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1. [pdf] FeelingBetterNow
2. 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.

3. [pdf] Your Guide to EquiLiving (Client Guide)
4. [pdf] Benefits of segregated funds in a TFSA
5. 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):

   

6. [pdf] Application for Agency Contract to Sell Insurance Products - MGA, AGA and National
7. Update: Improved Employee Assistance from Homewood Health

   As we announced in June, we are expanding our relationship with Homewood Health to help you meet the mental health and wellness needs of your employees and their families. Beginning Oct. 1, 2019, Homewood will be the new provider of both our Employee and Family Assistance Program (EFAP) and our online health and wellness services.

   Following the transition to Homewood, plan members will benefit from added features:

   • Signing in to Homewood Health online allows the platform to customize content unique to your interests.
   • All plan members will have access to a Health Risk Assessment to help identify health and wellness barriers.
   • i-Volve, Homewood's online cognitive behavioural therapy program is available for all plan members to help them manage anxiety and depression.

   Learn more about Homewood Health and how they will be providing your plan members with exceptional EFAP and online health and wellness resources.

   What does the transition to Homewood mean for you and your plan members?

   We will be working with you in the coming months to facilitate the transition and support your employees. Most importantly, there will be no disruption of service delivery to employees who are currently in short-term counselling with our current EFAP provider.

   The transition timeline

   Groups without an EFAP

   Online health and wellness resources will be available through EquitableHealth.ca just as they are now. Here's what you can expect in the coming months.

   September   

   • We will send plan administrators an email with more details about the resources available to assist in the transition, including:
     • How to register for Homewood Health online
     • A video orientation for plan members

   October

   • October 1^st – plan members can access the Homewood online resources! They simply need to visit homeweb.ca/Equitable to sign up and create their unique login.

   The transition timeline

   Groups with an EFAP

   We’ve created a helpful infographic that outlines the steps involved in the transition to the Homewood Health EFAP over the coming months. Please save or print it for easy reference. Below are some of the highlights.

   August

   • We will send plan administrators an email with official notice that the enrolment certificate for our current EAP provider, LifeWorks, will terminate on Sept. 30, 2019, and that Homewood Health Inc. will be our new Employee Assistance Program provider as of Oct. 1.

   September   

   • Homewood will send you a welcome email, including how to access the EFAP, who to contact for support and where to find resources to help share the news with plan members.
   • Homewood will follow up directly to answer any questions you may have.
   • Homewood will begin offering orientation and training sessions for both plan administrators and plan members. These will be running throughout the fall so you can attend at your convenience. 

   October

   • October 1^st – plan members can access the Homewood EFAP and online resources! They simply need to visit homeweb.ca/Equitable to sign up and create their unique login.
   • Orientation and training sessions will continue to be available for both plan administrators and plan members throughout October.

   Learn More

   The resources listed below answer common questions about Homewood and our EFAP transition:

   • EFAP Transition Infographic
   • Homewood Health - Improving Life
   • EFAP Transition FAQ
   • About Homewood

   If you have a question that is not addressed here, please contact your Group Account Executive or myFlex Sales Manager.

8. Equitable Life Group Benefits Bulletin – January 2022

   Short-term disability coverage for plan members with COVID-19*

   Please note: This announcement applies only to groups with short-term disability coverage through Equitable Life
    
   As the COVID-19 pandemic continues, and the situation evolves, we continue to adjust our practices to ensure ongoing support for our plan members.
    
   PCR tests no longer required for COVID-related STD claims
    
   Some provinces have recently restricted access to COVID-19 PCR testing to only high-risk individuals. To ensure your clients' eligible plan members receive their short-term disability benefits in a timely manner, we no longer require a positive PCR test for plan members submitting COVID-19-related STD claims.
    
   Plan members who are experiencing symptoms of COVID-19 or who have tested positive for the virus (either with a PCR test or with an at-home rapid test) and are unable to work from home should complete the Short Term Disability Plan Member COVID-19 Claim Form (#421A). 
    
   They should indicate the date of the onset of symptoms or date of their positive test result. Where applicable, they should also indicate the date they have been cleared by public health to end their self-isolation. The form includes an attestation that the information they have provided is accurate.
    
   The employer needs to complete the Short Term Disability Employer COVID-19 Claim Form (#421B). They should indicate the expected return-to-work date according to their provincial health guidelines, or using the date provided by a public health official.
    
   Waiting periods for COVID-related STD claims
    
   To support your clients' plan members during the initial stages of the pandemic, we waived the STD waiting period if a plan member’s absence was due to symptoms or a diagnosis of COVID-19.  Now that COVID-19 has become the “new normal,” we are returning to our standard practices and treating the virus as we would any other illness.
    
   Effective Jan. 1, 2022, standard waiting periods will apply for COVID-related STD claims, according to the terms of the Group policy. This ensures that all plan members submitting a STD claim are treated fairly, no matter what the cause of the claim.
    
   Eligible plan members will receive STD benefits up to a maximum of 10 days from the date of the onset of symptoms or a positive COVID-19 test result, minus the waiting period.
    
   For example, if the plan has a five-day waiting period, and the plan member returns to work nine days after a positive test result, they would be eligible for four days of benefits payments.
    
   If the claimant is still unwell after 10 days, then the standard Short Term Disability Claim Form (#421) needs to be completed.  
    
   If a plan member is admitted to hospital, benefits will be paid following the waiting period applicable to hospital claims. 
9. RxFood nutrition app added to all group benefits plans

   In this issue:

   • RxFood nutrition app added to all group benefits plans*

   • Coming soon: Coverage information at plan members’ fingertips on EquitableHealth.ca*

   *Indicates content that will be shared with your clients.
   
    

   RxFood nutrition app added to all group benefits plans

    

   Equitable® has added the RxFood nutrition app to all group benefits plans at no extra cost—giving every plan member more opportunity to make healthy and informed food choices.

    

   RxFood is Canada’s first clinically validated nutrition platform that’s used and trusted by leading health care institutions across the country, such as SickKids Hospital and Diabetes Canada, to help support better health outcomes through nutrition.

    

   Using technology powered by artificial intelligence, RxFood turns everyday meals into personalized insights, practical tips and tailored recommendations that are easy for plan members to act on and build into their routines.

    

   For more information, read our previous eNews article.

    

   Promoting RxFood to plan members

    

   This week, clients will receive a digital toolkit to help them encourage plan members to register for RxFood. Plan members must register to access this free benefit.

    

   The toolkit includes an RxFood brochure, a poster, an email template plan administrators can use to help spread the word, and the video below.
    

   
    

   Coming soon: Coverage information at plan members’ fingertips on EquitableHealth.ca

    

   Starting this month, Equitable plan members will be able to find helpful information about their health coverage more quickly and easily. We’re putting the key details at their fingertips on the EquitableHealth.ca^® home page.

    

   Faster access to health coverage details

    

   Our new coverage panel will provide plan members fast access to information about their paramedical coverage for themselves and their covered dependants – including coverage maximums, reimbursement details and more.

    

   Plan members with Health Care Spending Accounts or Taxable Spending Accounts will also be able to check their balances from the home page.

    

   Later this spring, we’ll add information about vision and dental benefits to the coverage panel, too.

    

   Simpler way to find benefits resources

    

   We’re also making it easier for plan members to access key resources. Benefits cards, booklets and other important sections of the site will now be linked directly from the home page.

    

   The video below walks plan members through the new features:

   
    

   More new features to come

    

   The coverage panel and resources section are the latest enhancements to our new plan member web experience, which we launched last fall. We’ll continue introducing more self-serve features this year.

    

   To learn more about our enhanced plan member home page, contact your Group Account Executive or visit Equitable.ca/effortless.

   
    
    
10. Frequently Asked Questions