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1. [pdf] Claimant Statement for Entities
2. Equitable Life Group Benefits Bulletin – September 2021 In this issue:
   • Right drug, right dose*
   • Responding to New Brunswick’s Biosimilar Initiative*
   • Helping plan members access our convenient digital options*
   • Reminder: Please access forms on EquitableHealth.ca*
   • Over-age dependents losing coverage?*
   *Indicates content that will be shared with your clients

   Right drug, right dose

   Equitable Life partners with Personalized Prescribing Inc. to help plan members avoid treatment trial and error
    
   Patients suffering from mental health conditions often need to try several medications before they find one that works for them. This is frustrating and can result in negative side-effects, a longer recovery, lost productivity, or a delayed return to work.
    
   To help plan members avoid this treatment trial and error, we have partnered with Personalized Prescribing Inc. to provide easier access to pharmacogenomic testing for plan members with mental health conditions.
    
   Pharmacogenomics 101
   Pharmacogenomics is the study of how an individual’s genes influence their response to medications. Pharmacogenomic testing can help determine how compatible a patient’s body may be to a particular drug, and helps their physician prescribe the most appropriate medication. The goal is to ensure the right drug is prescribed to deliver the most positive outcome with the fewest side effects.
    
   Easier access to pharmacogenomic testing
   Through our partnership with Personalized Prescribing Inc., any Equitable Life plan member diagnosed with a mental health condition can purchase a pharmacogenomic test for a discounted price of $399 plus HST – a 20% savings.
    
   We are also introducing the option for plan sponsors to add coverage of pharmacogenomic tests provided by Personalized Prescribing Inc. for mental health conditions.
    
   With this coverage, plan members are eligible for pharmacogenomic testing if:
   • They have been diagnosed with a mental health condition;
   • They are currently taking or have stopped taking a medication for a mental health condition that does not work or has side effects; and
   • The pharmacogenomic test is conducted by Personalized Prescribing Inc.
   How it works
   Getting a test is easy. The plan member starts by visiting www.personalizedprescribing.com/equitablelife to request a test kit.
    
   Once they receive their test kit from Personalized Prescribing Inc., they simply provide a saliva sample and send it back (postage is pre-paid). Within 7-10 business days, they receive an Rx Report™ that they can share with their doctor. This report includes details to help their doctor prescribe the right drug and the right dose for them.
    
   Benefits for plan members:
   • The plan member and their physician receive a full report that is easy to understand;
   • The report identifies the most compatible medications for the plan member’s condition and the medications to avoid;
   • The physician is able to prescribe the most appropriate medication with the fewest side effects; and
   • The plan member avoids medication trial and error.
   Benefits for employers:
   • Pharmacogenomic testing can be an effective prevention strategy to help employees stay healthy and potentially avoid a mental health-related work absence; and
   • Employees suffering from mental health conditions may be more productive when they are on the right medication for them.
   To learn more about pharmacogenomic testing through Equitable Life and Personalized Prescribing Inc., please visit www.personalizedprescribing.com/equitablelife. To request coverage for your clients, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.

   Responding to New Brunswick’s Biosimilar Initiative

   We are changing coverage for some biologic drugs in New Brunswick in response to the province’s Biosimilar Initiative. These changes will help protect your clients from additional drug costs while still providing access to equally safe and effective biosimilars.
    
   What is New Brunswick’s Biosimilar Initiative?
   New Brunswick’s Biosimilar Initiative will end provincial coverage of several originator biologic drugs for some or all conditions beginning on December 1, 2021. Patients 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?
   The most significant risk to plan sponsors who maintain coverage of originator biologics is coordination of benefits (CoB) risk. 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.
    
   For example, consider a patient who is covered under two private plans – their employer plan and a spousal plan. If their employer plan was the first payer for the originator biologic but delists the drug, the spousal plan now becomes the first payor. If the spousal plan continues to cover the cost of the originator, it now pays most or all of the cost of the drug.
   
   How is Equitable Life responding?
   To protect your clients’ plans from paying additional and avoidable drug costs, we are changing coverage in New Brunswick for most biologic drugs included in the provincial initiative.
    
   Beginning Feb. 1, 2022, plan members in New Brunswick will no longer be eligible for coverage of Humira, Lantus, Humalog and Copaxone if they have a condition for which Health Canada has approved a lower cost biosimilar version of the drug. These plan members will be required to switch to a biosimilar version of those drugs to maintain coverage under their Equitable Life plan.
    
   How will Equitable Life communicate this change to plan members?
   We will be communicating with affected claimants in early-December 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?
   All groups, except myFlex clients, who wish to opt out of this change and maintain coverage of these originator biologics for New Brunswick plan members can submit a policy amendment. Amendments must be submitted no later than Nov. 30, 2021.
    
   Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for New Brunswick plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.
    
   Groups that opt out of this change are also opting out of any future changes to our New Brunswick biosimilar initiative. Their drug plans will continue to cover any additional originator biologics that we subsequently add to the program.  
    
   Will this change impact my clients’ rates?
   The rate impact of this change and  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.
    

   Helping plan members access our convenient digital options

   Some of your clients’ plan members aren’t benefitting from our secure and convenient digital options to access and use their Group Benefits. They can sign up to submit claims electronically for faster claim payments, get claim payments deposited directly to their bank accounts, easily review their coverage details, quickly access their Group Benefits plan booklet, benefits card and more. We’ve made it easier than ever to sign up, with more resources all conveniently located at Equitable.ca/go/digital.

   Your clients’ plan members can visit this link to view:
   • A brochure with all the high-level instructions they need to get started on EquitableHealth.ca and the EZClaim mobile app
   • A full video guide on how to access and navigate EquitableHealth.ca
   If your clients’ plan members need help activating these services, they can give us a call at 1-800-265-4556 and select the option for web support. We’d be happy to help!
    

   Reminder: Please access forms on EquitableHealth.ca*

   We routinely update our Plan Administrator forms on EquitableHealth.ca based on their feedback and to stay compliant with legal and/or regulatory requirements. If your clients need a form, they should always pull the most recent version from EquitableHealth.ca instead of reusing forms they have saved on their computer. Using an old or outdated form may result in processing delays.
    
   Your clients can access the Plan Administrator forms by following these steps:
   • Login to EquitableHealth.ca
   • Select “Documents”
   • Toggle between English and French forms
   • Click on the document name to download a PDF copy

   Over-age dependents losing coverage?*

   Some of your clients’ plan members may have dependents who are reaching the maximum age for eligibility under their group benefits plan.
    
   If they are attending school full-time or are disabled, they may be eligible for continued coverage. Plan members with over-age dependents can simply complete the Application for Coverage of Dependent Child Over Age 21 (Form #441) and submit it through our online document submission tool. They can access the tool by logging into their Group Benefits account at www.equitablehealth.ca and clicking My Resources. 
   
   If they are not attending school full-time or disabled, they will no longer be covered under the plan. However, they may be eligible for 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 clients’ 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
3. EAMG Market Commentary January 2024

   
   
   Rates & Credit – Interest rates decreased sharply in Q4 as the market priced in aggressive interest rate cuts by central banks in 2024.  The prospect of lower interest rates also drove a strong risk-on tone to the market, with the risk premium on corporate bonds grinding tighter as prospects for a “soft landing” improved. The rally in interest rates resulted in the best quarter for bonds over the past 15 years, with the FTSE Canada Universe Index returning 8.3%.  Corporate bonds modestly underperformed the Universe Index with a return of 7.3%.  The lower return for corporate bonds was primarily driven by the fact that the corporate bond index is less sensitive to interest rate movements (as compared to the government index), partially offset by the risk-on tone to the market.  Within corporate bonds, lower-rated BBBs outperformed higher-rated A bonds. Industries with higher interest rate exposure such as infrastructure, energy, and communications outperformed those with less exposure (notably financials and securitization), consistent with the overall shift in the yield curve.
   
   
    
   Santa Came to Town – Moving in sync with bonds, global equities jolted higher into the end of the year with cooling inflation data and dovish comments from central bankers. The U.S. market outperformed most regions last quarter with the S&P 500 returning 11.7% in USD terms, bringing the total return in 2023 to 26.3%. The TSX added 8.1% in Q4, boosting the total annual return to 11.8%. Meanwhile, major developed economies from Europe, Australasia, and the Far East (EAFE) gained 5.0% in local currency terms over the quarter, helping the region produce a 16.8% return from the year prior. Prospects of interest rate cuts by the Federal Reserve saw the Loonie rally into year-end and resultantly, investors of Canadian dollar securities witnessed enhanced returns. Strong domestic U.S. economic data helped value pockets of the market outperform. That said, this was not a synchronized trend as China’s economic disappointment weighed on the performance of EAFE.
    
   
    
   U.S. Fundamentals – Our work shows that investors are shifting their focus away from operating margins and towards the ability to sustain debt levels ahead of renewing debt obligations. Corporate earnings beat modest expectations last quarter, contracting by less-than-expected on a year-over-year basis. Resilient operating margins continue to attract investors into equities. After three consecutive quarters of improving forward earnings guidance, we observed that the number of major companies expecting deteriorating financial performance grew to ~35%. We note that this is a sharp contrast relative to the optimistic run-up in equity valuations. In general, corporate pessimism has been underpinned by concerns for the health of the consumer, increasing wage pressures, and inflation.
    
   U.S. Quant Factors – While mega-cap technology stocks gave back some ground in the second half, crowding into the magnificent 7 remains noticeable with the cap weighted S&P 500 outperforming the equal weighted index by 12.5% last year. That said, value areas of the market – which underperformed through the first three quarters of the year – were top performing companies last quarter as the prospects for an economic “soft-landing” improved with U.S. inflation continuing to ease without substantial deteriorations of employment or output data. Quality-growth businesses initially outperformed as the higher-for-longer narrative continued to drive investors toward large cash-rich companies with stable margins. That said, this basket of companies gave back relative returns into quarter-end as weakness in operating margins persisted, making fundamentals appear stretched. Low volatility stocks (i.e. stocks with lower sensitivity to broad market movement and lower price volatility) rallied to start the quarter before dovish comments from central bankers improved risk-sentiment and ultimately pushed this basket lower on a relative basis. Lastly, dividend growth companies, which include businesses with a lengthy and established history of increasing dividends, underperformed the broader index as market participants punished businesses that slowed capital growth projects during the rising interest rate environment. While operating margins have declined, the basket’s strong cash flow and low debt burden may be advantageous if the market’s anticipation of impending interest rate cuts proves to be incorrect or mistimed.
    
   Canadian Fundamentals – Although Canadian companies exceeded bleak forecasts last quarter, earnings continue to contract on a year-over-year basis. Return on equity (ROE) – a gauge of how efficiently a corporation generates profits – continued to decline last quarter while corporate costs of capital remain elevated. In essence, Canadian companies are generating less value relative to their financing cost. Value creation underpins the sustainability of dividend payments, which are a unique and desirable attribute of the Canadian market. Meanwhile, the Bank of Canada held its overnight interest rate unchanged with market participants forecasting a higher probability of interest rate cuts in 2024. On the expectations of easing monetary conditions, dividend yields compressed while earnings forecasts improved with analysts predicting that index aggregate earnings will grow 6% to 8% in 2024. At a sector level, the energy industry’s financial performance normalized – in line with expectations – as weakening oil demand expectations overshadowed geopolitical conflict in the Middle East, ultimately pushing crude prices ~21% lower last quarter. The industrials and financials sectors beat expectations, helping offset softer-than-expected results from the consumer staples and technology sectors.
    
   Canadian Quant Factors – The Canadian banks underperformed for most of the year as they reported increasing provisions for nonperforming loans, reflecting forecasts of worsening economic conditions. That said, expectations of interest rate cuts in 2024 helped tame recession fears and eased concerns of slowing loan growth, propelling banks higher in the fourth quarter as they appeared more stable and therefore favourable than prior estimates. The high-quality basket underperformed last quarter as improving risk sentiment in the market reduced the attractiveness of secure companies with lower earnings variability. Furthermore, high dividend payers with solid growth prospects outperformed in the fourth quarter as market participants rewarded companies that demonstrated a strong ability to support future dividends and punished high yielding businesses with less certain financial capabilities.
    
   Views From the Frontline Rates – Interest rates declined sharply in Q4 as inflation continued to trend lower, fears of excess bond supply declined, and the Federal Open Market Committee signaled that the next change to their overnight policy interest rate would likely be lower. Labour market and consumer spending data remain resilient however businesses have indicated slowing across industries, more price-sensitive consumers, rising delinquencies, and concerns about the high cost of debt.  Central banks remain committed to achieving their 2% inflation target and most acknowledge that interest rates have likely peaked.
    
   Credit – The risk premium for corporate bonds (versus government bonds) tightened materially over the quarter, with a strong risk on tone to the market as investors priced in lower interest rates in 2024 and a “soft-landing” to economic concerns.  Corporate bond supply was well received by the market.  On the balance, we do not think the current risk premium adequately compensates for downside risk, and as such, we remain cautious on   corporate bonds and have a bias towards higher-quality, shorter-dated credit where we view the risk / reward dynamic as being more favourable.
    
   Equity – In the U.S., we allocated exposure to value names which outperformed over the quarter as the macroeconomic outlook improved on the backdrop of rate cut expectations. Looking forward, we expect that margins will continue to normalize as Covid-induced pent up demand fades. While we do not forecast margins to compress at an alarming rate, we believe sticky wage and input costs will continue to pressure businesses while consumers exhibit further exhaustion. As such, we are shifting our focus toward the balance between company reinvestment in capital projects and upcoming debt refinancing requirements. In line with this view, we favour businesses with stable cash flows and decreased debt loads as we believe they present an attractive contrarian opportunity if soft-landing projections prove to be overstated. Within Canada, we remain attentive to the inverse movements of ROE relative to financing costs over 2023. With the excess between ROE and financing costs compressing, businesses’ ability to create value appears more stretched than earlier in 2023. Therefore, we continue to favour high quality companies in Canada, which is typically defined by high ROE, stable earnings variability, and low financial leverage. Geographically, the U.S. economy appears to be in healthier condition with inflation easing while employment and output data remain stable and hence, our focus will be on capital expenditures. EAFE – which is generally more economically linked to China than North America – contains a large bucket of stable, high-quality businesses that may benefit from any upside economic surprises out of China. Lastly, through the lens of a Canadian investor, the Loonie’s relative value versus other major currencies presents another resource in our investment mandate to derive excess return.

    

   Downloadable Copy

   
    
     

   Mark Warywoda, CFA VP, Public Portfolio Management	Ian Whiteside, CFA, MBA AVP, Public Portfolio Management	Johanna Shaw, CFA Director, Portfolio Management	Jin Li Director, Equity Portfolio Management
   Tyler Farrow, CFA Senior Analyst, Equity	Andrew Vermeer Senior Analyst, Credit	Elizabeth Ayodele Analyst, Credit

    
   ADVISOR USE ONLY
   
   Any statements contained herein that are not based on historical fact are forward-looking statements. Any forward-looking statements represent the portfolio manager’s best judgment as of the present date as to what may occur in the future. However, forward-looking statements are subject to many risks, uncertainties, and assumptions, and are based on the portfolio manager’s present opinions and views. For this reason, the actual outcome of the events or results predicted may differ materially from what is expressed. Furthermore, the portfolio manager’s views, opinions or assumptions may subsequently change based on previously unknown information, or for other reasons. Equitable® assumes no obligation to update any forward-looking information contained herein. The reader is cautioned to consider these and other factors carefully and not to place undue reliance on forward-looking statements. Investments may increase or decrease in value and are invested at the risk of the investor. Investment values change frequently, and past performance does not guarantee future results. Professional advice should be sought before an investor embarks on any investment strategy.
    
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