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January 2023 eNews
Responding to Saskatchewan’s biosimilar switch initiative*
We are changing coverage for some biologic drugs in Saskatchewan 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 new government policy while providing access to equally safe and effective lower-cost biosimilars.
Saskatchewan’s provincial biosimilar initiative
Announced in October 2022, the Saskatchewan Biosimilars Initiative ends coverage of ten biologic drugs beginning on April 30, 2023.
Patients in the province who are using these drugs will be required to switch to biosimilar versions of these drugs by April 30, 2023, in order to maintain their Saskatchewan Drug Plan coverage.
Equitable Life’s response
To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Saskatchewan for most biologic drugs included in the provincial initiative.
Beginning April 30, 2023, plan members in the province 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 February 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.
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 Saskatchewan includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
Ontario announces 2023 biosimilar switch program*
The government of Ontario recently announced the launch of a biosimilar initiative to switch patients from eight originator biologic drugs to biosimilar versions of the drugs.
Patients in Ontario using affected originator biologic drugs will have until December 29, 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans.
We are actively monitoring and investigating the impact of this new policy on private drug plans in Ontario. We plan to implement changes to coverage of biologic drugs in the province in 2023 to help prevent this change from resulting in additional costs for our clients’ drug plans. We will provide more details in the coming months.
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
Dental fee guide updates*
Each year, Provincial and Territorial Dental Associations publish fee guides. Equitable Life® uses these guides to help determine the reimbursement limits for dental procedures. For your reference, below is the list of the average dental fee increases for general practitioners that will be used by Equitable Life for 2023.***Dental fee guide increases over 2022***
***Data for all provinces and territories was not available at the time of publication. This chart will be updated on EquitableHealth.ca as more information becomes available.
Equitable Life ranks high with Canadian group advisors*
Equitable Life ranked second nationally and first in Ontario among major insurers in a recent survey of Canadian group benefits advisors.
NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 130 leading group consultants, brokers and third-party administrators across the country between May and August 2022 for its annual Canadian Group Benefits Study. Based on these interviews, NMG ranked group insurers in six categories, ranging from operational management to technology.
Nationally, Equitable Life ranked either first or second in four of the six main categories:
Advisors in Ontario, in particular, scored Equitable Life very favourably. We ranked #1 overall in the province, finishing first in four of the six overall categories, including: Relationship Management, Operational Management, Underwriting and Claims Management and Technology.
“The fact that advisors regard us so highly in so many categories is a testament to our mutual status and our ability to focus exclusively on our clients and advisors,” said Marc Avaria, Senior Vice President of Group. “We are truly working together to build strong, enduring and aligned partnerships.”
“While we are happy with these results, we won’t rest on our laurels,” added Avaria. “We will continue to dedicate ourselves to providing our clients and advisors with a better benefits experience.”
Here are more of the highlights from this year’s results:
Nationally, we ranked first in all 10 subcategories in Operational Management, including:- Overall service to intermediaries,
- Overall service to plan sponsors,
- New quote process,
- Plan implementation,
- Renewal process,
- Information shared at renewal,
- Accuracy and timeliness of reporting and billing,
- Administration quality and responsiveness,
- Taking ownership and
- Management information quality and availability.
- Company relationship management,
- Ease of doing business,
- Account executive capability,
- Market knowledge,
- Visit/call quality,
- Effective coordination and
- Advice.
- Fairness and timeliness of disability claims (1st)
- Fairness and timeliness of health claims (2nd)
- Fraud management (2nd)
- Competitiveness of pooling charges (2nd)
- Group underwriting flexibility (3rd)
- Health and dental TLR competitiveness (3rd)
- Overall technology – Intermediary (2nd)
- Member experience (2nd)
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February 2023 eNews
Responding to Nova Scotia’s biosimilar switch initiative
We are changing coverage for some biologic drugs in Nova Scotia 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 new government policy while providing access to equally safe and effective lower-cost biosimilars.Nova Scotia’s provincial biosimilar initiative
Announced in February 2022, the Nova Scotia Biosimilar Initiative ends coverage of seven biologic drugs for residents enrolled in Pharmacare programs.
Pharmacare patients in the province using these drugs will be required to switch to biosimilar versions of these drugs by February 3, 2023, in order to maintain their Nova Scotia Pharmacare coverage.Equitable Life’s response
To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Nova Scotia for most biologic drugs included in the provincial initiative.
Beginning June 1, 2023, plan members in the province 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.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 Nova Scotia plan members can submit a policy amendment. Amendments must be submitted no later than April 1, 2023. Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Nova Scotia plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.
Groups that choose to maintain coverage of these originator biologics for existing claimants will also maintain coverage for any originator biologics that we subsequently add to our Nova Scotia biosimilar initiative.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.Communicating this change to plan members
We will inform any affected plan members in April 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.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 Nova Scotia includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
Changes to New Brunswick drug interchangeability rules
We are introducing changes to help ensure that your clients with voluntary or mandatory generic pricing for their drug plans will benefit more from the cost savings of these two features, regardless of the province where the drugs are dispensed.
Currently, when determining whether a lower-cost alternative is available for a brand-name drug, most insurers only consider drugs that the provincial drug plan identifies as interchangeable.
However, the public drug plan in New Brunswick does not identify a drug as interchangeable if the drug is not listed on its formulary – even if Health Canada has deemed the drug interchangeable.
As a result, plans with mandatory or voluntary generic pricing have continued to reimburse some drugs in New Brunswick based on the cost of the brand-name drug, even if a lower-cost generic alternative is available.
Effective March 20, 2023, if your clients have drug plans with mandatory or voluntary generic pricing, we will adjudicate any drug claims in New Brunswick using the lowest cost alternative that Health Canada approves as bioequivalent. This will occur even if the public drug plan has not identified the drug as interchangeable.
To benefit from this more robust drug plan control, plan sponsors must have mandatory or voluntary generic pricing in place.
For more information about this change or about implementing mandatory or voluntary generic pricing for your clients, please contact your Group Account Executive or myFlex Sales Manager.
New template: plan members eligible for additional coverage
Often, based on salary, some plan members may become eligible to apply for extra Life, Accidental Death & Dismemberment (AD&D), Short Term Disability or Long Term Disability coverage. If this occurs, your clients receive a notification from Group Benefits Administration. We have now developed a template that your clients can provide to applicable plan members if they become eligible for extra coverage. The template makes it simpler for your clients to pass on these details to their plan members efficiently.
The new template is available for download under the Quick Links section of EquitableHealth.ca. It is a fillable PDF form that your clients can complete and provide to their plan members when necessary. The document is called Over the Non-Evidence Limit for Plan Members Notification.
If you have any questions about the template, please contact your Group Account Executive or myFlex Sales Manager. - [pdf] Equitable GIF Advisor Guide
- Financial planning concepts & tools
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Calming client fears about inflation and market volatility
Watch any news report or read any social media feed and you will see stories about inflation and market volatility. Inflation is one of the reasons that investing in equities is important - they can help to provide long-term returns that offset the effects of inflation. Help your clients stay on track during periods of market volatility and elevated inflation by following a few key investment strategies.
Time diversification through dollar-cost averaging
Volatile markets can provide opportunities. While your client may be skeptical, remind them about the benefits of dollar-cost averaging. Dollar-cost averaging adds time diversification, meaning your client buys into the market at different points in time. Regular investing can even allow your client to see growth during times of volatility. To learn more, click here.
It is time in the markets, not timing the markets that works long-term
Investing for the long-term allows your client to ride the waves of the investment market. The S&P/TSX Composite Index, for example, has had a compound annual return of approximately 7.8% over the past 25 years.[1] These returns account for the most recent financial crisis and the dot-com bubble. Previous market declines have offered buying opportunities for clients who have funds to invest. To learn more, click here.
Keep your clients invested with segregated funds
Segregated funds, like Equitable Life’s® Pivotal Select™, offer additional benefits beyond those offered by mutual funds and Exchange Traded Funds. Segregated fund guarantees (maturity and death) can protect your clients’ money during periods of market stress. A segregated fund guarantee will provide your client with the better of the guaranteed amount or the market value at the maturity date or date of death. A Pivotal Select segregated fund guarantee can give your client the confidence to stay invested during market uncertainty. To learn more about using Equitable Life’s segregated funds to keep your client invested, click here.
To learn more about the advantages of investing with Equitable Life, click here.
® Denotes a trademark of The Equitable Life Insurance Company of Canada.
[1] Annualized S&P/TSX Composite total return from January 3, 1995, to February 28, 2020. - Policy Loan
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Update: Improved Employee Assistance from Homewood Health
As we announced in June, we are expanding our relationship with Homewood Health to help you meet the mental health and wellness needs of your employees and their families. Beginning Oct. 1, 2019, Homewood will be the new provider of both our Employee and Family Assistance Program (EFAP) and our online health and wellness services.
Following the transition to Homewood, plan members will benefit from added features:
- Signing in to Homewood Health online allows the platform to customize content unique to your interests.
- All plan members will have access to a Health Risk Assessment to help identify health and wellness barriers.
- i-Volve, Homewood's online cognitive behavioural therapy program is available for all plan members to help them manage anxiety and depression.
Learn more about Homewood Health and how they will be providing your plan members with exceptional EFAP and online health and wellness resources.
What does the transition to Homewood mean for you and your plan members?
We will be working with you in the coming months to facilitate the transition and support your employees. Most importantly, there will be no disruption of service delivery to employees who are currently in short-term counselling with our current EFAP provider.
The transition timeline
Groups without an EFAP
Online health and wellness resources will be available through EquitableHealth.ca just as they are now. Here's what you can expect in the coming months.
September
- We will send plan administrators an email with more details about the resources available to assist in the transition, including:
- How to register for Homewood Health online
- A video orientation for plan members
October
- October 1st – plan members can access the Homewood online resources! They simply need to visit homeweb.ca/Equitable to sign up and create their unique login.
The transition timeline
Groups with an EFAP
We’ve created a helpful infographic that outlines the steps involved in the transition to the Homewood Health EFAP over the coming months. Please save or print it for easy reference. Below are some of the highlights.
August
- We will send plan administrators an email with official notice that the enrolment certificate for our current EAP provider, LifeWorks, will terminate on Sept. 30, 2019, and that Homewood Health Inc. will be our new Employee Assistance Program provider as of Oct. 1.
September
- Homewood will send you a welcome email, including how to access the EFAP, who to contact for support and where to find resources to help share the news with plan members.
- Homewood will follow up directly to answer any questions you may have.
- Homewood will begin offering orientation and training sessions for both plan administrators and plan members. These will be running throughout the fall so you can attend at your convenience.
October
- October 1st – plan members can access the Homewood EFAP and online resources! They simply need to visit homeweb.ca/Equitable to sign up and create their unique login.
- Orientation and training sessions will continue to be available for both plan administrators and plan members throughout October.
Learn More
The resources listed below answer common questions about Homewood and our EFAP transition:
If you have a question that is not addressed here, please contact your Group Account Executive or myFlex Sales Manager.
- Critical Illness - More Covered Conditions
- About
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Changes to the PMPRB
Earlier this month, the Government of Canada announced the final amendments to the Patented Medicines Regulations. These changes will impact how the Patented Medicine Review Board (PMPRB) sets the ceiling price for patented drugs and evaluates if the price of a drug reflects the value it has for patients. The intent of these updates is to enable the PMPRB to more effectively protect Canadians from excessive patented drug prices.
These changes do not come into effect until July 1, 2020. Finalizing the guidelines and consultation with stakeholders will occur leading up to this date. It is yet to be determined which drugs will be included in the final guidelines. It is anticipated the guidelines will initially focus on drugs launched shortly prior to and after July 1, 2020.
Equitable Life supports the modernization of the PMPRB and the ongoing need to evolve drug plan management tools in order to support the health of Canadians and drug plan affordability for public and private payers.
If you have any questions, please contact your Group Account Executive.