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February 2020 Advisor eNews
In this issue:
Provincial biosimilar update
Legislative changes for Alberta’s Coverage for Seniors program
Coming soon: enhancements to Equitable EZClaim® Online
Provincial biosimilar update
Alberta Biosimilar Initiative
On December 12, 2019, the Alberta government introduced the launch of the Alberta Biosimilar Initiative. This program will require patients using several originator biologic drugs to switch to a biosimilar, and patients using a non-biologic complex drug (NBCD) to switch to its subsequent entry version before July 1, 2020 in order to maintain coverage.
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” drug. Biosimilars 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.
Alberta Health will initially cover both the originator and biosimilar or subsequent entry version of a NBCD drug as patients start the switching process.
The following table outlines the affected originator drugs, their biosimilars or subsequent entry, and the conditions affected by the program.
Biosimilar Drug Originator Biosimilar/Subsequent Entry Indications Affected etanercept Enbrel Brenzys Ankylosing Spondylitis
Rheumatoid ArthritisErelzi Ankylosing Spondylitis
Psoriatic Arthritis
Rheumatoid Arthritisinfliximab Remicade Inflectra
RenflexisAnkylosing Spondylitis
Plaque Psoriasis
Psoriatic Arthritis
Rheumatoid Arthritis
Crohn’s Disease
Ulcerative Colitisinsulin glargine Lantus Basaglar Diabetes (Type 1 and 2) Filgrastim Neupogen Grastofil Neutropenia pegfilgrastim Neulasta Lapelga Neutropenia glatiramer* Copaxone Glatect Multiple Sclerosis *Glatiramer is a non-biologic complex drug where the originator is Copaxone and the subsequent entry is Glatect.
Equitable Life is actively investigating the benefit, risk and appropriate plan changes associated with this new policy on private drug plans and will keep you informed.
For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.
British Columbia
In 2019, BC Pharmacare introduced a Biosimilars Policy that impacted coverage of three biologic drugs – Remicade, Enbrel and Lantus. As of November 25, 2019, these drugs were no longer eligible in BC for most conditions for which lower cost biosimilar versions are available. Patients in the province with these conditions were required to switch to biosimilar versions of these drugs in order to maintain their coverage.
The second phase of the BC Biosimilar Policy takes effect March 6, 2020 when Remicade will be delisted for Crohn’s Disease and Ulcerative Colitis. Patients in the province with these conditions will be required to switch to Inflectra or Renflexis in order to maintain their coverage.
Biosimilar Drug Originator Biosimilar Indications Affected infliximab Remicade Inflectra
RenflexisCrohn’s Disease
Ulcerative ColitisWe have communicated with the affected plan members, informing them of the need to switch medications. If plan members have any questions or concerns, our Customer Care team is here to help and support them through the transition.
If you have any questions about this policy, please contact your Group Account Executive or myFlex Sales Manager.
Ontario
In November 2019 Ontario Minister of Health Christine Elliot indicated that the government was planning to launch consultations to explore solutions in managing biologics.
Equitable Life will continue to monitor these developments and keep you informed of any impact on private drug plans.
Legislative changes for Alberta’s Coverage for Seniors program
The government of Alberta has announced that as of March 1, 2020, seniors’ family members (such as spouses and dependents) who are younger than 65 will no longer be covered by the provincial Coverage for Seniors program. Albertans 65 years of age and older will continue to be covered under the provincial plan.
Equitable Life plan members and their dependents will continue to be covered under the parameters of their group benefits plan.
For more information, please see the Alberta Seniors Health Benefits website.
Coming soon: enhancements to Equitable EZClaim® Online
Faster vision claims processing and payment
Equitable Life will soon provide real-time processing of vision claims submitted via EZClaim Online.
This means plan members will be able to find out the status of their vision claim almost instantaneously. And, for approved claims, they will receive payment even sooner – often in as little as 24 hours.
In order to allow for instantaneous processing and faster payment, plan members will be prompted to enter some additional information including the practitioner’s name, the date of the expense, the type of expense and amount of the expense when submitting their claims for these services.
Equitable Life plan members can submit all vision claims via EZClaim, including coordination of benefits and Health Care Spending Account claims.
This enhancement will be coming to our EZClaim Mobile app in the coming months.
New printable claims extract
As part of our ongoing efforts to improve customer experience for plan members, we will also offer a claims extract in a printable format within the plan member site. Plan members will be able to select a date range and claimant, then generate and download a detailed list of health and dental claims. This is a helpful way to keep track of claims, especially when reviewing them in preparation for income tax filing.
Once these enhancements are live you will be notified in an eNews, and an announcement will be posted on the plan member section of EquitableHealth.ca.
Elimination of Out-of-Country Travellers Program in Ontario
Effective January 1, 2020, the Ontario government eliminated OHIP coverage for emergency services for Ontarians travelling outside of Canada.
Previously, the Out-of-Country Travelers Program provided some reimbursement for services required to treat conditions that are acute, unexpected, arose outside Canada and require immediate treatment. The program covered between $200 and $400 per day for inpatient services and $50 per day for outpatient and doctor services.
For groups who have out-of-country coverage from Allianz, this change will not impact the cost to your plan members, or the process plan members follow in the event of an emergency while travelling.
Plan members should still call Allianz in the event of an out of country emergency. Allianz will deal with their claim as usual and will now pay for the portion of the claim previously paid by OHIP. Plan members will not have any additional out-of-pocket costs.
We will be sharing this information with plan members as a news item on our plan member website, equitablehealth.ca.
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And the Equitable FHSA Contests winners are...
Equitable® is proud to be the first insurance company to offer a First Home Savings Account (FHSA) to Canadians.
Since launch in September 2023, we have received an incredible response to Equitable’s FHSA, available on Pivotal Select™ Investment Class (75/75) and Pivotal Select Estate Class (75/100).
As part of this historic launch, we offered contests for clients to win $8,000 towards their 2024 FHSA contribution, with their advisor winning $2,000. We’ve now completed the draws and are thrilled to announce the following winners:
January 16, 2024, draw:
Client: Jagan A., ON
Advisor: Krupa P., ON
February 13, 2024, draw:
Client: Pawandeep K., ON
Advisor: Jaskaranjit S., ON
Congratulations to our winners! It warms our hearts to know we are helping Canadians save for their first home.
From all of us at Equitable, thank you for your trust and partnership.
® or ™ denotes a trademark of The Equitable Life Insurance Company of Canada.
Date Posted: March 13, 2024 -
Group - COVID-19 Group Benefits Updates
As the coronavirus (COVID-19) continues to spread, it’s important that you have the most up-to-date information about how it impacts you, your clients and their plan members. To help, we have created a COVID-19 Updates page on EquiNet, our secure advisor site. There you will find links to past editions of our eNews, as well as the most up to date FAQ. Please check back often. We will continue to provide timely updates on any developments that impact our clients and their plan members or their benefits coverage.
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A New Universal Life Insurance Solution for the 21st Century – Available NOW!
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Equitable Generations is a universal life product that offers investment options that resonate with today’s 21st century client while reducing every fee possible. It also reduces the cost of insurance to help clients maximize their opportunity to purchase coverage and build tax-advantaged wealth.
NEW: EZstartTM Generations
Today we are launching EZstart Generations which is:
- A mobile-optimized tool for advisors
- Designed to start a conversation and provide a possible universal life solution in under one minute
- Goals based - you can see how Equitable Generations™ universal life insurance can perform at different stages of a client’s life.
NEW: SMS
Effective today, September 26, 2022 when you submit an application, you can opt-in to receive text message updates for your new business applications.
That’s a text message when:- The application is received,
- A decision has been made by Equitable Life,
- The policy is ready for delivery, and
- The commissions have been triggered.
Learn more
Find all the exciting details on our virtual launch splash page (www.equitable.ca/ul) and watch our informative videos to get all the information you need to start selling Equitable Generations universal life.
Check out our Equitable Generations universal life splash page: www.equitable.ca/ul
Click on the Marketing Materials tab on EquiNet® for all of our new Equitable Generations marketing materials.Please contact your Regional Sales Manager for more information.
TM and ® denote trademarks of The Equitable Life Insurance Company of Canada.
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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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