming months.

    September   

    • We will send plan administrators an email with more details about the resources available to assist in the transition, including:
      • How to register for Homewood Health online
      • A video orientation for plan members

    October

    • October 1st – plan members can access the Homewood online resources! They simply need to visit homeweb.ca/Equitable to sign up and create their unique login.

    The transition timeline

    Groups with an EFAP

    We’ve created a helpful infographic that outlines the steps involved in the transition to the Homewood Health EFAP over the coming months. Please save or print it for easy reference. Below are some of the highlights.

    August

    • We will send plan administrators an email with official notice that the enrolment certificate for our current EAP provider, LifeWorks, will terminate on Sept. 30, 2019, and that Homewood Health Inc. will be our new Employee Assistance Program provider as of Oct. 1.

    September   

    • Homewood will send you a welcome email, including how to access the EFAP, who to contact for support and where to find resources to help share the news with plan members.
    • Homewood will follow up directly to answer any questions you may have.
    • Homewood will begin offering orientation and training sessions for both plan administrators and plan members. These will be running throughout the fall so you can attend at your convenience. 

    October

    • October 1st – plan members can access the Homewood EFAP and online resources! They simply need to visit homeweb.ca/Equitable to sign up and create their unique login.
    • Orientation and training sessions will continue to be available for both plan administrators and plan members throughout October.

    Learn More

    The resources listed below answer common questions about Homewood and our EFAP transition:

    If you have a question that is not addressed here, please contact your Group Account Executive or myFlex Sales Manager.

  10. Equitable Life Group Benefits COVID-19 Update

    The test of a great partner is one who stands tall when you and your clients need to rely on them most. As the COVID-19 pandemic continues, we thought you might find it helpful to have a summary of where we are during this crisis.

    You can download this PDF version to refer to when meeting with your clients.

    We are here with you and for you

    We’ve taken several steps to support you, your clients and their plan members during this crisis, including:

    • Providing premium refunds for insured, non-refund Health and Dental benefits;
    • Waiving the waiting period for short-term disability claimants who tested positive for COVID-19;
    • Extending out-of-country travel coverage for plan members who were unable to return to Canada;
    • Providing increased flexibility for premium payments; and
    • Keeping you and your clients informed with timely Q&As and announcements, webinars, and insights into the impact of COVID-19 on benefits plans.

    As well, to commemorate our 100th Anniversary this year, we donated $4.5 million to purchase and install a new MRI for Grand River Hospital. And we donated $50,000 – $10,000 each – to five charities in British Columbia, Alberta, Manitoba, Ontario and Quebec. For more information about our celebrations, check out our website at www.equitable100.ca.

    We have adjusted our business to become digital

    Our business is near 100% digital, so the vast majority of our employees are now working remotely from home and are fully functional.  Since the pandemic began, our IT and operations teams have digitally enhanced more than 20 different processes and services to make it easier for us to integrate with our distribution partners in this new reality.

    We pride ourselves on our customer service

    In 2019, our dedication to customer service was recognized with outstanding survey results.

    • In a 2019 survey of customers from 15 life insurance companies,1 Equitable Life ranked #1 on the Net Promoter Score, a measure used across industries to gauge the loyalty of a firm's customer relationships; and
    • A survey of Group consultants, brokers and third-party administrators 2 ranked Equitable Life in the top two insurers across all categories.

    For 2020, we continue to deliver service at the same level with no disruptions during this crisis. Our Customer Care Centre remains open to support plan members and can be reached at 1.800.265.4556. And our Client Relationship Specialists are available for Plan Administrator questions and support.

    We are financially strong and stable

    We remain financially strong and continue to focus on meeting the needs of Canadians. At the end of the first quarter, our Life Insurance Capital Adequacy Test (LICAT) ratio is at 152.5%, well above our goal and the regulatory requirement.

    As the global situation continues to evolve, rest assured that Equitable Life is unwavering in our commitments to you and the communities we serve. We are here with you and for you. Please contact your Group Account Executive or myFlex Sales Manager if you have questions or need assistance.

     

     

    1  LIMRA CxP Customer Experience Benchmarking Program, Life Insurance In-Force Experience 2019

    NMG Consulting’s Canadian Group Benefits Survey 2019