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Equitable Life Coronavirus Update – March 13, 2020
As the coronavirus (COVID-19) continues to spread, it’s important that you, your clients and their plan members have the most up-to-date information. We are providing timely updates on any developments that impact your clients and their plan members or their benefits coverage.
Please share this information with your clients. You can direct them to EquitableHealth.ca, where we have posted a version of these updates.
Coronavirus travel coverage*
For groups with Travel Assist coverage
The Public Health Agency of Canada has issued several Travel Health Notices advising Canadians to avoid travel to countries and regions where there have been outbreaks of coronavirus (COVID-19).
A good resource to help your clients and their plan members understand how the spread of the coronavirus may impact their travel plans is the Public Health Agency of Canada’s Coronavirus Travel Advice site. The levels of risk by country and region are regularly updated.
If your clients’ plan members cannot avoid travelling, Public Health recommends they take steps to prevent illness and seek medical attention if they become sick.
Where to find the latest information
The list and level of travel advisories can change at any time. Please check the Government of Canada’s Travel Advisor and Advisory page for the most current information.
If your clients’ plan members have coronavirus symptoms while travelling, please advise them to contact Travel Assist at the numbers listed below for assistance.
Advise plan members to call before they travel
If a plan member is travelling anywhere outside of the province or country and their benefits plan includes Travel Assist, plan administrators should advise them to make sure they’re prepared for a medical emergency by following these steps.
- Check the Government of Canada’s Travel Advisor and Advisory page. Note that it is important to click on the country to check whether any specific regions of that country have travel advisories.
- If they have questions, they should call Travel Assist before they travel for assistance and benefit information.
- Pack their Equitable Life benefits card and provincial health card.
- In a medical emergency, call the Travel Assist 24-Hour Hotline:
- Toll-free Canada/USA: 1.800.321/9998
- Global call collect: 519.742.3287
- Allianz Global Assistance ID #9089
Allianz Global Assistance administers Equitable Life’s Travel Assist benefits. Allianz has an international network of medical facilities, transportation providers, medical correspondents and multilingual administrative agents who aid with medical, legal and most travel-related emergencies 24-hours a day, seven days a week.
Early prescription refills and drug shortages*
In response to concerns about COVID-19 TELUS Health, our pharmacy benefits manager, has announced it is maintaining its standard rules for refills of medication. Plan members can refill their medications when at least two-thirds of the last dispensed supply has been used.
If plan members need more than the maximum supply allowed on their plan, they must pay out-of-pocket for the excess amount. They can then submit a claim to ask for an exception request.
TELUS is taking this position to help maintain access to medication for all patients. They continue to monitor the situation. We will provide an update if it changes.
Drug shortages
TELUS Health monitors for drug shortages and updates their system for any unavailable drugs. This helps to ensure accurate claims payment. If a referenced lowest-cost generic drug is unavailable, claims for drugs in the class will be paid at the next lowest-cost generic alternative available.
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Group Benefits - Premium relief for Dental and Extended Health Care benefits
We know this is a difficult time for Canadian employers and that many of your clients are facing financial hardship as a result of the COVID-19 pandemic. We continue to look for ways to help employers manage while still supporting their employees.
With many health practitioners closing their offices due to the pandemic restrictions, plan member use of dental benefits and some health benefits has declined.
So, we are pleased to announce that we are offering premium relief for all Traditional and myFlex insured non-refund customers for Health and Dental benefits, as follows:
- A 50% reduction on Dental premiums; and
- A 20% reduction on vision and extended healthcare rates (excluding prescription drugs), which equates to an 8% reduction on Health premiums.
These reductions are retroactive to April 1, 2020 and will appear as a credit against the next available billing. We will assess the situation monthly and expect to continue with monthly refunds for as long as the current crisis period continues.
We expect that claims experience and premiums will return to normal once the current pandemic restrictions are lifted.
In the meantime, plan members will continue to have full access to their benefits coverage throughout the pandemic. In many cases, dental offices remain open for emergency services, and a variety of healthcare providers are available virtually.
Commissions
We know the pandemic has put financial strain on your business as well, so we will continue to pay full compensation. Although your overall commission will be unaffected by these premium reduction adjustments, you may see a temporary reduction in your commission payments if you are on a pay-as-earned basis while we put through mass changes. If so, we will then make an additional top-up payment to cover that shortfall as soon as we are able.
Communication
We will be communicating this premium relief program to your clients April 21st at 8:00am EST.
A PDF of the communication is also available here.Questions?
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager. In the meantime, we have provided some Questions and Answers below.
Will the premium reduction on Health and Dental benefits have an impact on the renewals that were deferred?
No. Renewals will proceed as normal, with rate adjustments based only on months where full premium was paid. For most clients, we anticipate “normal” rate adjustments at renewal compared to rates paid prior to refunds taking effect.
Does this adjustment apply equally to clients who have had their renewal deferred?
Yes, these adjustments apply to all Traditional and myFlex insured, non-refund customers for Health and Dental benefits.
How does this affect clients who have terminated or amended a plan?
If a benefit is in-force during the month of April, the adjustment will be credited to the next available billing. For clients who have temporarily terminated all benefits, this will be applied against the first bill once benefits have been reinstated. No cash refunds will be paid.
Will you recover any of the adjustment at a future point in time?
No, we will not recover this adjustment.
Instead of this premium reduction adjustment, can a client cancel or adjust some of the benefits on their plan?
Yes, you and your clients always have the option of changing the coverage on a plan, such as reducing or removing a benefit to help control costs. Please speak to your Group Account Executive or myFlex Sales Manager about the options available.
Are TPAs and self-administered groups eligible for the premium reduction?
Yes. TPAs and self-administered groups are eligible for the premium reduction. However, timing for the credit will be dependent on the billing practices of the TPA or self-administered group. We will apply these credits as soon as we are able. - [pdf] Borrowing money to save money
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