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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?*
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.
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.
- 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.
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
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 - [pdf] Daily/Guaranteed Interest Account Client Brochure
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Short-term disability coverage for plan members in quarantine or self-isolation*
Please note: This announcement applies only to groups with short-term disability coverage through Equitable Life
With the spread of COVID-19, many people have been instructed to self-isolate or quarantine themselves or are doing so voluntarily. We realize this is a stressful situation for people and they may be wondering if they are eligible for disability benefits. Short-term disability is designed to replace a plan member’s earnings if they are unable to work due to illness and injury. As a result, only plan members who meet the following criteria are eligible for benefits:
- Plan members who have tested positive for COVID-19 and are unable to work from home are eligible for coverage from Day 1 of their self-isolation period.
- Plan members who have not been tested but have symptoms consistent with COVID-19 and are unable to work from home, are eligible for coverage. Claims will be assessed according to the terms of the plan.
Plan members who are in quarantine for any other reason, but do not have symptoms consistent with COVID-19, are not eligible for coverage. These plan members should consider applying for Employment Insurance (EI) benefits, if they do not have an option to work from home.
Submitting COVID-19-related STD claims
To make things easier for plan members who need to submit claims related to COVID-19, we will not require a physician’s statement. Instead plan members should submit our simplified Short Term Disability Plan Member COVID-19 Claim Form.
Plan Administrators need to complete their portion of the regular Short Term Disability Form (Form #421).
This is a temporary process that will remain in effect through the current coronavirus situation. We will update on changes and share them on EquitableHealth.ca.
Applying for the Employment Insurance sickness benefit
Canadians quarantined due to COVID-19, who are not receiving Short Term Disability benefits, can apply for Employment Insurance (EI) sickness benefits. The one-week waiting period for EI sickness benefits has been waived. Service Canada’s dedicated toll-free support number is 1-833-381-2725 or (TTY) 1-800-529-3742.
*Indicates content that will be shared with your clients
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There is still time for your clients to contribute to their Tax-Free Savings Account
If you have clients that have not contributed to their Tax-Free Savings Account (TFSA) this year, great news… there is still time!
You know that an Equitable Life® TFSA is a great way to save. Each year residents of Canada who are at least 18 years of age are eligible to invest up to $6,000* into their TFSA, in addition to any previously unused contribution room. Deposits made into a TFSA are made with after-tax dollars. This means that withdrawals can be made at any time on a tax-free basis.
Interested in increasing an existing Pre-Authorized Debit (PAD) TFSA deposit?
Clients with an existing PAD (or who had one in the previous six months), can go online to make any adjustments to a scheduled deposit to their TFSA. Clients can simply login to Equitable Life’s Client Access®. Client Access is Equitable’s secure online client site that connects clients to tools and policy information.
Consider a one-time deposit or set up a PAD?
To get started with one-time deposit, clients simply log in to their online bank account and select the option to add a new bill/payee and search for Equitable Life Savings Plan. The Equitable Life savings plan policy number will serve as the account number.
Clients that complete their deposits using online banking do not have to worry about mailing a cheque or missing the deadline. Deposits are applied based on the investment direction on file.
If you have clients that would like to set up a PAD, simply complete Form #378. For details on how to submit forms during COVID-19, refer to the NEW APPLICATIONS & TRANSACTION AUTHORIZATION REQUIREMENTS webpage.
If you have any questions, please reach out to your local Regional Investment Sales Manager or Advisor Services at 1.866.884.7427 Monday to Friday, 8:30 a.m. to 7:30 p.m. ET or email savingsretirement@equitable.ca.
*The annual TFSA limit is set by Canada Revenue Agency (CRA) and is currently $6,000. Your notice of assessment will tell you if you have unused contribution room from previous years. Contributions over the maximum will be charged a monthly penalty of 1% by CRA.
® denotes a trademark of The Equitable Life Insurance Company of Canada -
New year tune-up for Equimax participating whole life
It’s a new year and time for an Equimax® tune up! We have made some exciting changes for new sales of Equimax Estate Builder® and Equimax Wealth Accumulator® effective February 11, 2023.
These exciting enhancements make Equimax even more robust, simpler and cost effective, to ensure it continues to be the preferred participating whole life solution for clients and advisors alike.
Watch our informative video to learn more.
Check out our Equimax splash page for complete details on all the enhancements, our transition rules, and much more.
What’s new?- All new children’s policies will now be issued as non-smoker for life – we will no longer request a non-smoker declaration for new children's policies.
- We have also removed the policy fees on new Equimax sales, reducing total premium payments – allowing clients to buy even more coverage for the same payment.
The following enhancements add more value, making it easier for you to recommend Equimax as your preferred whole life solution.- Monthly Excelerator Deposit Option(EDO) payments and EDO payments received off anniversary will now buy more paid-up additional insurance,
- Dividends earned on EDO payment paid-up additions, and credited on the base policy, can now buy even more paid-up additions,
- New clients now have the option to elect individual policies on joint last to die (JLTD) plans if their personal situation changes,
- We have also changed the way we calculate monthly premiums – resulting in lower premium payments across the board,
- And we have added our KIND™ benefit program to Equimax, as we did for our newest Generations Universal Life solution last September – making it easier for families and beneficiaries at claim time.
- And, finally, we are introducing some new sales illustration features, a Web-based software and more to help you market Equimax!
Plus, visit our Equimax product page on EquiNet®, then click on the Marketing Materials tab for the latest Equimax marketing materials.
Need more information? Please contact your local wholesaler.
® and ™ denotes a trademark of The Equitable Life Insurance Company of Canada. -
IMPORTANT NOTICE: FUNDS WITH DEFERRED SALES CHARGE OPTIONS
The Canadian Council of Insurance Regulators require all insurance companies to discontinue the sale of segregated funds with Deferred Sales Charge (DSC) effective June 1, 2023*.
PIVOTAL SELECT™ SEGREGATED FUND PRODUCTS
On May 29, 2023, funds with a DSC or Low Load (LL) sales charge option will be allocated to the No Load (NL) sales charge option of the funds available within the policy.
- Any existing amounts held in DSC or LL funds will retain the existing DSC schedule, outlined in the client’s contract. The annual 10% available (20% for RIF policies) for withdrawal without fees continues to apply through to the expiry of the fee schedule.
- If the default deposit instructions and/or pre-authorized scheduled deposits the client previously provided include funds with DSC or LL, these instructions will automatically update to NL of the same fund for all future deposits.
In alignment with Equitable's current administrative rules, if the client has DSC or LL funds, the client will not be able to deposit No Load Chargeback funds (NL-CB and NL-CB5) within the same policy.
For more information, please click here.LEGACY SEGREGATED FUND PRODUCTS
Ongoing deposits to DSC funds continue when a segregated fund product does not have an alternative sales charge option available within the contract. This applies to the following products:
- Personal Investment Portfolio
- Pivotal Solutions II
- Pivotal Solutions DSC
Clients may continue to make new deposits to the DSC funds within the policy. Any new segregated fund deposits, as well as any existing segregated fund amounts within the policy, will retain the DSC schedule outlined in the contract.
For more information, please click here.
Equitable's Advisor Services Team is available Monday to Friday, 8:30 a.m. – 7:30 p.m. ET at 1.866.884.7427 or by email at savingsretirement@equitable.ca. You can also contact your Regional Investment Sales Manager.
*Draft regulation in Quebec is currently under review which may affect Equitable Life’s approach for clients in the Province of Quebec with legacy segregated fund products. We will continue to monitor provincial regulatory developments.
™ or ® denote registered trademarks of The Equitable Life Insurance Company of Canada.
Date posted: May 4, 2023
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NEW MARKETING MATERIAL! Equimax Participating Whole Life, Strong and Stable Dividends
Participating whole life policyholders can get some of the participating account earnings back as dividends.1
Dividend scales change over time. This new marketing piece shows how the actual values of policies look like against those that were estimated. It looks at two sample policies and compares them to the original sales illustrations. One example shows an Equimax Estate Builder® policy. The other example shows an Equimax® Wealth Accumulator® policy.
We are proud of our strong and stable dividend results. We have paid dividends to our participating policyholders every year since 1936. And we’re still going strong!
We want to make sure that we can continue to provide long-term income and growth to support the dividend scale and meet the product guarantees. We do this with constant focus on how we invest and manage risk to support the participating account.
As a mutual life insurance company, we are owned by our policyholders who count on us and our services. Their trust in our knowledge, experience, and financial strength helps us keep our commitments to them—now and in the future.
Dividend scales may change.2 But with a balanced approach, Equitable Life’s Equimax® Participating Whole Life continues to deliver excellent value. It gives guaranteed life insurance protection with the potential for earnings.
Want to learn more? Check out our new marketing piece: Equimax Participating Whole Life, Strong and Stable Dividends (2075).
For more information, reach out to your local wholesaler.
® and TM denote trademarks of The Equitable Life Insurance Company of Canada.
1 Dividends are not guaranteed and are paid at the sole discretion of the Board of Directors. Dividends may be subject to taxation. Dividends will vary based on the actual investment returns in the participating account as well as mortality, expenses, lapse, claims experience, taxes, and other experience of the participating block of policies.
2 If low interest rates continue, investment returns will be lower, and this may mean decreases in the dividend scale in the future. Dividend payments are not guaranteed, but they will never be negative.