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January 2023 eNews
Responding to Saskatchewan’s biosimilar switch initiative*
We are changing coverage for some biologic drugs in Saskatchewan 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.
Saskatchewan’s provincial biosimilar initiative
Announced in October 2022, the Saskatchewan Biosimilars Initiative ends coverage of ten biologic drugs beginning on April 30, 2023.
Patients in the province who are using these drugs will be required to switch to biosimilar versions of these drugs by April 30, 2023, in order to maintain their Saskatchewan Drug Plan 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 Saskatchewan for most biologic drugs included in the provincial initiative.
Beginning April 30, 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.
Communicating this change to plan members
We will inform any affected plan members in early February 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 Saskatchewan includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
Ontario announces 2023 biosimilar switch program*
The government of Ontario recently announced the launch of a biosimilar initiative to switch patients from eight originator biologic drugs to biosimilar versions of the drugs.
Patients in Ontario using affected originator biologic drugs will have until December 29, 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans.
We are actively monitoring and investigating the impact of this new policy on private drug plans in Ontario. We plan to implement changes to coverage of biologic drugs in the province in 2023 to help prevent this change from resulting in additional costs for our clients’ drug plans. We will provide more details in the coming months.
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
Dental fee guide updates*
Each year, Provincial and Territorial Dental Associations publish fee guides. 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.***Dental fee guide increases over 2022***
***Data for all provinces and territories was not available at the time of publication. This chart will be updated on EquitableHealth.ca as more information becomes available.
Equitable Life ranks high with Canadian group advisors*
Equitable Life ranked second nationally and first in Ontario among major insurers in a recent survey of Canadian group benefits advisors.
NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 130 leading group consultants, brokers and third-party administrators across the country between May and August 2022 for its annual Canadian Group Benefits Study. Based on these interviews, NMG ranked group insurers in six categories, ranging from operational management to technology.
Nationally, Equitable Life ranked either first or second in four of the six main categories:
Advisors in Ontario, in particular, scored Equitable Life very favourably. We ranked #1 overall in the province, finishing first in four of the six overall categories, including: Relationship Management, Operational Management, Underwriting and Claims Management and Technology.
“The fact that advisors regard us so highly in so many categories is a testament to our mutual status and our ability to focus exclusively on our clients and advisors,” said Marc Avaria, Senior Vice President of Group. “We are truly working together to build strong, enduring and aligned partnerships.”
“While we are happy with these results, we won’t rest on our laurels,” added Avaria. “We will continue to dedicate ourselves to providing our clients and advisors with a better benefits experience.”
Here are more of the highlights from this year’s results:
Nationally, we ranked first in all 10 subcategories in Operational Management, including:- Overall service to intermediaries,
- Overall service to plan sponsors,
- New quote process,
- Plan implementation,
- Renewal process,
- Information shared at renewal,
- Accuracy and timeliness of reporting and billing,
- Administration quality and responsiveness,
- Taking ownership and
- Management information quality and availability.
- Company relationship management,
- Ease of doing business,
- Account executive capability,
- Market knowledge,
- Visit/call quality,
- Effective coordination and
- Advice.
- Fairness and timeliness of disability claims (1st)
- Fairness and timeliness of health claims (2nd)
- Fraud management (2nd)
- Competitiveness of pooling charges (2nd)
- Group underwriting flexibility (3rd)
- Health and dental TLR competitiveness (3rd)
- Overall technology – Intermediary (2nd)
- Member experience (2nd)
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January 2024 eNews
In this issue:
- Equitable scores high marks with group advisors*
- REMINDER: Equitable's National Biosimilar Program starts in March*
- 2024 dental fee guide updates*
- Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*
Equitable scores high marks with group advisors*
Equitable ranked first for operational service among major group insurers in a recent study of Canadian group benefits advisors.
NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 146 Canadian group benefits brokers, consultants, MGAs and third-party administrators between May and August 2023 for its annual Canadian Group Benefits Study. Based on these interviews, NMG ranked group insurers in six categories, ranging from operational management to technology.
Nationally, Equitable ranked among the top three in five of the six main categories, including number one for Operational Management:Category Ranking Operational management 1st Initiatives (including seminars & training) 2nd Technology 3rd Underwriting & claims management 3rd Relationship management 3rd
“Advisors regard us highly in many categories. That’s a testament to our mutual status and ability to focus exclusively on our clients and advisor partnerships,” said Marc Avaria, Executive Vice President, Group Insurance Division. “We are truly working together to build strong, enduring and aligned partnerships with our clients and advisors.”
“We’re delighted with these results and are committed to continuously advancing our delivery of a better benefits experience for our clients and advisors,” added Avaria.More highlights from the latest NMG survey
Nationally, we ranked first in seven subcategories in Operational Management, including:- Overall service to intermediaries,
- Overall service to plan sponsors,
- New quote process,
- Plan implementation,
- Renewal process,
- Accuracy and timeliness of reporting and billing, and
- Administration quality and responsiveness
And we were rated strongly in Technology, finishing in the top three for:- Overall technology for Intermediary (2nd)
- Member experience (3rd)
- Quality of technology for the plan sponsor (2nd)
- Quality of mobile application (2nd)
REMINDER: Equitable's National Biosimilar Program starts in March*
In October 2023 we announced the upcoming launch of our national biosimilar program. Starting March 1, 2024, we are expanding our biosimilar switch initiatives to provide a single, nationwide** program.
Why we’re making the switch
Over the past few years, most provinces have introduced policies to delist some originator biologic drugs. They require most patients to switch to biosimilar versions of those drugs to be eligible for coverage under their public drug plans. Soon, it is expected that all provincial drug plans will cover only biosimilars.
Equitable’s National Biosimilar Program simplifies drug plan coverage by replacing our provincial programs. It also protects clients from additional drug costs while offering access to lower-cost biosimilars deemed equally safe and effective by Health Canada.
How will this affect clients' drug plans?
Because we have already introduced biosimilar switch initiatives in most provinces, the impact of this change will be minimal. It will primarily affect plan members in provinces or territories where we haven’t already required the switch to biosimilars. It will also affect plan members who are taking biosimilars that were not originally included in the switch initiative for their province.
Regardless of where they live, plan members across Canada 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. Plan members already taking the originator biologic will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable plan. We will support their transition with education, personalized communication, and resources.
Advance notice for plan members
We contacted affected claimants in early December to give them enough time to change their prescriptions 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 Account Executive.
** Excludes plan members in Quebec who participate in a separate provincial program.
2024 dental fee guide updates*
Each year, Provincial and Territorial Dental Associations publish fee guides. Equitable uses these guides to help determine the reimbursement limits for dental procedures.
For your reference, you may wish to refer to the 2024 list of the average dental fee increases for general practitioners.
Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*
Equitable is proud to congratulate our Employee and Family Assistance Plan (EFAP) partner, Homewood Health®, for winning the Canadian HR Reporter 2023 Reader’s Choice Award in Employee Assistance Plan services. Homewood’s EFAP provides confidential support for a range of health, family, money, and work issues through face-to-face, phone, email, chat, or video counselling. The award recognizes their high standards in counselling and mental health support services.
The annual Reader’s Choice Awards identify organizations that provide outstanding expertise and services for HR professionals and employers across Canada. Those organizations provide valuable information on useful, innovative HR and employee benefits products and programs, in categories such as recruitment, mental health services, employee engagement programs, and more.
Sharing Homewood Health with your clients
Since 2019, we have worked with Homewood to provide mental health services for Equitable benefits plan members.
Your clients can access Homewood Health’s award-winning EFAP for an additional fee by adding it to their benefits plan. Services are available 24/7, 365 days a year.
All Equitable clients also have free access to Homewood Health Online in their benefits plan. Homewood Online provides a variety of helpful wellness resources, including:
- Homeweb, an online and mobile health and wellness portal,
- Health Risk Assessment, a group of assessment tools to help plan members identify and overcome health and wellness barriers, and
- Online Internet-based cognitive behavioural therapy (iCBT) through Sentio to manage symptoms of anxiety and/or depression.
Questions
To learn more about Homewood Health’s services, contact your Group Account Executive or myFlex Account Executive.
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