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Equitable Life Group Benefits Bulletin – May 2020
In this issue:
- Digital options for your clients and their plan members*
- Alberta delaying biosimilar initiative*
- Yukon increasing insurance premium tax*
- Manitoba and New Brunswick relaxing drug limits*
- Free guide to accessing virtual healthcare*
- Homeweb for plan members who are losing coverage*
*Indicates content that will be shared with your clients
Easy and convenient digital resources for your clients and their plan membersDuring this time of physical distancing, people are looking for ways to interact with their providers virtually. We have several convenient digital tools available to make it easier for your clients and their plan members.
For plan administrators:
Plan administrator portal (EquitableHealth.ca)Our secure portal allows plan administrators to easily manage their plan anytime and anywhere. Instead of printing and mailing forms, they can make real-time updates at their convenience. The site also makes it easy to:
- View or upload forms and other important documents;
- Retrieve billing information;
- Estimate monthly premium costs; and
- View announcements, tips and reminders.
Plan administrators can visit www.equitablehealth.ca to activate their account.
Digital Welcome Kits
Instead of paper kits that can easily get lost or quickly become outdated, plan members receive personalized welcome kits via an interactive email, including instructions on how to:
- Activate their online group benefits account;
- Download their digital benefits card;
- Submit claims from their computer or mobile device;
- Review their coverage details; and
- Explore health and wellness resources.
Easy automated payments
Automated payments are a convenient way to avoid missed payments, suspended claims and disruption. Plan administrators simply complete the pre-authorized debit form and send to GroupCollections@equitable.ca. Or contact Group Collections about online banking and electronic funds transfer (EFT).
We can help
For assistance, plan administrators can contact their Client Relationship Specialist or our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca.
For plan members:
Plan member portal (EquitableHealth.ca)By logging into EquitableHealth.ca, plan members have secure 24/7 access to their personalized Group Benefits account. They can:
- View and submit claims;
- Review their coverage details; and
- Access health and wellness resources.
Electronic claims payment and notifications
Once plan members have activated their Group Benefits account on EquitableHealth.ca, they can easily set up receiving their claim payments via direct deposit, and their claim notifications via email.
EZClaim Mobile App
Submitting claims is fast, easy and secure with the Equitable EZClaim® mobile app for iOS and Android devices. Plan members can view and submit health and dental claims and review their coverage details.
Digital Benefits Cards
Instead of digging through their wallets, plan members can download a digital version of their benefits card to their mobile device.
We can help
We’ve created a video guide to help plan members access and use their digital resources. For further assistance, plan members can contact our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca.
Alberta government delaying biosimilar initiativeAs we announced in the February 2020 issue of eNews, the Alberta Biosimilar Initiative will require patients using several originator biologic drugs to switch to a biosimilar in order to maintain coverage through their Alberta government sponsored drug plan.
Due to the increased demands the COVID-19 pandemic is placing on healthcare providers, the Alberta government has postponed the switching requirement. Affected patients will now have until January 15, 2021 to switch to the biosimilar version of their drug in order to maintain provincial coverage.
We continue to investigate appropriate options to help ensure this provincial change does not unreasonably impact Equitable Life groups and patients and will keep you informed.
For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.
Yukon increasing Insurance Premium TaxThe Yukon Government has announced that it plans to increase its Insurance Premium Tax rates effective January 1, 2021. The premium tax rates for group life and accident and sickness insurance are expected to increase from 2% to 4%. The new tax rates will be applied to premiums paid on or after January 1, 2021.
Manitoba and New Brunswick relaxing drug limitsIn order to protect the drug supply during the COVID-19 crisis, residents of most provinces were temporarily limited to receiving a 30-day supply of drugs when filling a prescription. Normally, doctors prescribe a 90-day supply for most maintenance-type drugs.
The Government of Manitoba and the Government of New Brunswick are now relaxing this 30-day limit for prescription drugs where shortages do not exist. They will address potential shortages of specific drugs if necessary.
As the situation continues to evolve, there may continue to be changes to provincial legislation and prescription limits. Plan members should speak to their pharmacist for the most up to date information.
Free guide to accessing virtual healthcareWith many health clinics closed and the healthcare system under strain, people are looking to access a doctor and other health providers virtually.
As we announced previously, we’ve made it easier for plan members to find the information they need using our Guide to Accessing Virtual Healthcare. This online resource provides information about and links to a range of virtual health services they need to take care of their health and the health of their family during these challenging times.
The Guide also indicates which services are covered by public health plan, so there’s no cost to the patient to access them if they provide their valid provincial health card.
We will continue to update the Guide as more virtual healthcare providers and services become available.The Guide is available on both EquitableHealth.ca and Equitable.ca.
Homeweb for plan members who are losing coverageWe know these are difficult times for Canadian employers and their employees. As businesses temporarily suspend operations, some employers have had to make the difficult decision to temporarily lay off employees or put their benefits coverage on hold.
That’s why we were pleased to announce that Homewood Health® and Equitable Life will extend access to Homeweb, a personalized online mental health and wellness portal, for up to 120 days for plan members who have temporarily lost their benefits coverage due to COVID-19.
Employees and their family members will continue to have access to the Homeweb website and mobile app, including:
- iVolve, online self-directed Cognitive Behavioural Therapy;
- Resources to support themselves and their family members through the COVID-19 pandemic;
- An interactive online Health Risk Assessment; and
- An online library of tools, assessments and e-courses.
This will allow businesses undergoing financial hardship to provide some support to employees who are temporarily without benefits coverage.
- [pdf] Payout Annuity Advisor Guide
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Equitable Life Group Benefits Bulletin – November 2021
In this issue:
- Deadline to opt out of New Brunswick biosimilar program*
- Web Reports Quick Reference Guide now available for plan administrators*
- Reminder: Review manual allocations for HCSAs and/or TSAs*
- Help your clients take advantage of our convenient digital options*
Reminder: Deadline to opt out of New Brunswick biosimilar program*
Earlier this year, we announced via eNews that on Feb. 1, 2022, we are ending coverage for some originator biologic drugs in New Brunswick in response to the province’s Biosimilar Initiative.* These changes will help protect your clients’ plans from additional drug costs while still providing access to equally safe and effective biosimilars.
Do my clients need to take any action?
No action is required if employers want to have the originator biologics excluded from their plan. Plan members taking these targeted originator biologics will be contacted directly to allow them ample time to transition to the biosimilar. Any cost savings associated with the change will be factored in at renewal.
All groups, except myFlex clients, who wish to opt out of this change and maintain coverage of these originator biologics for existing claimants in New Brunswick 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. This means that their drug plans will continue to cover any additional originator biologics for which we subsequently end coverage as part of the biosimilar program.
Questions?
If you have a question that isn’t answered here, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.
* The list of affected drugs or conditions is dynamic and may change.Web Reports Quick Reference Guide now available for plan administrators
A Web Reports Quick Reference Guide is now available for plan administrators on EquitableHealth.ca. This new guide offers a listing of our newest reports available on the plan administrator web. It also provides instructions for plan administrators outlining how to pull the report using the plan administrator portal.
The guide is available under the Quick Links section on both the advisor and plan administrator portals on EquitableHealth.ca.Reminder: Review manual allocations for HCSAs and/or TSAs*
If your client’s Health Care Spending Account (HCSA) and/or Taxable Spending Account (TSA) has manual allocations, they need to allocate these amounts to plan members each year. Please review all your plan members’ profiles on EquitableHealth.ca to ensure they have received their allocation(s) for the current benefit year.
If your clients have Plan Administrator update access on EquitableHealth.ca, they can update these amounts online by doing the following:- Select “View certificate”
- Select “Health Care Spending Account” or “Taxable Spending Account”
- Select “Update Allocation” in Task Center
- Enter amount in “Revised Allocation Amount”
- Override Reason – “Plan Administrator Request”
- Select “Save”
- Select “Reports”
- Select “New”
- Select “Next”
- Select “HCSA” or “TSA Totals by Plan Member”
- Select “Next”
- Enter end date of “12/31/2020”
- Select “Next”
- Select “Finish”
- View “Report”
Help your clients take advantage of our convenient digital options*
We have several digital options available to make it easier for your clients to do business with us and for their plan members to access and use their benefits plan. Over 71% of plan administrators are managing their plan online and 78% of plan members are already using our digital tools.
For plan administrators:- Online Plan Member Enrolment tool – allows all groups to add new plan members without the need for paper forms
- Plan Administrator Portal (EquitableHealth.ca) – plan administrators can easily manage their plan anytime and anywhere
- Digital Welcome Kits – personalized welcome kits are delivered to plan members via email
- Easy automated payments – plan administrators can avoid missed payments by setting up pre-authorized debit or electronic funds transfer
- Plan Member Portal (EquitableHealth.ca) – plan members get secure, 24/7 access to their claims history, coverage details and health and wellness resources
- Electronic Claim Payments and Notifications – plan members can get claim updates sooner in their email inbox and payments right into their bank account
- EZClaim Mobile App – submitting claims from a mobile device is fast, easy and secure
- Digital Benefits Cards – plan members no longer have to dig through their wallet – they can download their benefits card on their mobile device
We’ve created a brochure and a video guide to help plan members access and use their digital resources. For further assistance, plan members can visit www.equitable.ca/go/digital. They can also contact our Web Services team at 1.800.265.4556 ext. 283 or groupbenefitsadmin@equitable.ca. -
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
ErelziAnkylosing Spondylitis
Rheumatoid Arthritis
Polyarticular juvenile idiopathic arthritis (JIA)
Psoriatic Arthritis
Plaque Psoriasis (adults and children)Infliximab Remicade Inflectra
Renflexis
AvsolaAnkylosing 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
NivestymNeutropenia Pegfilgrastim Neulasta Lapelga
Fulphila
ZiextenzoNeutropenia Glatiramer* Copaxone Glatect
TEVA-Glatiramer AcetateMultiple 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 InitiativeIn 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):
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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.
*Indicates content that will be shared with your clients
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Making it easier to do business with Equitable
We wanted to share some exciting updates with you that focus on enhancing your experience with Equitable®. Improving your journey with us is a top priority, and we continually seek ways to make doing business simpler and more convenient.
The following are our latest enhancements designed specifically to benefit you.
New annual premium payment options for Life and Critical Illness plans
● Great news! We recently introduced new additional payment methods for clients making their first and subsequent annual insurance premium payments.
● And - we're thrilled to introduce a new lower annual premium requirement of $2,500 for clients who wish to pay their annual premiums by Pre-Authorized Debit (PAD)!
● Learn more about these changes here.
Improved forms for requesting in-force illustrations
● We understand the importance of efficient workflows, and that's why we have recently updated and improved the following forms to make requesting inforce illustrations even easier:
● Term, CI & Whole Life Illustration and Quote for inforce policies
● Universal Life Illustration and Quote for inforce policies
For these and other Equitable forms, navigate to EquiNet® -> Individual Insurance -> Forms.
We trust that these improvements will be met with enthusiasm! And this is just the beginning – stay tuned for more enhancements in the new year!
Questions? Please reach out to your local wholesaler or our customer service team.
® or TM denote trademarks of The Equitable Life Insurance Company of Canada
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Saving time with our fully digital group benefits application
On May 1, 2023, we are launching Equitable BenefitsApply™, our fully digital group benefits application.
This enhancement to the benefits application process will help both you and your clients save time when applying for an Equitable Life group benefits policy. We designed and developed BenefitsApply with input and feedback from several advisors and clients, who tested the tool for themselves.
In most cases, BenefitsApply will replace our traditional paper implementation process.*
BenefitsApply eliminates the need for clients to complete and sign multiple, lengthy paper forms. Time-saving features for you and your clients include:- A fully digital online application that you can access wherever and whenever you need it,
- Pre-filled standard fields,
- Only one signature required from plan sponsors,
- A smart application that only includes the sections relevant to the client and the plan design they have chosen, and
- Automatic notifications of any missing fields.
We will continue improving BenefitsApply’s features based on feedback from the people who use it—you and your clients. We encourage you to share any feedback you have with your Group Account Executive or your Client Relationship Specialist.
*BenefitsApply is currently available for groups with up to four divisions and up to four classes. It is not available for myFlex Benefits plans, or for clients with a customized master application. - [pdf] Cloud DX FAQ
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