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1. NEW MARKETING MATERIAL! Flexibility for supplemental income with Equimax Equitable has created a new piece to help you understand our new Equimax^® illustration feature, Paid-Up Additions (PUA) to Cash Dividends, now available!
   
   Did you know Equimax clients can switch from the PUA dividend option to the cash dividend option by simply requesting a dividend option change?^1,2
   
   You can illustrate this for paid-up 10 pay and 20 pay Equimax plans! Show clients how they can build in added flexibility and use their policy to create a source of future supplemental income by simply changing the dividend option to cash.³
    
   Illustration Considerations:
   ● Works with Equimax Estate Builder^® or Equimax Wealth Accumulator^®.
   ● Illustrate the Excelerator Deposit Option (EDO) to help build the policy values while the PUA dividend option is in effect. EDO payments can’t be made once the policy is switched to the cash dividend option.
   ● If a client needs temporary insurance coverage – like mortgage protection - illustrate term riders for how long they are needed to meet the specific goal.³
   ● If critical illness coverage is needed our competitively priced 20 pay critical illness riders are a great fit to provide paid-up critical illness coverage.³ 
   
   Clients should apply for the coverage they need. This concept is about flexibility to create a future source of supplemental income.
   
   Want to learn more? Check out our new marketing piece: Flexibility for supplemental income with Equimax (2077).
   
   For more information, reach out to your local wholesaler.
    
    
   ^® and ^TM denote trademarks of The Equitable Life Insurance Company of Canada.
   ¹ Dividends are not guaranteed and are paid at the sole discretion of the Board of Directors.  Dividends may be subject to taxation. Dividends will vary based on the actual investment returns in the participating account as well as mortality, expenses, lapse, claims experience, taxes, and other experience of the participating block of policies.
   ² To request a change to the dividend option complete and submit form 558 (Request for Withdrawal of Dividends, Change in Option, or Premium Offset). A client can request a change to the cash dividend option from any other dividend option regardless of the premium type or whether premiums continue to be payable, subject to our current administration rules and guidelines. Some dividend option changes are subject to underwriting. Underwriting is not required to change from the PUA to cash dividend option, however, underwriting is required to change from the cash dividend option to the PUA dividend option.
   ³ This concept is intended to illustrate a one-time switch to cash dividends once premiums are no longer payable for the policy (including premiums for riders). Premiums are paid with after-tax dollars and dividends paid in cash are subject to taxation.  If premiums are payable there will be tax savings for the client to use the before-tax cash dividend to reduce the premium instead of taking it entirely as a cash payment.  This concept is intended for longer term planning, not to meet short term cash needs by switching back and forth between the PUA and cash options. Clients should consider a policy loan or a cash withdrawal to meet short-term cash needs; policy loans and cash withdrawals may be subject to taxation.
    
2. May 2023 eNews

   Update: Introducing changes to our Diabetes Management Program

   Beginning June 1, 2023, we are introducing additional standard drug plan controls as part of our Diabetes Management Program.
    
   The controls will apply to GLP-1 agonists approved by Health Canada for the treatment of diabetes, such as: Adlyxine, Mounjaro, Ozempic, Rybelsus, Trulicity, and Victoza. 
    
   This change will help manage the impact of these high-cost diabetes medications for your clients while continuing to provide plan members with access to effective treatments to manage their disease.
    

   Why are we introducing this change?

   GLP-1 agonists are the highest cost diabetes drugs on the market. Current Diabetes Canada Clinical Practice Guidelines recommend that most Type 2 diabetics begin treatment with lower-cost and equally effective first-line therapies, such as Metformin.
    
   Some GLP-1 agonists are also used “off-label”. In other words, they are often prescribed for conditions for which they have not been approved by Health Canada, such as weight loss.
    
   These additional controls will help ensure that these drugs are used appropriately – only for the treatment of diabetes and only after other first-line treatments have been tried.
    
   If a client wishes to provide coverage for drugs specifically approved by Health Canada for weight loss, we have coverage options available.    
    

   How will this program work?

   Plan members who receive a new prescription for a GLP-1 agonist will need to try a first-line diabetic treatment before they are eligible for coverage of the GLP-1 agonist. If the plan member has previously tried first-line therapies and found them ineffective, they will be eligible for a GLP-1 agonist.
    
   Plan members who are already taking a GLP-1 agonist to treat diabetes will continue to be eligible for coverage. Some claimants may need to provide confirmation of their diabetes diagnosis from their physician or pharmacist in order to maintain coverage. We will provide claimants ample time to confirm their diagnosis.
    

   Questions?

   If you have any questions about these additional standard controls or how they will impact your clients, please contact your Group Account Executive or myFlex Sales Manager.
    

   Coming soon: Survey for plan administrators with recent disability claims

   We are regularly enhancing our communication processes to help your clients with disability plans manage their workplace absences more effectively. Later this month, we will distribute a short survey to plan administrators who have submitted a disability claim in the past six months. The survey will ask recipients about their satisfaction with the frequency and detail of our disability management communications.
   
   The email will come from GBClientFeedback@equitable.ca, and the survey will remain open until the end of the day on May 19, 2023. All responses will be confidential. Survey respondents will receive the option to provide their contact information so that we can follow up on feedback they have provided.
   
   We plan to use the feedback to help ensure that we’re meeting your clients’ expectations and delivering industry-leading service.
   
   In a previous issue of eNews, we published a list of the average dental fee increases for general practitioners based on the latest Provincial and Territorial Dental Association fee guides.
   
   Since then, the Canadian Life and Health Insurance Association (CLHIA) has updated the 2023 dental fees for some provinces. Provinces with dental fee updates since our previous eNews are bolded and italicized. 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 2023.
    
3. [pdf] Now it’s even easier to grow your savings online!
4. Path to Success Module 3
5. Path to Success Module 4
6. Update on our service levels during the COVID-19 pandemic

   Supporting your clients and their plan members is more important than ever during the ongoing COVID-19 pandemic

   So, we’re providing an update on our service levels.

   We acted quickly to ensure there were no disruptions in service – most of our staff were working remotely from home and fully functional within a few days. We’ve reallocated resources from functions where volumes are down, such as dental claims, to those experiencing higher volumes. We also created a separate queue for COVID-19-related STD claims.

   As a result, we’ve been able to maintain the industry-leading service levels you have come to expect from us, and our turnaround times continue to be well within our targets.

   Here’s a summary of what you and your clients can currently expect in terms of average turnaround times:

   Service category	Average Turnaround Time (as of April 26th)
   Customer Care Centre wait times	89% of calls answered within 20 seconds
   Responses to emails to our Service Team	Within 24 hours
   Health claims	2 days
   Dental claims	2 days
   Life claims	1 day
   STD claims	4 days
   LTD claims	4 days
   Plan member updates	2 days
   New customer implementations	16 days
   COVID-19-related plan amendments	4 days
   Other plan amendments	8 days
   Quotes	2 days ahead of deadline

   We will closely monitor the situation and continue to adapt to ensure we maintain our service levels. And we will do our best to resolve any service issues that arise as quickly as possible.

   Please feel free to contact your Group Account Executive or myFlex Sales Manager and let us know how we’re doing.

7. Take emotions out of investing
   Taking the emotion out of investing can be easier said then done. Most of us at one time or another have decided upon something strictly because of how we felt at the time, not because it was logical or made good financial sense. I am sure most of us have a good story to tell.
   
   When it comes to financial planning, you always want to encourage your clients to be a rational investor and accept that market fluctuation is part of the investment journey. Over the last few months, even the hardiest rational investor has been challenged to accept the market fluctuations. History shows us that this too, shall pass and markets will rise once more. The biggest question asked is always, when?
   
   While no one has a crystal ball with that answer, the best we can do is help our clients understand that when building portfolios, risk is always at the forefront of any good investment strategy. The level of risk is just one of the building blocks to constructing a financial portfolio that will see the client through good times and bad.
   
   Need more help? Equitable Life has created an emotional investing brochure to help your clients manage through these extraordinary times. To download a copy, click here. We have also included a template letter that you can personalize and use to reach out to your clients. To download an editable copy, click here.
   
    
8. Tools to manage mental health

   As we all continue to manage the impacts of the COVID-19 pandemic, it’s important to remind your clients of the valuable supports available to help their plan members cope through this challenging time.

   Free trusted information and COVID-19 resources

   Our partner FeelingBetterNow® is responding to the pandemic by providing trusted public resources that offer mental health support. They are available to anyone 24 hours a day, seven days a week, and include:

   • What to do if you’re anxious or worried about COVID-19;
   • Resources for parents and caregivers; and
   • National and Provincial Public Health resources.

   Access COVID-19 resources from FeelingBetterNow.

   FeelingBetterNow Mental Health Assessment

   In addition to these public resources, Equitable Life clients with FeelingBetterNow as part of their group benefits plan have access to online mental health resources. FeelingBetterNow can help plan members identify their risk for mental health concerns and work with their doctor on diagnosis and treatment. It’s an anonymous tool developed by mental health experts which provides:

   • Emotional and mental health assessments;
   • Practical, evidence-based tools employees and their doctor can use to assess, treat, and follow-up on emotional and mental health concerns; and
   • Convenient online access to information and effective resources.

   FeelingBetterNow is easy to use and completely anonymous. It takes less than 20 minutes to complete the assessment and view your results.

   Learn more about FeelingBetterNow, then contact your Group Account Executive or myFlex Sales Manager to discuss how your clients can add this service to their plan.

9. Have you heard about Equitable Client Access?
   Equitable Client Access^® allows clients to self-serve on some of the more popular requests. Thousands of clients have already signed up for Equitable Client Access and are enjoying the benefits of accessing their secure information 24/7.
   
   •   Does your client need to change or stop existing Pre-Authorized payment (PAD)? Equitable Client Access can do that.
   •   Does your client need to change a withdrawal date for a PAD? Equitable Client Access can do that too.
   •   Address or banking information changes? Equitable Client Access has your clients covered.
   •   Does your client need to change her beneficiary from Aunt Flora to Uncle Ned? Equitable Client Access can even do that.
   
   Equitable Client Access is a secure online client site that connects clients with policy information, right at their fingertips. In addition to the self-serve features, Equitable Client Access can also provide:
   
   •    Insurance coverage and guarantees
   •    Investment allocation, performance and market values
   •    Transaction history
   •    Statements and letters
   •    Advisor contact information, along with so much more.
   
   
   If your clients have not signed up for Equitable Client Access, direct them to client.equitable.ca - it only takes a few minutes to set up an account, and connects your clients with their policy information online – anytime!
   
   Have a question about Equitable Client Access? Want to tell your client how to go paperless? Check out our updated FAQ or contact your Regional Investment Sales Manager today.
    
10. 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):