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Equitable Life Group Benefits Bulletin – February 2022 In this issue:

Update: Alberta biosimilar coverage changes*
Preferred Biosimilar Program*
Responding to Quebec’s biosimilar policy*
Dental fee guide updates*
Reminder: Review manual allocations for HCSAs and/or TSAs*
Mental health resources for plan members*

*Indicates content that will be shared with your clients

Update: Alberta biosimilar coverage changes*
Four originator biologics added to Alberta Biosimilar Initiative

In 2022, Alberta’s provincial drug plan is adding four originator biologics to its Biosimilar Initiative. It has ended or will end provincial coverage of these drugs for some or all conditions, as follows:

Lovenox: Jan. 10, 2022
Humalog: Feb. 1, 2022
NovoRapid: April 1, 2022
Humira: May 1, 2022

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.

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 these originator biologic drugs for plan members in Alberta.

Effective May 1, 2022, claimants currently taking these drugs will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable Life plan.

This is a continuation of the Alberta biosimilar switch program we launched last March, when the province first introduced its Biosimilar Initiative.

Do my clients need to take any action?
No action is required by plan sponsors. Plan members taking these targeted originator biologics will be contacted directly to allow them ample time to transition to a biosimilar. Any cost savings associated with the change will be factored in at renewal.

Groups that opted out of the biologic coverage changes we made last March will automatically be opted out of these coverage changes, as well as any future changes to our Alberta biosimilar switch program. This means that their drug plans will continue to provide coverage to existing claimants for any originator biologics we stop covering as part of our biosimilar program.

Advisors with clients who wish to opt out of our Alberta biosimilar program, or who previously opted out and want to opt back in, should speak to their Group Account Executive or myFlex Sales Manager.

Communication to plan members
We will be communicating these coverage changes with affected claimants in early March to allow them ample time to change their prescriptions and avoid any interruptions in their treatment or their coverage. Thus far, the transition to biosimilars, has been smooth and continues to be successful.

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 also 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.

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

Preferred Biosimilar Program*

As part of our ongoing efforts to help ensure the sustainability of your clients’ drug plans, we continue to engage in strategic partnerships with pharmaceutical manufacturers.

We are pleased to announce a partnership to make Hyrimoz our preferred biosimilar for Humira. This partnership will generate additional savings for plan sponsors.

Plan members will still have the choice to use Humira biosimilars other than Hyrimoz. However, in the absence of alternative sources of reimbursement, this may increase their out-of-pocket amount.

The Preferred Biosimilar Program will take effect March 1, 2022 for all new claimants across Canada who start using a Humira biosimilar. It will take effect May 1 for existing claimants in Alberta who switch to a Humira biosimilar, to align with changes to the provincial plan.

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

Responding to Quebec’s biosimilar policy

Last year, the Quebec government announced it is phasing out coverage of biologic drugs. Beginning April 13, 2022, patients in Quebec using originator biologics will be required to switch to the corresponding biosimilar covered on the province’s public plan in order to maintain coverage.

The following populations are excepted from this new policy:

Pregnant women, who should be transitioned to biosimilars in the 12 months after childbirth.
Pediatric patients, who should be transitioned to biosimilars in the 12 months after their 18^th birthdays.
Patients who have experienced two or more therapeutic failures while being treated with a biologic drug for the same chronic disease.

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.

We are actively investigating the impact of this new policy on private drug plans in Quebec. We plan to implement further enhancements to our biosimilar programs in Quebec later this year to help prevent this change from resulting in additional costs for our clients’ drug plans. We will provide more details in the coming months.

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 2022.*

Dental fee guide increases over 2021*

Province/Territory	Average Fee Increase
Alberta	3.9%
British Columbia	7.35%
Manitoba	5.79%
New Brunswick	5.9%
Newfoundland and Labrador	5%
Nova Scotia	7.05%
Northwest Territories	3%
Nunavut	3.1%
Ontario	4.75%
Prince Edward Island	4.75%
Quebec	5%
Saskatchewan	5.99%

*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.

Reminder: Review manual allocations for HCSAs and/or TSAs*

If your client’s Health Care Spending Account (HCSA) and/or Taxable Spending Account (TSA) has manual allocations, they need to allocate these amounts to plan members each year. Please review all your plan members’ profiles on EquitableHealth.ca to ensure they have received their allocation(s) for the current benefit year.

If your clients have Plan Administrator update access on EquitableHealth.ca, they can update these amounts online by doing the following:

Select “View certificate”
Select “Health Care Spending Account” or “Taxable Spending Account”
Select “Update Allocation” in Task Center
Enter amount in “Revised Allocation Amount”
Override Reason – “Plan Administrator Request”
Select “Save”

If your clients have Plan Administrator reporting access on EquitableHealth.ca, they can determine which plan members have a zero allocation by running the “HCSA Totals by Plan Member” report online by doing the following:

Select “Reports”
Select “New”
Select “Next”
Select “HCSA” or “TSA Totals by Plan Member”
Select “Next”
Enter end date of “12/31/2020”
Select “Next”
Select “Finish”
View “Report”

To provide us with the amounts to be updated, please have your client contact our Group Benefits Administration Team at GroupBenefitsAdmin@equitable.ca.

Mental health resources for plan members*

As the COVID-19 pandemic continues to evolve, many Canadians are experiencing increased levels of stress, anxiety, and depression. Through our partnership with Homewood Health®, all of our clients and their plan members have access to a number of health and wellness resources designed to provide guidance and support. These resources include a number of webinars which discuss various COVID-19 and mental health-related topics. The webinars are pre-recorded so plan members can stream them at their convenience.

Understanding the Impact of COVID-19 on Your Mental Health
English webinar
French webinar

COVID-19: Loneliness & Isolation Fatigue - Self-Care Strategies
English webinar
French webinar

COVID-19: Dealing with Seasonal Affective Disorder
English webinar
French webinar

Reducing Anxiety & Managing the Transition Back to the Classroom - for Teachers
English webinar
French webinar

COVID-19: Specialized Mental Health Support for Health Care Professionals
English webinar
French webinar

COVID-19: Supporting Children’s Mental Health
English webinar
French webinar

Additional resources, including articles, tools, videos and podcasts, are available at Homeweb.ca/Equitable. Please encourage your clients to share these resources with their plan members.

Equitable Life Group Benefits Bulletin – March 2022 In this issue:
*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

January 2024 eNews

In this issue:

Equitable scores high marks with group advisors*
REMINDER: Equitable's National Biosimilar Program starts in March*
2024 dental fee guide updates*
Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*

*Indicates content that will be shared with your clients.

Equitable scores high marks with group advisors*

Equitable ranked first for operational service among major group insurers in a recent study of Canadian group benefits advisors.

NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 146 Canadian group benefits brokers, consultants, MGAs and third-party administrators between May and August 2023 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 ranked among the top three in five of the six main categories, including number one for Operational Management:

Category	Ranking
Operational management	1st
Initiatives (including seminars & training)	2nd
Technology	3rd
Underwriting & claims management	3rd
Relationship management	3rd

“Advisors regard us highly in many categories. That’s a testament to our mutual status and ability to focus exclusively on our clients and advisor partnerships,” said Marc Avaria, Executive Vice President, Group Insurance Division. “We are truly working together to build strong, enduring and aligned partnerships with our clients and advisors.”

“We’re delighted with these results and are committed to continuously advancing our delivery of a better benefits experience for our clients and advisors,” added Avaria.

More highlights from the latest NMG survey

Nationally, we ranked first in seven subcategories in Operational Management, including:

Overall service to intermediaries,
Overall service to plan sponsors,
New quote process,
Plan implementation,
Renewal process,
Accuracy and timeliness of reporting and billing, and
Administration quality and responsiveness

In Underwriting and Claims Management, we finished in the top three for flexibility of underwriting (2nd).

And we were rated strongly in Technology, finishing in the top three for:

Overall technology for Intermediary (2nd)
Member experience (3rd)
Quality of technology for the plan sponsor (2nd)
Quality of mobile application (2nd)

REMINDER: Equitable's National Biosimilar Program starts in March*

In October 2023 we announced the upcoming launch of our national biosimilar program. Starting March 1, 2024, we are expanding our biosimilar switch initiatives to provide a single, nationwide** program. 

Why we’re making the switch

Over the past few years, most provinces have introduced policies to delist some originator biologic drugs. They require most patients to switch to biosimilar versions of those drugs to be eligible for coverage under their public drug plans. Soon, it is expected that all provincial drug plans will cover only biosimilars.

Equitable’s National Biosimilar Program simplifies drug plan coverage by replacing our provincial programs. It also protects clients from additional drug costs while offering access to lower-cost biosimilars deemed equally safe and effective by Health Canada.

How will this affect clients' drug plans?

Because we have already introduced biosimilar switch initiatives in most provinces, the impact of this change will be minimal. It will primarily affect plan members in provinces or territories where we haven’t already required the switch to biosimilars. It will also affect plan members who are taking biosimilars that were not originally included in the switch initiative for their province.    

Regardless of where they live, plan members across Canada 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. Plan members already taking the originator biologic will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable plan. We will support their transition with education, personalized communication, and resources. 

Advance notice for plan members

We contacted affected claimants in early December to give them enough time to change their prescriptions 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 Account Executive.    
 ** Excludes plan members in Quebec who participate in a separate provincial program. 

2024 dental fee guide updates*

Each year, Provincial and Territorial Dental Associations publish fee guides. Equitable uses these guides to help determine the reimbursement limits for dental procedures.

For your reference, you may wish to refer to the 2024 list of the average dental fee increases for general practitioners.

Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*

Equitable is proud to congratulate our Employee and Family Assistance Plan (EFAP) partner, Homewood Health®, for winning the Canadian HR Reporter 2023 Reader’s Choice Award in Employee Assistance Plan services. Homewood’s EFAP provides confidential support for a range of health, family, money, and work issues through face-to-face, phone, email, chat, or video counselling. The award recognizes their high standards in counselling and mental health support services.

The annual Reader’s Choice Awards identify organizations that provide outstanding expertise and services for HR professionals and employers across Canada. Those organizations provide valuable information on useful, innovative HR and employee benefits products and programs, in categories such as recruitment, mental health services, employee engagement programs, and more.

Sharing Homewood Health with your clients

Since 2019, we have worked with Homewood to provide mental health services for Equitable benefits plan members.

Your clients can access Homewood Health’s award-winning EFAP for an additional fee by adding it to their benefits plan. Services are available 24/7, 365 days a year.

All Equitable clients also have free access to Homewood Health Online in their benefits plan. Homewood Online provides a variety of helpful wellness resources, including:

Homeweb, an online and mobile health and wellness portal,
Health Risk Assessment, a group of assessment tools to help plan members identify and overcome health and wellness barriers, and
Online Internet-based cognitive behavioural therapy (iCBT) through Sentio to manage symptoms of anxiety and/or depression.

Questions

To learn more about Homewood Health’s services, contact your Group Account Executive or myFlex Account Executive.

EZcomplete now displays Critical Illness insurance premiums We have exciting news about EquiLiving^® Critical Illness EZcomplete® applications. Effective April 22, 2023, EZcomplete will calculate and display critical illness insurance premiums automatically! This will save you time during the application process.

EZcomplete will calculate and show both the yearly and monthly premium amounts as you complete the application – this is similar to other Equitable Life insurance products. This means you do not need to run a separate illustration to determine and input the premium amount into EZcomplete anymore.

To learn more about Critical Illness, the Equitable way, visit our Critical Illness page on EquiNet or contact your local wholesaler.

^®and^TM denote trademarks of The Equitable Life Insurance Company of Canada.
New illustration software now available!
We have updated our illustration software. Please be sure to download the latest version:
2023-3 (August 2023).

- Web-based illustration software on secure EquiNet^® (log in required)
- Desktop illustration software

We have new rates for our Equimax® Wealth Accumulator and Estate Builder plans. Please refer to our Transition Rules for all the details on processing your applications.

Need more information?
For information on these changes, please contact your Equitable Life wholesaler.

^_®denotes a trademark of The Equitable Life Insurance Company of Canada.
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