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Group Benefits - Premium relief for Dental and Extended Health Care benefits
We know this is a difficult time for Canadian employers and that many of your clients are facing financial hardship as a result of the COVID-19 pandemic. We continue to look for ways to help employers manage while still supporting their employees.
With many health practitioners closing their offices due to the pandemic restrictions, plan member use of dental benefits and some health benefits has declined.
So, we are pleased to announce that we are offering premium relief for all Traditional and myFlex insured non-refund customers for Health and Dental benefits, as follows:
- A 50% reduction on Dental premiums; and
- A 20% reduction on vision and extended healthcare rates (excluding prescription drugs), which equates to an 8% reduction on Health premiums.
These reductions are retroactive to April 1, 2020 and will appear as a credit against the next available billing. We will assess the situation monthly and expect to continue with monthly refunds for as long as the current crisis period continues.
We expect that claims experience and premiums will return to normal once the current pandemic restrictions are lifted.
In the meantime, plan members will continue to have full access to their benefits coverage throughout the pandemic. In many cases, dental offices remain open for emergency services, and a variety of healthcare providers are available virtually.
Commissions
We know the pandemic has put financial strain on your business as well, so we will continue to pay full compensation. Although your overall commission will be unaffected by these premium reduction adjustments, you may see a temporary reduction in your commission payments if you are on a pay-as-earned basis while we put through mass changes. If so, we will then make an additional top-up payment to cover that shortfall as soon as we are able.
Communication
We will be communicating this premium relief program to your clients April 21st at 8:00am EST.
A PDF of the communication is also available here.Questions?
If you have any questions, please contact your Group Account Executive or myFlex Sales Manager. In the meantime, we have provided some Questions and Answers below.
Will the premium reduction on Health and Dental benefits have an impact on the renewals that were deferred?
No. Renewals will proceed as normal, with rate adjustments based only on months where full premium was paid. For most clients, we anticipate “normal” rate adjustments at renewal compared to rates paid prior to refunds taking effect.
Does this adjustment apply equally to clients who have had their renewal deferred?
Yes, these adjustments apply to all Traditional and myFlex insured, non-refund customers for Health and Dental benefits.
How does this affect clients who have terminated or amended a plan?
If a benefit is in-force during the month of April, the adjustment will be credited to the next available billing. For clients who have temporarily terminated all benefits, this will be applied against the first bill once benefits have been reinstated. No cash refunds will be paid.
Will you recover any of the adjustment at a future point in time?
No, we will not recover this adjustment.
Instead of this premium reduction adjustment, can a client cancel or adjust some of the benefits on their plan?
Yes, you and your clients always have the option of changing the coverage on a plan, such as reducing or removing a benefit to help control costs. Please speak to your Group Account Executive or myFlex Sales Manager about the options available.
Are TPAs and self-administered groups eligible for the premium reduction?
Yes. TPAs and self-administered groups are eligible for the premium reduction. However, timing for the credit will be dependent on the billing practices of the TPA or self-administered group. We will apply these credits as soon as we are able. -
January 2024 eNews
In this issue:
- Equitable scores high marks with group advisors*
- REMINDER: Equitable's National Biosimilar Program starts in March*
- 2024 dental fee guide updates*
- Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*
Equitable scores high marks with group advisors*
Equitable ranked first for operational service among major group insurers in a recent study of Canadian group benefits advisors.
NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 146 Canadian group benefits brokers, consultants, MGAs and third-party administrators between May and August 2023 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 ranked among the top three in five of the six main categories, including number one for Operational Management:Category Ranking Operational management 1st Initiatives (including seminars & training) 2nd Technology 3rd Underwriting & claims management 3rd Relationship management 3rd
“Advisors regard us highly in many categories. That’s a testament to our mutual status and ability to focus exclusively on our clients and advisor partnerships,” said Marc Avaria, Executive Vice President, Group Insurance Division. “We are truly working together to build strong, enduring and aligned partnerships with our clients and advisors.”
“We’re delighted with these results and are committed to continuously advancing our delivery of a better benefits experience for our clients and advisors,” added Avaria.More highlights from the latest NMG survey
Nationally, we ranked first in seven subcategories in Operational Management, including:- Overall service to intermediaries,
- Overall service to plan sponsors,
- New quote process,
- Plan implementation,
- Renewal process,
- Accuracy and timeliness of reporting and billing, and
- Administration quality and responsiveness
And we were rated strongly in Technology, finishing in the top three for:- Overall technology for Intermediary (2nd)
- Member experience (3rd)
- Quality of technology for the plan sponsor (2nd)
- Quality of mobile application (2nd)
REMINDER: Equitable's National Biosimilar Program starts in March*
In October 2023 we announced the upcoming launch of our national biosimilar program. Starting March 1, 2024, we are expanding our biosimilar switch initiatives to provide a single, nationwide** program.
Why we’re making the switch
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.
Equitable’s National Biosimilar Program simplifies drug plan coverage by replacing our provincial programs. It also protects clients from additional drug costs while offering access to lower-cost biosimilars deemed equally safe and effective by Health Canada.
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. It will also affect 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.
Advance notice for plan members
We contacted affected claimants in early December to give them enough time to change their prescriptions 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.
2024 dental fee guide updates*
Each year, Provincial and Territorial Dental Associations publish fee guides. Equitable uses these guides to help determine the reimbursement limits for dental procedures.
For your reference, you may wish to refer to the 2024 list of the average dental fee increases for general practitioners.
Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*
Equitable is proud to congratulate our Employee and Family Assistance Plan (EFAP) partner, Homewood Health®, for winning the Canadian HR Reporter 2023 Reader’s Choice Award in Employee Assistance Plan services. Homewood’s EFAP provides confidential support for a range of health, family, money, and work issues through face-to-face, phone, email, chat, or video counselling. The award recognizes their high standards in counselling and mental health support services.
The annual Reader’s Choice Awards identify organizations that provide outstanding expertise and services for HR professionals and employers across Canada. Those organizations provide valuable information on useful, innovative HR and employee benefits products and programs, in categories such as recruitment, mental health services, employee engagement programs, and more.
Sharing Homewood Health with your clients
Since 2019, we have worked with Homewood to provide mental health services for Equitable benefits plan members.
Your clients can access Homewood Health’s award-winning EFAP for an additional fee by adding it to their benefits plan. Services are available 24/7, 365 days a year.
All Equitable clients also have free access to Homewood Health Online in their benefits plan. Homewood Online provides a variety of helpful wellness resources, including:
- Homeweb, an online and mobile health and wellness portal,
- Health Risk Assessment, a group of assessment tools to help plan members identify and overcome health and wellness barriers, and
- Online Internet-based cognitive behavioural therapy (iCBT) through Sentio to manage symptoms of anxiety and/or depression.
Questions
To learn more about Homewood Health’s services, contact your Group Account Executive or myFlex Account Executive.
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