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Claims payments and notifications will go fully digital on July 1, 2023
We are committed to providing a better benefits experience. We have secure and convenient digital options to make it easier for plan members to access and use their benefits plan, including EquitableHealth.ca and the EZClaim Mobile app.
Most plan members are already using these tools to set up email claim notifications and direct deposit. They get their claim updates faster and their claims paid more quickly, right into their bank account.
To help ensure that all plan members benefit from faster claim payments and notifications, we are making these services fully digital as of July 1, 2023. That means, in most cases, we will no longer mail paper claim cheques or explanation of benefits (EOB) notifications.**
Plan members who haven’t already activated direct deposit and email notifications will need to activate these services via their plan member account on EquitableHealth.ca.How we’ll help plan members get set up
Fortunately, it’s simple for plan members to set up these features. And it only takes a few minutes. To make it even easier, we’ve created a Plan Member Guide to Getting Started Online. It includes simple instructions to help plan members use our digital features and get the most from their benefits plan.
We have also created a toolkit that plan administrators can email to their plan members to walk them through the simple steps. Access the toolkit here.
And we’re available to guide plan members who may need help. They can call us at 1.800.265.4556 and select “Plan Member Web Support”. Our Client Care Centre Team is happy to help them activate these services.How we’ll communicate with plan members
We will start communicating this change to plan members in April. For plan members who aren’t taking advantage of these convenient features, we will send them an email to let them know about the change, with instructions and support on getting set up.
We will also include an insert with all mailings of paper cheques and EOB notifications sent out. And we will post an announcement and banner on EquitableHealth.ca to let plan members know about the change.
How we’ll support plan members who need extra help or accommodations
After July 1, 2023, we will follow up with plan members who have not yet activated direct deposit or email notifications for their claims and provide any extra help and support they may need. And, of course, we’ll make exceptions for plan members who aren’t willing or reasonably able to use these features.Questions?
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
** Disability claimants will continue to receive paper Explanation of Benefits notifications in the mail. Some pay-direct drug claims will also continue to be paid by cheque. - [pdf] Borrowing Money to Make Money
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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.
- Financial planning concepts & tools
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Message from Ron Beettam
As COVID-19 continues to spread, we want to reassure you that we remain ready and committed to support you and your clients.
We have a robust and well-tested business continuity plan in place and our business is almost 100% digital. Almost 90% of our employees are now working remotely from home and are maintaining the high level of service you have come to expect from us. We still have a fully functioning Document Services Centre that is managing our incoming and outgoing mail. Our sales and customer service teams remain open to support you and your clients.
Equitable Life’s online application process, EZcomplete®, offers non face-to-face capability and continues to be your go-to resource for managing your business virtually. We are receiving a record number of online applications and are committed to helping you maintain a certain degree of daily activity. EZcomplete® non-face-to-face works for all life, critical illness and segregated fund applications.
Advisors will be pleased to know that we have increased non-medical limits for life insurance. We are also looking at other underwriting changes, digital delivery of life insurance contracts and additional digital payment options.
Our Savings & Retirement advisors will find our new Transaction Authorization Requirements table a valuable resource for submitting forms and documents. Can’t meet with your client in person to get a signature? Not to worry. You can have your client sign a letter of direction and take a picture to authorize a number of transactions.
Transacting in a non face-to-face environment can be a challenge but we will continue to revisit existing processes and look for ways to modify requirements to help you to continue managing your business. All of us are facing an unprecedented number of urgent situations where there is no established protocol. Our commitment to you and your clients is to respond quickly, and to be flexible where we can, tailoring solutions to specific needs.
To stay up-to-date, please refer to Equitable Life’s COVID-19 information page. There you will find the latest information for all lines of business.
As the global situation continues to evolve rapidly, we ask for your patience as our solutions also evolve quickly and accordingly. Rest assured that Equitable Life is unwavering in our support, and we will be here to help you protect what matters most to Canadians.
Ron Beettam, President and CEO -
NEW MARKETING MATERIAL! Equimax Participating Whole Life, Strong and Stable Dividends
Participating whole life policyholders can get some of the participating account earnings back as dividends.1
Dividend scales change over time. This new marketing piece shows how the actual values of policies look like against those that were estimated. It looks at two sample policies and compares them to the original sales illustrations. One example shows an Equimax Estate Builder® policy. The other example shows an Equimax® Wealth Accumulator® policy.
We are proud of our strong and stable dividend results. We have paid dividends to our participating policyholders every year since 1936. And we’re still going strong!
We want to make sure that we can continue to provide long-term income and growth to support the dividend scale and meet the product guarantees. We do this with constant focus on how we invest and manage risk to support the participating account.
As a mutual life insurance company, we are owned by our policyholders who count on us and our services. Their trust in our knowledge, experience, and financial strength helps us keep our commitments to them—now and in the future.
Dividend scales may change.2 But with a balanced approach, Equitable Life’s Equimax® Participating Whole Life continues to deliver excellent value. It gives guaranteed life insurance protection with the potential for earnings.
Want to learn more? Check out our new marketing piece: Equimax Participating Whole Life, Strong and Stable Dividends (2075).
For more information, reach out to your local wholesaler.
® and TM denote trademarks of The Equitable Life Insurance Company of Canada.
1 Dividends are not guaranteed and are paid at the sole discretion of the Board of Directors. Dividends may be subject to taxation. Dividends will vary based on the actual investment returns in the participating account as well as mortality, expenses, lapse, claims experience, taxes, and other experience of the participating block of policies.
2 If low interest rates continue, investment returns will be lower, and this may mean decreases in the dividend scale in the future. Dividend payments are not guaranteed, but they will never be negative. -
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.
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.
What is the difference between biologics and biosimilars?
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. -
Celebrating our most popular Pivotal Select funds
In August 2022, Equitable® launched 12 new segregated funds in Pivotal Select’s Investment Class (75/75). We wanted to bring some new innovative solutions to the product, including six sustainable investment funds. To say the launch of these funds was successful would be an understatement.
The funds are quickly becoming some of the most popular funds in Pivotal Select™, and their performance in 2023 was impressive. Equitable wants to celebrate these funds and encourage clients to consider them for their portfolios.
As of February 29, 2024, nine out of the 12 funds received a 1st quartile ranking for their 1-year return and two more were 2nd quartile. The table below shows the new funds that ranked in the top two quartiles for their 1-year returns.
Access additional fund performance information
If you haven’t looked at these funds yet, now is the time. Speak to clients about their investment options and see if these funds fit within their investment portfolio.
Talk to your Director, Investment Sales today for more information.Disclaimer
Any amount that is allocated to a segregated fund is invested at the risk of the contractholder and may increase or decrease in value. Segregated fund values change frequently, and past performance does not guarantee future results. Investors do not purchase an interest in underlying securities or funds, but rather, an individual variable insurance contract issued by The Equitable Life Insurance Company of Canada. There are risks involved with investing in segregated funds. Please read the Contract and Information Folder before investing for a description of risks relevant to each segregated fund and for a complete description of product features and guarantees. Copies of the Contract and Information Folder are available on equitable.ca.
Management Expense Ratios (MERs) are based on figures as of February 29, 2024, and are unaudited. MERs may vary at any time. The MER is the combination of the management fee, insurance fee, operating expenses, HST, and any other applicable non-income tax for the fund and for the underlying fund. For clients with larger contract values, a Management Fee Reduction may be available through the Preferred Pricing Program. For details, please see the Pivotal Select Contract and Information Folder.
® and TM denote trademarks of The Equitable Life Insurance Company of Canada.
Posted April 18, 2024