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- [pdf] myFlex - How it works, what to consider
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An update on Travel Assist coverage
The last several months have been very difficult for plan members. We recognize how important it is for them to get back to a sense of normalcy, including making summer travel plans.
As countries start to reopen their borders, plan members with Travel Assist emergency medical benefits may have questions about whether they will be covered while travelling.
For plan members who want to travel outside of Canada, here’s what they need to know.
Out-of-country travel
Plan members travelling to countries that are popular vacation destinations and have reopened their borders will be covered for eligible expenses, including those related to COVID-19.
Please note: While a country may be open for travel, plan members should contact Allianz before departing to confirm that they are covered for travel to their specific destination.
Plan members travelling to countries for which the Government of Canada has issued a Level 4 travel advisory (“Avoid all travel”) will not be covered.
Please note that every country has different travel restrictions. Travelers could be denied entry to another country, even though their travel may be considered essential. Or they may be forced to self-isolate when they arrive at their destination. Canadians travelling to another country should consult that country’s travel restrictions and guidelines before departure and re-entry into Canada.
Communicating with plan members
Below is a link to a plan member version of this communication. Please encourage your clients to share this with their plan members who have Travel Assist coverage on their benefits plan. It’s important for them to know their coverage details before they make their travel plans. We have also posted this update on the plan member website at EquitableHealth.ca.
An update on Travel Assist coverage PDF
If you have questions, please contact your Group Account Executive or myFlex Sales Manager.
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April 2023 eNews
Vision care discounts from Bailey Nelson for Equitable Life plan members*
We are pleased to announce we are partnering with Bailey Nelson to provide Equitable Life plan members with discounts on prescription and non-prescription eyewear. Bailey Nelson is a leading provider of prescription glasses, contact lenses and sunglasses with locations across Canada, as well as an online store.
All Equitable Life plan members will have access to the following discounts from Bailey Nelson:
*Includes anti-reflection and anti-scratch treatment. Glasses offers are based on 2 pairs of single vision or 1 pair of premium progressive lenses. Lens add-ons, such as high-index lenses and prescription tinted lens tints may involve additional costs.
**Non-prescription glasses only. Cannot be combined with 2 for $200 discount.
Plan members can provide their Equitable Life discount code in-store or at online checkout. Your clients may wish to distribute this convenient flyer with an overview of the available discounts to their plan members.
Plan members can bring their prescription to a Bailey Nelson location or provide it online to order glasses and contact lenses. Bailey Nelson also provides eye exams in-store for $99.
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
Equitable Life helps tackle benefits fraud through Joint Provider Fraud Investigation (JPFI) initiative*
Protecting your clients’ plans is important to us. That’s why Equitable Life is working with other Canadian life and health insurers to conduct joint investigations into health service providers that are suspected of fraudulent activities through the Canadian Life and Health Insurance Association’s (CLHIA’s) Joint Provider Fraud Investigation (JPFI) initiative. This collaborative initiative between major Canadian life and health insurers through the CLHIA is a major step toward reducing benefits fraud in the life and health benefits insurance industry.How the JPFI works
The JPFI builds on the 2022 launch of a CLHIA-supported industry program. The program uses advanced artificial intelligence to help identify fraudulent activity across an industry pool of anonymized claims data. Joint investigations will examine suspicious patterns across this data.
Through this project, Equitable Life can initiate a request to begin a joint fraud investigation when we:- See suspected provider fraud in our own data or the pooled data, or
- Receive a substantiated tip about potential provider fraud
How Equitable Life protects your clients’ benefits plans from fraud
Benefits fraud is a crime that affects insurers, employers and employees and puts the sustainability of workplace benefits at risk. CLHIA estimates that employers and insurers lose millions each year to benefits fraud and abuse.
Our Investigative Claims Unit (ICU) consists of security and fraud experts who use data analytics and artificial intelligence to proactively identify and investigate suspicious billing patterns or claims activity to open investigations. We de-list healthcare providers who are engaged in questionable or fraudulent practices, pursue the recovery of improperly obtained funds, and report practitioners to regulatory bodies and law enforcement where appropriate.
Learn more about benefits fraud, or contact your Group Account Executive or myFlex Sales Manager for more information.Second phase of TELUS eClaims transition*
In June 2022, we switched to TELUS Health eClaims as our digital billing provider to give our plan members a faster and more convenient option for submitting paramedical and vision claims. The switch has allowed our plan members to take advantage of TELUS’s extensive network of over 70,000 paramedical and vision providers.
We’ve now begun the second phase of our TELUS Health eClaims implementation. This phase will focus on improving the experience for paramedical and vision providers. We will begin issuing reconciliation statements for the claims they submit on behalf of their patients. These statements will make it easier for them to use the TELUS Health eClaims portal and provide incentive for even more providers to sign up.
Please encourage your clients to remind their plan members about this convenient option. We have created a helpful one-pager that plan members can bring with them next time they have an appointment with their healthcare provider.
If you have any questions about TELUS Health eClaims, please contact your Group Account Executive or myFlex Sales Manager.
Changes to STD application process for COVID-19 cases*
As the COVID-19 situation evolves, we continue to adjust our disability management practices to ensure ongoing support and a fair experience for all our plan members.
As of May 1, 2023, we will begin managing COVID-19-related short-term disability (STD) claims the same way that we manage disability claims for any other illness or condition. If a plan member is unable to work due to COVID-19 symptoms or a positive COVID-19 test, they must now use the standard STD application, including the Attending Physician Statement portion.
Once we receive the claim, we will adjudicate it according to our standard process.
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
* Indicates content that will be shared with your clients.
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Important cybersecurity readiness guidance
As an advisor, you collect and store clients’ sensitive personal information. Protecting this information is essential. In July 2023, the Canadian Insurance Services Regulatory Organization (CISRO) released a guide on Cybersecurity Readiness. It includes tips on keeping this sensitive client data and your business systems safe.
Please read the guide in full. Also, check your own practices to be cyber ready and reduce your risk of an incident.
Some key tips in the guide include:
1. Make cybersecurity a priority: Stay alert to cyber threats. These can be suspicious emails, texts or calls. Make sure your team knows how to keep your data and systems safe and has clear, documented processes to follow.
2. Know what to protect: Understand what data and business systems need to be protected.
3. Identify the risks: Spot the risks in your practice and those from third-party service providers.
4. Implement security measures: Take steps to protect your data and business systems.
5. Be ready to respond: Know how to spot and react to cyber incidents. The guide has useful tips on creating a Cyber Incident Response Plan.
And lastly – if you receive client instructions electronically (by email, text, or messaging apps), always confirm these over the phone to ensure it’s really the client sending the instructions.
Keep your business and important client data safe by staying informed and alert. We encourage you to read the full Cybersecurity Readiness document to learn more about how to prepare for cyber threats.
In our industry, protecting clients’ sensitive data and systems is essential. Thank you for your commitment to cybersecurity!
® or TM denotes a trademark of The Equitable Life Insurance Company of Canada. -
Do clients imagine owning a dream home?
We’re here to help make that happen! Clients who contribute to a First Home Savings Account between May 1 and September 30, 2025, will be entered for a chance to win an incredible $8,000 in our Close to Home contest. Whether opening a new account or making an annual contribution, this is a golden opportunity to help them get one step closer to homeownership.Advisors, Your Efforts Matter Too! By guiding clients towards their homeownership dreams, you’ll be entered to win $1,000 as a special thank you for your dedication and support. At Equitable®, we believe that when we grow together, success is mutual.
Don’t Miss Out! Enter today using Equitable’s user-friendly online application platform, EZcomplete®, or process an online transaction with ease using Equitable’s EZtransact®. It’s fast, simple, and could bring clients closer to their dream home.Want to learn more? Speak to your Director, Investment Sales, and help clients take the first step towards making homeownership a reality.
Equitable’s Close to Home Contest: No purchase necessary. Contest period May 1, 2025, to September 30, 2025. Enter by making a deposit to an Equitable FHSA during the contest period or by submitting a no-purchase entry. Two prizes for a total value of $8,000 CAD to be drawn on October 15, 2025, will be awarded. The servicing advisor for the policy to which the selected entrant made the deposit is also an eligible winner and will receive a $1,000 CAD prize. For example, if an Equitable client is a winner of the $8,000 prize, the client’s servicing advisor wins a $1,000 prize. Open to legal residents of Canada of the age of majority. Odds of winning depend on number of eligible Entries received during the Contest Period. For full contest rules, including no-purchase method of entry, see the full contest rules.
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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. - [pdf] Daily/Guaranteed Interest Account Application - TFSA
- COVID-19 Group Benefits Updates