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August 2019 Advisor eNews
Coming soon:
Tech updates for plan members
Technology doesn’t stand still, and neither does your clients' businesses. That’s why we continually invest in technology to make things easier for your clients and their employees.
Faster claims processing on Equitable EZClaim® Mobile
Equitable Life now provides real-time processing of massage therapy, physiotherapy and chiropractor claims submitted via the EZClaim Mobile app.
That means plan members are able to find out the status of their 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, and the type and amount of the expense, when submitting their claims for these services.
Equitable Life plan members can submit all types of health and dental claims via EZClaim Mobile, including co-ordination of benefits and Health Care Spending Account claims. Currently, 43% of all claims are submitted through the user-friendly app.
AS part of our ongoing efforts to improve the mobile claims experience for plan members, we've also added biometric login functionality to allow plan members to sign in to the app using their face or fingerprint. And we've redesigned our landing page on the mobile app to make it easier for plan members to navigate the various features of the app.
We will be announcing this enhancement to plan members on EquitableHealth.ca
Introducing InpatProtect:
Health coverage for employees who are new to Canada
For a new employee starting to work in Canada, looking after basic health needs can be difficult.
There’s a waiting period for provincial health coverage, and group benefits plans don’t cover the physician, hospital or emergency services that they or their eligible dependents may need during their initial months in the country. They could end up incurring significant unexpected health expenses.
That’s why Equitable Life has launched InpatProtectTM. InpatProtect provides temporary coverage to look after the basic health needs of employees and their eligible dependents during their transition to Canada. Your clients can recruit from outside the country knowing that their employees will have some protection in the event of a medical need, including an emergency.
For up to 90 days, InpatProtect will cover employees and their eligible dependents for basic services that would normally be reimbursed under provincial health plans, such as:
- Physician services
- Prescriptions for medications
- Diagnosis and treatment for illness or injury
- Hospital services
- In-patient services
- Drugs prescribed and delivered as an inpatient in-hospital
- Out-patient services
- Emergency services
- Ambulance services
- Emergency dental services
Contact your Group Marketing Manager or myFlex Sales Manager for more information about this new product from Equitable Life.
De-listed service providers
As part of our ongoing initiative to have Group Benefits plans only reimburse eligible claims, we conduct reviews of the billing and administrative practices of service providers, including clinics, facilities and medical suppliers.
As a result of these reviews we may de-list certain providers. We will no longer accept, or process claims for services and/or supplies obtained from those providers. The plan member can still choose to obtain services or supplies from these providers, but Equitable Life will not provide reimbursement for the claims.
Review Equitable Life’s de-listed service providers
The delisted service provider list is also posted on EquitableHealth.ca for plan members to review to determine if their claim(s) are eligible for reimbursement under their Group Benefits plan.
For more information about protecting group benefits plans from abuse, check out our articles.
1 Based on Equitable Life health and dental claims submitted between January 2019 – March 2019
Google Home and Google Assistant are registered trademarks of Google LLC.
® denotes a trademark of The Equitable Life Insurance Company of Canada unless otherwise indicated. - Physician services
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Equitable Life of Canada ends 2020 in a position of financial strength
Equitable Life of Canada is pleased to report that our strategic approach continued to serve us well in 2020, despite operating in a global pandemic.
Equitable Life, one of Canada’s largest mutual life insurance companies, closed out 2020 with strong earnings and solid growth.
The Company reported earnings of $153 million, equating to a return on policyholders’ equity of 16%. This result was driven by strong sales, investment performance, positive impacts from favourable expense ratios and reserve assumption changes.
“There is no doubt the global pandemic has had, and continues to have, a profound impact on the lives of Canadians and created challenges for all of us in 2020 that we could never have envisioned,” said Ron Beettam, Equitable Life’s President and Chief Executive Officer. “Thanks to the resiliency and commitment of our entire team, we effectively responded to unfavourable impacts caused by the pandemic, including market volatility, and continued to achieve a high growth rate on most key measures, ending 2020 in a position of financial strength.”
Equitable Life reported premiums and deposits of $1.7 billion in 2020, contributing to $6.0 billion of assets under administration. This growth was supported by very strong sales during the pandemic, as more Canadians turned to insurance to protect the financial security of their families. Dividends to participating policyholders increased by 24% over the prior year.
The Individual Insurance business reported 2020 sales of $149 million, reflecting the third consecutive year of double-digit sales growth. Savings & Retirement reported sales of $401 million, driven by sales of segregated funds. Group Benefits delivered sales of $46 million, despite competitive industry pricing strategies and the impact the pandemic had on businesses.
Equitable Life finished the year with an impressive LICAT ratio of 166%, well above the regulatory target and one of the highest in the industry. This capital result demonstrates that we are well-positioned to continue meeting our commitments to our policyholders. In addition, DBRS Limited (DBRS Morningstar) upgraded our Financial Strength rating to A (high) with Stable Trends in September.
“While we don’t yet know what future impacts the global pandemic could have on our business, we know we can face the future with confidence,” said Beettam. “I am very proud of all that we have accomplished together, especially throughout this unpredictable year, and I know the Company is very well positioned to meet the challenges ahead and will continue building on those achievements by focusing on organic and profitable growth across all lines of business, with a continued emphasis on meeting the needs of our policyholders and distribution partners.”
2020 Financial Highlights
- Net income of $153 million, for a return on policyholders' equity of 16%
- Capital strength, as measured by the LICAT ratio, ended the year at 166%
- Participating policyholders' equity surpassed $1 billion
- Premiums and deposits increased by 6.8% to $1.7 billion
- Sales of $149 million in Individual Insurance, $401 million in Savings and Retirement, and $46 million in Group Benefits
- Assets under administration grew 17.6% to $6 billion
- Benefits and payments to policyholders of $820 million
- Dividends to participating policyholders increased by 24% to $61 million
About Equitable Life of Canada
Canadians have turned to Equitable Life since 1920 to protect what matters most. We work with independent advisors across Canada to offer individual insurance, savings & retirement, and group benefits solutions to meet your needs.
Equitable Life is not your typical financial services company. We have the knowledge, experience and ability to find solutions that work for you. We’re friendly, caring and interested in helping. As a mutual company, we are not driven by shareholder pressures for quarterly results. This allows us to focus on management strategies that foster prudent long-term growth, continuity and stability. We are dedicated to meeting our commitments to customers – now and in the future.
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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
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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Equitable Life Group Benefits Bulletin - November 2022
The importance of timely plan member eligibility updates*
Effective Dec. 1, 2022, we are implementing a revised process for managing plan member and dependent health and dental claims that have been incurred and paid after coverage has been terminated. This new process is consistent with industry practices.
If health or dental claims have been incurred and paid after a plan member’s termination date but before we received notice of the termination, we will align the plan member’s or dependent’s termination date with the service date of the last paid claim, retaining premiums up until that date.
If no claims have been incurred and paid after the termination date, Equitable Life will process the termination as requested and refund any excess premium, subject to a maximum premium refund credit of three months.
Currently, we process the termination as requested and attempt to recover any claim overpayments directly from the plan member. We then refund any excess premiums that have been paid, subject to the maximum refund credit amount.
To avoid claims being incurred and paid after a plan member’s termination date, it is important for your clients to update plan member and dependent eligibility dates on or before the effective date of the change.
If you have any questions about the process your clients should follow for updating plan member eligibility, please contact your Group Account Executive or myFlex Sales Manager.QuickAssess®: Absence and accommodation request review services*
It can be difficult to navigate chronic or complex cases of absenteeism or accommodation requests. That’s where QuickAssess® can help.
QuickAssess is an optional, fee-per-use service that can provide your clients with an unbiased, timely assessment of complex plan member absences and workplace accommodation requests. Our disability experts can provide recommendations to help your clients manage:- Workplace absences
- Chronic or patterned absenteeism
- Requests to modify workplaces or duties
- Return-to-work coordination
- Employee Insurance sick leaves
For more information on using QuickAssess, including eligibility requirements, please contact your Group Account Executive or myFlex Sales Manager.
**Within two business days of receiving a completed QuickAssess Absence and Accommodation Review Referral Form and all required information. For more complex referrals, more time will be required.Finding a health care provider with TELUS eClaims direct billing*
By visiting TELUS’s Find a Provider page, your clients’ plan members can now easily search for paramedical and vision providers who are registered on the TELUS Health eClaims network and who can submit claims directly to us on behalf of their patients. Searches can be filtered by postal code to help plan members find the most convenient provider options.
As our direct billing provider for pharmacy, vision and paramedical claims, TELUS Health has an extensive network of 70,000 health care providers that provide direct billing to streamline the claims process.
Please note, plan members should always check Equitable Life’s list of de-listed providers before selecting a health care provider. The list is available for your clients and their plan members on EquitableHealth.ca, and is updated regularly.
For more information about TELUS eClaims, please contact your Group Account Executive or myFlex Sales Manager.First phase of the Canada Dental Benefit proposed for Dec. 1, 2022*
The federal government’s new Canada Dental Benefit is proposed to take effect on Dec. 1, 2022, subject to Parliamentary approval. The program will cover eligible expenses retroactive to Oct. 1, 2022, and this first phase would apply to Canadians under 12 years of age.
If implemented, the Canada Dental Benefit will provide dental care to Canadian families with under $90,000 adjusted net income annually. By 2025, the federal government expects to extend the benefit to children under 18, senior citizens and Canadians with disabilities.
Parents or guardians will be required to apply for this coverage through the Canada Revenue Agency (CRA) and must not have private dental coverage for the child(ren).
This new program will have no impact on your clients’ dental coverage and no action is required on their part.
* Indicates content that will be shared with your clients.
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National Pharmacare (Plan NP) takes effect in B.C. on March 1
In this issue:
National Pharmacare (Plan NP) takes effect in B.C. on March 1
Travel coverage details plan members should know if they’re in or going to Mexico*
*Indicates content we will share with your clients.
National Pharmacare (Plan NP) takes effect in B.C. on March 1
The Province of British Columbia (B.C.) will implement the first phase of the National Pharmacare Act, also known as Bill C64 (Act), on March 1, 2026.
The new program will be called National Pharmacare (Plan NP). The province joins Manitoba and Prince Edward Island, who have already implemented the first phase of their own programs. All three provinces, along with Yukon, signed bilateral pharmacare agreements with the federal government last year.
National Pharmacare (Plan NP) coverage details
The federal government has agreed to provide universal coverage for many diabetes drugs and contraceptives, including deductibles, during the first phase of implementation of the Act. Equitable will no longer cover drugs that are eligible for coverage under Plan NP.
Diabetes devices and supplies are not included in the first phase of plan implementation. However, expanded coverage for certain diabetes-related devices and supplies is expected to begin in B.C. on April 1, 2026.
Since B.C. already offers universal coverage of contraceptives through its provincial pharmacare program, the province is using that portion of the federal funding to cover menopausal hormone therapy (MHT), also called hormone replacement therapy (HRT).
Many diabetes medications such as metformin, insulin, sulfonylureas and SGLT-2 inhibitors will be fully covered under Plan NP.
Some diabetes medications and MHTs will only be partially covered when the program takes effect. As well, many diabetes medications will continue to require Special Authority through the province.
What will Equitable plan members need to do?Coverage will be provided automatically at the pharmacy counter. Plan members simply need to present a prescription for a covered medication and their Medical Services Plan of B.C. (MSP) card to their pharmacist. If a plan member isn’t fully enrolled in the MSP yet, their pharmacist will help them secure coverage under Plan NP.
The pharmacist will charge the provincial plan directly for the relevant medications. There will be no direct impact to plan members or their experience at the pharmacy for fully covered drugs.
Where do GLP-1 drugs fit in?
GLP-1 agonist drugs will not be covered under Plan NP. Equitable plan members who are prescribed this type of drug to treat diabetes must try a first-line diabetic treatment before we can deem them eligible for coverage of the GLP-1 agonist.
Plan members who are already taking a GLP-1 agonist to treat diabetes will continue to be eligible for coverage. New plan members or plan members with new prescriptions for GLP-1 agonists must provide us proof that shows they’ve tried a first-line diabetic treatment to confirm eligibility—unless we already have a previous record of their insulin use. Proof can be either a past receipt or a claim statement.
Our priority is supporting the best outcomes for plan sponsors and their members. We are working with TELUS Health, our pharmacy benefits manager, to keep you updated as more details become available.
Travel coverage details plan members should know if they’re in or going to Mexico
Plan members with Travel Assist medical emergency coverage included in their benefits plan should keep the following information in mind if they’re planning travel to Mexico or if they’re in the country now.
Due to recent violence in Mexico, the Government of Canada has issued the following travel advice to anyone in or planning to visit the country.
Plan members are not covered if they receive out-of-province services where the Canadian government had issued a warning to avoid all or non‑essential travel before they entered the country.
Plan members should contact Trident Global Assistance, the company that administers our Travel Assist benefits, before departing if they have questions about their coverage or to confirm if they’re covered for travel to their specific destination.
Here’s how plan members can reach the Trident Global Assistance toll-free 24-hour emergency hotline:
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In Canada or the U.S: 1-800-321-9998
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Elsewhere: Call collect at 519-742-3287
They should be prepared to provide the following information:
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Name
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Group policy number
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Certificate number
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Government health insurance plan number
If a plan member arrived in Mexico before the travel advisory was issued and are past their day allowance, they should call Trident if they need to have their day maximum extended past the allowable period.
Equitable’s Travel Assist medical emergency coverage does not include any trip cancellation or trip interruption benefits.
Communicating to plan members
We are making every effort to share this information with affected plan members. Please encourage your clients who have Travel Assist coverage included in their benefits plan to share this message with their plan members.
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