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May 2023 eNews
Update: Introducing changes to our Diabetes Management Program
Beginning June 1, 2023, we are introducing additional standard drug plan controls as part of our Diabetes Management Program.
The controls will apply to GLP-1 agonists approved by Health Canada for the treatment of diabetes, such as: Adlyxine, Mounjaro, Ozempic, Rybelsus, Trulicity, and Victoza.
This change will help manage the impact of these high-cost diabetes medications for your clients while continuing to provide plan members with access to effective treatments to manage their disease.
Why are we introducing this change?
GLP-1 agonists are the highest cost diabetes drugs on the market. Current Diabetes Canada Clinical Practice Guidelines recommend that most Type 2 diabetics begin treatment with lower-cost and equally effective first-line therapies, such as Metformin.
Some GLP-1 agonists are also used “off-label”. In other words, they are often prescribed for conditions for which they have not been approved by Health Canada, such as weight loss.
These additional controls will help ensure that these drugs are used appropriately – only for the treatment of diabetes and only after other first-line treatments have been tried.
If a client wishes to provide coverage for drugs specifically approved by Health Canada for weight loss, we have coverage options available.
How will this program work?
Plan members who receive a new prescription for a GLP-1 agonist will need to try a first-line diabetic treatment before they are eligible for coverage of the GLP-1 agonist. If the plan member has previously tried first-line therapies and found them ineffective, they will be eligible for a GLP-1 agonist.
Plan members who are already taking a GLP-1 agonist to treat diabetes will continue to be eligible for coverage. Some claimants may need to provide confirmation of their diabetes diagnosis from their physician or pharmacist in order to maintain coverage. We will provide claimants ample time to confirm their diagnosis.
Questions?
If you have any questions about these additional standard controls or how they will impact your clients, please contact your Group Account Executive or myFlex Sales Manager.
Coming soon: Survey for plan administrators with recent disability claims
We are regularly enhancing our communication processes to help your clients with disability plans manage their workplace absences more effectively. Later this month, we will distribute a short survey to plan administrators who have submitted a disability claim in the past six months. The survey will ask recipients about their satisfaction with the frequency and detail of our disability management communications.
The email will come from GBClientFeedback@equitable.ca, and the survey will remain open until the end of the day on May 19, 2023. All responses will be confidential. Survey respondents will receive the option to provide their contact information so that we can follow up on feedback they have provided.
We plan to use the feedback to help ensure that we’re meeting your clients’ expectations and delivering industry-leading service.
In a previous issue of eNews, we published a list of the average dental fee increases for general practitioners based on the latest Provincial and Territorial Dental Association fee guides.
Since then, the Canadian Life and Health Insurance Association (CLHIA) has updated the 2023 dental fees for some provinces. Provinces with dental fee updates since our previous eNews are bolded and italicized. 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.
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Update on our service levels during the COVID-19 pandemic
Supporting your clients and their plan members is more important than ever during the ongoing COVID-19 pandemic
So, we’re providing an update on our service levels.
We acted quickly to ensure there were no disruptions in service – most of our staff were working remotely from home and fully functional within a few days. We’ve reallocated resources from functions where volumes are down, such as dental claims, to those experiencing higher volumes. We also created a separate queue for COVID-19-related STD claims.
As a result, we’ve been able to maintain the industry-leading service levels you have come to expect from us, and our turnaround times continue to be well within our targets.
Here’s a summary of what you and your clients can currently expect in terms of average turnaround times:
Service category Average Turnaround Time
(as of April 26th)Customer Care Centre wait times 89% of calls answered within 20 seconds Responses to emails to our Service Team Within 24 hours Health claims 2 days Dental claims 2 days Life claims 1 day STD claims 4 days LTD claims 4 days Plan member updates 2 days New customer implementations 16 days COVID-19-related plan amendments 4 days Other plan amendments 8 days Quotes 2 days ahead of deadline We will closely monitor the situation and continue to adapt to ensure we maintain our service levels. And we will do our best to resolve any service issues that arise as quickly as possible.
Please feel free to contact your Group Account Executive or myFlex Sales Manager and let us know how we’re doing.
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Take emotions out of investing
Taking the emotion out of investing can be easier said then done. Most of us at one time or another have decided upon something strictly because of how we felt at the time, not because it was logical or made good financial sense. I am sure most of us have a good story to tell.
When it comes to financial planning, you always want to encourage your clients to be a rational investor and accept that market fluctuation is part of the investment journey. Over the last few months, even the hardiest rational investor has been challenged to accept the market fluctuations. History shows us that this too, shall pass and markets will rise once more. The biggest question asked is always, when?
While no one has a crystal ball with that answer, the best we can do is help our clients understand that when building portfolios, risk is always at the forefront of any good investment strategy. The level of risk is just one of the building blocks to constructing a financial portfolio that will see the client through good times and bad.
Need more help? Equitable Life has created an emotional investing brochure to help your clients manage through these extraordinary times. To download a copy, click here. We have also included a template letter that you can personalize and use to reach out to your clients. To download an editable copy, click here.
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Tools to manage mental health
As we all continue to manage the impacts of the COVID-19 pandemic, it’s important to remind your clients of the valuable supports available to help their plan members cope through this challenging time.
Free trusted information and COVID-19 resources
Our partner FeelingBetterNow® is responding to the pandemic by providing trusted public resources that offer mental health support. They are available to anyone 24 hours a day, seven days a week, and include:
- What to do if you’re anxious or worried about COVID-19;
- Resources for parents and caregivers; and
- National and Provincial Public Health resources.
Access COVID-19 resources from FeelingBetterNow.
FeelingBetterNow Mental Health Assessment
In addition to these public resources, Equitable Life clients with FeelingBetterNow as part of their group benefits plan have access to online mental health resources. FeelingBetterNow can help plan members identify their risk for mental health concerns and work with their doctor on diagnosis and treatment. It’s an anonymous tool developed by mental health experts which provides:
- Emotional and mental health assessments;
- Practical, evidence-based tools employees and their doctor can use to assess, treat, and follow-up on emotional and mental health concerns; and
- Convenient online access to information and effective resources.
FeelingBetterNow is easy to use and completely anonymous. It takes less than 20 minutes to complete the assessment and view your results.
Learn more about FeelingBetterNow, then contact your Group Account Executive or myFlex Sales Manager to discuss how your clients can add this service to their plan.
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Have you heard about Equitable Client Access?
Equitable Client Access® allows clients to self-serve on some of the more popular requests. Thousands of clients have already signed up for Equitable Client Access and are enjoying the benefits of accessing their secure information 24/7.
• Does your client need to change or stop existing Pre-Authorized payment (PAD)? Equitable Client Access can do that.
• Does your client need to change a withdrawal date for a PAD? Equitable Client Access can do that too.
• Address or banking information changes? Equitable Client Access has your clients covered.
• Does your client need to change her beneficiary from Aunt Flora to Uncle Ned? Equitable Client Access can even do that.
Equitable Client Access is a secure online client site that connects clients with policy information, right at their fingertips. In addition to the self-serve features, Equitable Client Access can also provide:
• Insurance coverage and guarantees
• Investment allocation, performance and market values
• Transaction history
• Statements and letters
• Advisor contact information, along with so much more.
If your clients have not signed up for Equitable Client Access, direct them to client.equitable.ca - it only takes a few minutes to set up an account, and connects your clients with their policy information online – anytime!
Have a question about Equitable Client Access? Want to tell your client how to go paperless? Check out our updated FAQ or contact your Regional Investment Sales Manager today.
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Changes to coverage of Humira in BC
BC Pharmacare recently announced it is adding Humira to the list of drugs included in its ongoing initiative to switch patients to biosimilar versions of high-cost biologics. Patients taking Humira for most conditions will be required to switch to a biosimilar version of the drug by Oct. 7, 2021 to maintain coverage under the public plan.
Biologics are drugs that are engineered using living organisms like yeast and bacteria. The first version of a biologic developed is also known as the “originator” biologic. Biosimilars are also biologics. They are highly similar to the originator biologic drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.
How we are responding to protect our clients
To help prevent this change from resulting in additional costs for our clients’ drug plans, while still providing plan members with access to safe and effective medications, we will no longer cover Humira for plan members in BC. Effective Oct. 7, 2021, claimants currently taking Humira will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable Life plan.
We will be communicating this change to plan administrators later this week. And we will be communicating with affected claimants in early August to allow 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 Sales Manager.