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1. Equitable Life Group Benefits Bulletin - September 2022

   Homewood Health launches Sentio, an upgraded iCBT platform

   Equitable Life’s mental health partner, Homewood Health, has launched Sentio, an upgraded platform for Internet-based cognitive behavioural therapy (iCBT). This self-directed platform is now available to all Equitable Life clients, and it replaces Homewood’s previous iCBT platform, i-Volve.
   
   Sentio Self-Directed iCBT is a comprehensive digital cognitive behavioural therapy platform. Developed by Homewood’s mental health experts, it is an action-oriented solution for plan members, giving them practical resources and activities to help with their depression, anxiety and overall mental health challenges.
    
   Available as a standalone app, on mobile, tablet and desktop, Sentio contains over 20 unique treatment goals for issues like stress management, improving sleep, managing depressive thoughts, and coping with panic. Users can work through treatment goals in any order, at their own pace. It also includes tools and resources to help plan members build skills and change their thought patterns. 

   Sentio iCBT benefits

   Sentio integrates seamlessly with Homewood Pathfinder so that users can easily locate and take advantage of the iCBT activities available. Sentio also includes a number of unique features:
   • More interactive features and activities to help plan members build valuable mental health skills
   • Integrated symptom measurement and progress tracking
   • Interactive multimedia learning and cognitive exercises to enhance learning
   • Progress, learnings, and exercises that have been accessed are available to be re-accessed for 12 months 
   Access to i-Volve will end 30 days after your clients received access to Sentio, but plan members can complete any in-progress sessions until then.
   
   Please contact your Group Account Executive or myFlex Sales Manager if you have any questions.
    

   Streamlining disability claims with Opifiny

    Equitable Life is partnering with Opifiny to provide a quicker and more seamless disability claims experience.
    
   Opifiny is an online platform that streamlines the disability claims process for consulting physicians, benefits plan sponsors, and disability plan members. Equitable Life will be using Opifiny for ongoing disability claims management, modernizing the process of gathering medical assessments and information.
    
   Disability claims frequently involve several instances of correspondence between Equitable Life and the plan member’s medical team. By using the secure platform, health care professionals can access, respond to and process medical insurance requests easily from any device. They can typically complete administrative tasks associated with disability claims in a quarter of the time. The platform is secure and protects the privacy of their patients’ confidential information.
    
   By digitizing and modernizing the claims management process for doctors, Equitable Life will have faster access to higher quality claims information. For some claims, using Opifiny may enable Equitable Life to help plan members safely return to work sooner.
    

   Reminder: Obtaining plan member signatures on all administration forms

   Please remind your clients that plan members must sign all administration forms, including enrolment forms, benefits change forms, and beneficiary designation forms. Once completed, a plan administrator can keep the form or send it to us. We are not able to accept a beneficiary designation that has not been signed by the plan member. Having appropriately signed forms helps to ensure that any life insurance claims are paid to the intended recipients.
   
   For your clients’ convenience, forms can be signed electronically using one of our approved vendors, which include DocuSign, BambooHR, Adobe Sign, and many more.
   
   If you have questions about providing signed forms, please contact your Group Account Executive or myFlex Sales Manager.
    

   Correction: Coverage for full-time students and dependents with disabilities

   In our August edition of eNews, we provided incorrect information about benefits coverage options for over-age dependents. We indicated that over-age dependents who are full-time students may continue to be eligible under the plan member’s benefits plan if they are studying in their home province. However, attending a post-secondary institution in their home province is not a requirement for continued eligibility. Dependents who are full-time students may continue to be eligible for coverage regardless of where in Canada they are attending post-secondary education.
   
   If your clients have any questions about extending coverage for over-age dependents that are full-time students, please notify them of this error.
    
   We apologize for any inconvenience or confusion this may have caused.
   
   
    
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6. Responding to Ontario’s biosimilar switch initiative

   We are changing coverage for some biologic drugs in Ontario in response to the province’s biosimilar initiative. These changes will help protect your clients’ plans from additional drug costs that may result from this government policy while providing access to equally safe and effective lower-cost biosimilars.

   Ontario’s provincial biosimilar initiative
   Announced in December 2022, Ontario’s biosimilar switch program ends coverage of eight biologic drugs for Ontario residents covered by the Ontario Drug Benefit (ODB). The transition to biosimilar versions of these drugs began on March 31, 2023. ODB recipients using these drugs will be required to switch to biosimilar versions of these drugs by December 29, 2023, to maintain their provincial coverage

   Equitable Life’s response
   To ensure this provincial change doesn’t result in your clients paying additional and avoidable drug costs, we are changing coverage in Ontario for most biologic drugs included in the provincial initiative.
   
   Beginning October 1, 2023, plan members in Ontario will no longer be eligible for most originator biologic drugs 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 the drug to maintain coverage under their Equitable Life plan. 

   Communicating this change to plan members
   We will inform any affected plan members in early August of the need to switch their medications so that they have ample time to change their prescriptions and avoid any interruptions in treatment or coverage. 

   Will this change impact my clients’ rates?
   Any cost savings associated with the change will be factored in 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 known as the “originator” biologic. Biosimilars are highly similar to the drugs they are based on and Health Canada considers them to be equally safe and effective for approved conditions

   Questions?
   If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.

   ** The list of affected drugs is dynamic and will change as Ontario includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
7. Announcing Equitable Life's National Biosimilar Program Beginning March 1, 2024, we are expanding our biosimilar switch program nationally** to protect all our clients and to make our coverage consistent across Canada.
   
   Our national biosimilar initiative will simplify drug plan coverage, replacing our provincial programs with one program across the country.
    

   Why now?

   Over the past few years, most provinces have introduced policies to delist some originator biologic drugs. They require most patients to switch to biosimilar versions of those drugs to be eligible for coverage under their public drug plans. Soon, it is expected that all provincial drug plans will cover only biosimilars.
   
   In response, we have implemented biosimilar switch initiatives in BC, Alberta, Saskatchewan, Ontario, Quebec, New Brunswick and Nova Scotia to align with these provincial changes. Our initiatives are designed to protect our clients from additional drug costs that may result from these government policies while providing access to equally safe and effective lower cost biosimilars.
    

   How will this affect clients’ drug plans?

   Because we have already introduced biosimilar switch initiatives in most provinces, the impact of this change will be minimal. It will primarily affect plan members in provinces or territories where we haven’t already required the switch to biosimilars, and plan members who are taking biosimilars that were not originally included in the switch initiative for their province. 
   
   Regardless of where they live, plan members across Canada will no longer be eligible for most originator biologic drugs if they have a condition for which Health Canada has approved a lower cost biosimilar version of the drug. Plan members already taking the originator biologic will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable plan. We will support their transition with education, personalized communication, and resources.
    

   Will this change affect clients' rates?

   Any cost savings associated with the change will be factored in 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 known as the “originator” biologic. Biosimilars are highly similar to the drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.
    

   Advance notice

   We will be communicating with affected claimants in early December to allow them ample time to change their prescription and avoid any interruptions in their treatment or their coverage. 
   
   If you have any questions about this change, please contact your Group Account Executive or myFlex Account Executive.
   
   
   **Excludes plan members in Quebec who participate in a separate provincial program. 
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