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1. [pdf] Equitable GIF Advisor FAQ
2. [pdf] Equitable GIF Product at a glance
3. [pdf] Advisors Edge Insurance for Children Article
4. [pdf] Payout Annuities Product at a Glance
5. [pdf] Beneficiary Change Form
6. [pdf] Pivotal Select Contract and Information Folder
7. [pdf] Do you know Dakari and Ash
8. [pdf] Do you know Leona
9. 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.

10. February 2023 eNews

    Responding to Nova Scotia’s biosimilar switch initiative

    We are changing coverage for some biologic drugs in Nova Scotia in response to the province’s biosimilar initiative. These changes will help protect your clients’ plans from additional drug costs that may result from this new government policy while providing access to equally safe and effective lower-cost biosimilars. 

    Nova Scotia’s provincial biosimilar initiative

    Announced in February 2022, the Nova Scotia Biosimilar Initiative ends coverage of seven biologic drugs for residents enrolled in Pharmacare programs.
    
    Pharmacare patients in the province using these drugs will be required to switch to biosimilar versions of these drugs by February 3, 2023, in order to maintain their Nova Scotia Pharmacare coverage. 

    Equitable Life’s response

    To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Nova Scotia for most biologic drugs included in the provincial initiative.
    
    Beginning June 1, 2023, plan members in the province 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.** These plan members will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable Life plan.  

    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 Nova Scotia plan members can submit a policy amendment. Amendments must be submitted no later than April 1, 2023. Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Nova Scotia plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.
    
    Groups that choose to maintain coverage of these originator biologics for existing claimants will also maintain coverage for any originator biologics that we subsequently add to our Nova Scotia biosimilar initiative.  

    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.

    Communicating this change to plan members

    We will inform any affected plan members in April of the need to switch their medications so that they have ample time to change their prescriptions and avoid any interruptions in treatment or coverage. 

    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 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.
    
    **The list of affected drugs is dynamic and will change as Nova Scotia includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
     

    Changes to New Brunswick drug interchangeability rules

    We are introducing changes to help ensure that your clients with voluntary or mandatory generic pricing for their drug plans will benefit more from the cost savings of these two features, regardless of the province where the drugs are dispensed.
    
    Currently, when determining whether a lower-cost alternative is available for a brand-name drug, most insurers only consider drugs that the provincial drug plan identifies as interchangeable.
    
    However, the public drug plan in New Brunswick does not identify a drug as interchangeable if the drug is not listed on its formulary – even if Health Canada has deemed the drug interchangeable.
    
    As a result, plans with mandatory or voluntary generic pricing have continued to reimburse some drugs in New Brunswick based on the cost of the brand-name drug, even if a lower-cost generic alternative is available.
    
    Effective March 20, 2023, if your clients have drug plans with mandatory or voluntary generic pricing, we will adjudicate any drug claims in New Brunswick using the lowest cost alternative that Health Canada approves as bioequivalent. This will occur even if the public drug plan has not identified the drug as interchangeable.
    
    To benefit from this more robust drug plan control, plan sponsors must have mandatory or voluntary generic pricing in place.
    
    For more information about this change or about implementing mandatory or voluntary generic pricing for your clients, please contact your Group Account Executive or myFlex Sales Manager.
     

    New template: plan members eligible for additional coverage

    Often, based on salary, some plan members may become eligible to apply for extra Life, Accidental Death & Dismemberment (AD&D), Short Term Disability or Long Term Disability coverage. If this occurs, your clients receive a notification from Group Benefits Administration. We have now developed a template that your clients can provide to applicable plan members if they become eligible for extra coverage. The template makes it simpler for your clients to pass on these details to their plan members efficiently.
    
    The new template is available for download under the Quick Links section of EquitableHealth.ca. It is a fillable PDF form that your clients can complete and provide to their plan members when necessary. The document is called Over the Non-Evidence Limit for Plan Members Notification.
    
    If you have any questions about the template, please contact your Group Account Executive or myFlex Sales Manager.