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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 *
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
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Paper Pivotal Select applications (Form #1383 and #1384)
On April 27, 2020 Equitable Life® launched its NL-CB sales charge option to its Pivotal Select™ segregated fund lineup. The new option provides an additional choice to the existing Low Load (LL), No Load (NL) and Deferred Sales Charge (DSC) selections. To reflect the new sales charge option, Pivotal Select applications (Form #1383 and #1384) were updated.
The paper Pivotal Select applications (Form #1383 and #1384) with a version date prior to 2020/04/27 (located on the back page and in the bottom right-hand corner of the application) will no longer be accepted as of July 1, 2020. If you currently have applications with a date that is before 2020/04/27, please destroy them and order new applications from our Supply Team. To order new applications, click here.
Want to be sure you always have the most up-to-date application? Try our EZcomplete® online application platform. EZcomplete makes it easy to process your non-face-to-face applications and allows your clients to provide their signature remotely on their own device.
For more information about the NL-CB sales charge option, please click here. For more information about Equitable Life’s EZcomplete, click here. -
New segregated fund sales charge option from Equitable Life of Canada
On December 7, 2020 Equitable Life® will add a new No Load CB5 (NL-CB5) sales option with a 60-month chargeback schedule to the Pivotal Select™ segregated funds lineup. This new sales charge option complements the recently launched No Load CB (NL-CB) option which has a 36-month chargeback schedule.
This new sales option for Pivotal Select gives you and your clients five sales charge options to choose from: Low Load (LL), No Load (NL), No Load CB (NL-CB), No Load CB5 (NL-CB5) and Deferred Sales Charge (DSC). The addition of NL-CB5 provides an option for those advisors who want to increase the upfront portion of their commission. The benefit to clients is no Deferred Sales Charge to contend with. If your client chooses to withdraw funds within 5 years after purchase, there is a chargeback of commission to you.
By offering five sales charge options, the choice between three distinct guarantee classes (Investment Class (75/75), Estate Class (75/100) and Protection Class (100/100)), and a diverse selection of investment funds, the Pivotal Select contract provides the flexibility to build an investment solution that meets the needs of your clients.
Need to meet with your client online? Our EZcomplete® application makes it easy to process your non-face-to-face applications and do business with Equitable Life. EZcomplete gives you the option to conduct your non face-to-face business easily and quickly, enabling your clients to provide their signature remotely on their own device.
For more information about Equitable’s NL-CB5 or any of Equitable’s products, contact your local Regional Investment Sales Manager or our Advisor Services team at 1.866.881.7427 Monday to Friday 8:30 a.m. – 7:30 p.m. ET or email savingsretirement@equitable.ca.
To learn more, click here.
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Make room for more EDO room
Effective June 26, 2021, a term rider added to an Equimax Estate Builder® or Equimax Wealth Accumulator® policy may allow for an increase to the maximum Excelerator Deposit Option (EDO) payment limit.
Highlights:
● This enhancement will apply to adult single life Equimax Estate Builder and Wealth Accumulator policies where the Owner Signature Date on the application for insurance is June 26, 2021 or after.
● For the term rider to increase the EDO payment limit, it must be issued at the same time as the Equimax coverage.
● Term rider EDO payment limit assumes the term rider is held at least 10 years.
● The illustration system and EZcomplete application will calculate the maximum EDO payment including any increase from a term rider.
● Policies already issued do not qualify.
Full details about the changes can be found in the transition rules.
Who can benefit from this product enhancement?
Your clients who have a temporary insurance need and add a term rider to their Equimax plan may be able to take advantage of the additional exempt room and higher EDO payment limits to build the policy values. Make Equimax® your first choice for your clients’ whole life insurance needs.
New Illustration software is now available
The updated illustration software will be available for download after 9 a.m. ET on Friday, June 25, 2021.
Want more information?
● Learn more about the changes and transition rules
● Contact your Regional Sales Manager for more information on these changes and other sales ideas
® denotes a registered trademark of The Equitable Life Insurance Company of Canada. -
Excelerator Deposit Option – maximum payment limit changes
The Excelerator Deposit Option (EDO) gives your client the option to make additional payments, subject to specified limits and our current administrative rules and guidelines, above the required guaranteed policy premium. EDO payments can help grow the long-term values in your client’s policy. This change is regarding the maximum EDO payment limit that applies to the policy.
● NEW! If a request is received to terminate, convert, or reduce the term rider and the term rider has been in effect for 10 years or longer, the EDO maximum for the policy will not be reduced.
For Equimax policies with an Owner Signature Date of June 26, 2021 or after where a term rider has increased the maximum EDO payment limit on the policy
● If a request is received to terminate, convert, or reduce the term rider and the term rider has been in effect for less than 10 years (it has not reached the 10th policy anniversary), the EDO maximum for the policy will be reduced accordingly.
Current rules as to when underwriting is required for EDO payments continue to apply, as do current rules surrounding acceptance of EDO payments and maintaining the tax-exempt status of the policy and can be found in the Equimax Product Admin Guide.
Want more information? Contact your Regional Sales Manager for more information on these changes
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Saving time with our fully digital group benefits application
On May 1, 2023, we are launching Equitable BenefitsApply™, our fully digital group benefits application.
This enhancement to the benefits application process will help both you and your clients save time when applying for an Equitable Life group benefits policy. We designed and developed BenefitsApply with input and feedback from several advisors and clients, who tested the tool for themselves.
In most cases, BenefitsApply will replace our traditional paper implementation process.*
BenefitsApply eliminates the need for clients to complete and sign multiple, lengthy paper forms. Time-saving features for you and your clients include:- A fully digital online application that you can access wherever and whenever you need it,
- Pre-filled standard fields,
- Only one signature required from plan sponsors,
- A smart application that only includes the sections relevant to the client and the plan design they have chosen, and
- Automatic notifications of any missing fields.
We will continue improving BenefitsApply’s features based on feedback from the people who use it—you and your clients. We encourage you to share any feedback you have with your Group Account Executive or your Client Relationship Specialist.
*BenefitsApply is currently available for groups with up to four divisions and up to four classes. It is not available for myFlex Benefits plans, or for clients with a customized master application. - Take advantage of our online services today!
- [pdf] Pivotal Select Contract and Information Folder
- [pdf] How to access in-force illustrations
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Insights from a pandemic: Long-term COVID-19 drug risks
For the remainder of 2020 and beyond, COVID-19 will continue to add to the existing pressures driving up drug costs. Examples of contributing factors include:
- Claims for acute drugs will likely increase as elective surgeries resume and plan members address non-emergency health issues that were left unattended during COVID-19.
- Plan members whose employers are facing financial strain due to COVID-19 may stock up on their prescriptions in anticipation of losing their job and/or their benefits.
- An ongoing increase in the prevalence and severity of mental health issues and chronic conditions. In May and June, we saw a dramatic increase in the number of claimants for depression, ulcers, blood pressure and diabetes, and depression was associated with 1 in 5 claimants.
All trends thus far suggest we can expect about a 10% increase in average paid amounts per certificate in 2020 compared with 2019. But the impact won’t be the same for all groups. There will be significant variations, particularly for smaller groups, and some may see much larger cost increases.
Unknown COVID-19-related risks
Another risk exposure may come from the costs associated with drugs used to treat or prevent COVID-19. There are currently numerous vaccines in development, and more than 300 clinical trials are underway for both new and existing drugs to determine their effectiveness in treating the virus.
The cost of any vaccine or whether government or private plans will pay for it is unknown. Regardless, there will likely be other drugs indicated for the treatment or prevention of COVID-19 that private plans will be expected to cover. The cost of this impact for private payers is unknown, but potentially high.
Another unknown is what will happen with dispensing fees. While most provinces have lifted their 30-day prescription refill limits, it remains to be seen whether pharmacies will resume dispensing 60- and 90-day refills at pre-COVID levels for private plans. If not, this would mean the dispensing fees will continue to drive up drug costs.
Advisor opportunity
Despite the increase in drug plan risk in recent years, little has changed in plan design trends. Very few plan sponsors have adopted managed plans or other plan design options that could help manage risk.
This presents an opportunity for advisors to educate their clients about the risks their drug plan may be exposed to and the options available to manage that risk.
A practical starting point for those conversations is our Drug Plan Design Tool. With two simple questions, it can help confirm your client’s objectives and identify some best-fit solutions for their plan. Ask your Group Account Executive or myFlex Sales Manager for a copy of the tool.