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1. Responding to Alberta's Biosimilar Initiative

   Beginning March 15, 2021, we are changing coverage for some biologic drugs in Alberta in response to the province’s Biosimilar Initiative. These changes will help protect your clients from additional drug costs that may result from this new government policy while still providing access to equally safe and effective biosimilars.

   What is Alberta’s Biosimilar Initiative?

   Alberta’s Biosimilar Initiative will end provincial coverage of several originator biologic drugs for some or all conditions beginning on Jan. 15, 2021. Patients 18 and over who are using these drugs for the affected conditions will be required to switch to biosimilar versions of the drugs to maintain coverage under the province’s government drug plan.

   What is the impact on private drug plans?

   Industry response to Alberta’s Biosimilar Initiative has the potential to significantly impact your clients’ drug plan costs. If other insurance carriers follow suit with the province and delist the originator biologics, it could expose a plan that doesn’t delist them to significant coordination of benefits risk. (See Case Study below.)

   How is Equitable Life responding?

   To protect your clients’ plans from paying additional and avoidable drug costs, we are changing coverage in Alberta for most biologic drugs included in the provincial initiative.

   As of March 15, 2021, several originator biologic drugs will no longer be covered for plan members of all ages in Alberta. Plan members taking these biologics will be required to switch to the biosimilar versions of these drugs to maintain eligibility under their Equitable Life plan.

   What drugs and conditions are affected?

   The following table outlines the drugs and conditions that will be affected by this change. The list of affected drugs or conditions is dynamic and will change as Alberta includes more biologic drugs in its Biosimilar Initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.

   Drug name	Originator biologic   These drugs will no longer be covered in Alberta for the conditions listed in this table.	Biosimilar   Plan members will need to switch to these medications to maintain coverage under their Equitable Life plan.	Affected health conditions   The changes in coverage apply to these conditions.
   Etanercept	Enbrel	Brenzys Erelzi	Ankylosing Spondylitis Rheumatoid Arthritis Polyarticular juvenile idiopathic arthritis (JIA) Psoriatic Arthritis Plaque Psoriasis (adults and children)
   Infliximab	Remicade	Inflectra Renflexis Avsola	Ankylosing Spondylitis Plaque Psoriasis Psoriatic Arthritis Rheumatoid Arthritis Crohn's Disease (adults and children) Ulcerative Colitis (adults and children)
   Insulin glargine	Lantus	Basaglar	Diabetes (Type 1 and 2)
   Filgrastim	Neupogen	Grastofil Nivestym	Neutropenia
   Pegfilgrastim	Neulasta	Lapelga Fulphila Ziextenzo	Neutropenia
   Glatiramer*	Copaxone	Glatect TEVA-Glatiramer Acetate	Multiple Sclerosis

   *Glatiramer is a non-biologic complex drug.

   How will Equitable Life communicate this change to plan members?

   We will be communicating with affected claimants in January 2021 to allow them ample time to change their prescriptions and avoid any interruptions in their treatment or their coverage.

   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 Alberta plan members can submit a policy amendment. Amendments must be submitted no later than January 15, 2021. Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Alberta plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.

   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.

   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 also known as the “originator” biologic. Biosimilars are also biologics. They are highly similar to the originator drug they are based on and have been shown to have no clinically meaningful differences in safety or efficacy.

   Questions?

   If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.

   CASE STUDY: The Alberta Biosimilar Initiative and Coordination of Benefits (CoB) risk

   CoB risk is real and can be significant, even if a pharmaceutical savings program exists.

   The industry response to Alberta’s Biosimilar Initiative has the potential to significantly impact your clients’ drug plan costs. Some insurers may follow the province’s lead and delist these originator biologics. Others may cut back coverage to the cost of the biosimilars or maintain coverage of the originators. These differences could expose a plan that doesn’t delist the originator biologics to significant coordination of benefits risk. Here’s how:

   Let’s assume there are two private drug plans – Plan A and Plan B. Both plans are open plans with no deductible. Plan A has 80% co-insurance and Plan B has 100% co-insurance.

   BEFORE Alberta’s Biosimilar Initiative

   Before Alberta’s Biosimilar Initiative, both plans cover the originator biologics listed above.

   Plan A is the first private payer for an Alberta plan member taking an originator biologic drug for Rheumatoid Arthritis. Plan B is the second private payer. The cost of the originator biologic for the plan member is $30,000 annually. Here’s how the coordination of benefits would look before Alberta’s Biosimilar Initiative.

   

   
   AFTER Alberta’s Biosimilar Initiative

   In response to Alberta’s Biosimilar Initiative, the insurer for Plan A delists the originator biologic and requires plan members to switch to the biosimilar. The insurer for Plan B maintains coverage of the originator biologic. Under this scenario, if the plan member doesn’t switch, Plan B essentially becomes the first payer and sees their annual cost increase by 400% (from $6,000 to $30,000).

   

   
   Even if the insurer for Plan B cuts back coverage to the cost of the biosimilar or adjusts the paid amount because they have a savings program in place with the drug manufacturer, the impact could be significant. For example, if the insurer cuts back coverage to 50% (or $15,000 annually), Plan B would see a 150% annual cost increase (from $6,000 to $15,000):

   

2. [pdf] Daily/Guaranteed Interest Account Application - FHSA
3. EAMG market commentary
    

   March 11, 2022
   
   Since Russia first invaded the Ukraine, there’s been no shortage of headlines and commentaries trying to make sense of the situation. This is a tragedy that from a humanitarian standpoint that can’t be made sense of and our hearts go out to the people of Ukraine and those impacted. From a market standpoint, the common thinking is that geopolitical risks, aka war, historically haven’t been associated with significant corrections in the market. So far, the market reaction has been consistent with the historical experience, with the S&P 500 down only about 1% since the start of the conflict and the S&P/TSX Composite Index up close to 4%, despite the heightened daily volatility.
   
   Given the obvious challenges of predicting how these types of conflicts play out, we look to financial market indicators to give us a better sense of the potential risks in the market. And in this respect, the most obvious indicator is oil. Since the start of the Russian invasion, oil has rallied roughly 18%, which is even more impressive considering it had already rallied 21% from the start of the year to the beginning of the conflict.
   
   While we don’t know what will happen to energy markets over the coming weeks, we do know that oil shocks can result in higher inflation and sometimes lower growth. Inflation was already rising, although strategists generally viewed this as temporary on the expectation that the covid related supply chain disruptions and reopening pressures were the primary causes that would eventually self-correct. But as the Russian-Ukraine conflict intensifies, consensus views are moving towards inflation becoming more structural in nature. There are growing risks this will change consumer behaviour, causing inflation to be longer lasting than initially expected. Much of this has to do with the fact that as the world’s 3rd largest exporter of oil, Russia has taken a material amount of oil production capacity offline, resulting in significantly higher oil and gas prices. This also explains the significant outperformance of energy equities, and the broader S&P/TSX Composite Index vs US counterparts on a YTD basis.
   
   While there are beneficiaries to higher oil prices, the consumer certainly isn’t one of them given gas prices reflect movements in the oil market. So far in 2022 prices paid at the pump have gone up 30%, one of the fastest paces on record. This, in addition to food price increases, will put strain on the consumer as higher bills divert dollars away from discretionary spending and potentially slow economic growth.
   
   The other factor we’re closely watching is the overall health of the European economy, to which Russia supplies about 40% of Europe’s natural gas, 25% of their oil imports and 45% of their coal imports. While the European Commission has indicated plans to cuts their dependence on Russian energy well before 2030, the short-term impacts will be costly as Europe and other global markets see higher energy prices follow. As well, food prices will likely become an issue for the region given the interruption of supply out of the Black Sea which has driven grain and oilseed prices to levels not seen since 2008. Investors to date have priced in significant risk, evidenced by the performance of the Stoxx 50 which is down 17% YTD, one of the worst performing markets across the global universe.
   
   While commodity prices are just one indicator, we are mindful that they could be telling us inflation may be more persistent than previously expected. From a long-term perspective this hasn’t changed our view of the equity market. As a result of potential near term impacts however, we have reduced our exposure to European markets in favour of the Canadian market and as well we have added inflation and risk hedges with sector allocations to energy, consumer staples and utilities, while still maintaining our overall long-term target levels to equities. There is no direct exposure to Russia in any of the three Equitable Life Active Balanced Portfolios which includes Equitable Life Active Balanced Growth Portfolio Select, Equitable Life Active Balanced Portfolio Select and Equitable Life Active Balanced Income Portfolio Select.

   
   Downloadable Copy

   Any statements contained herein that are not based on historical fact are forward-looking statements. Any forward-looking statements represent the portfolio manager’s best judgment as of the present date as to what may occur in the future. However, forward-looking statements are subject to many risks, uncertainties and assumptions, and are based on the portfolio manager’s present opinions and views. For this reason, the actual outcome of the events or results predicted may differ materially from what is expressed. Furthermore, the portfolio manager’s views, opinions or assumptions may subsequently change based on previously unknown information, or for other reasons. Equitable Life of Canada® assumes no obligation to update any forward-looking information contained herein. The reader is cautioned to consider these and other factors carefully and not to place undue reliance on forward-looking statements. Investments may increase or decrease in value and are invested at the risk of the investor. Investment values change frequently, and past performance does not guarantee future results. Professional advice should be sought before an investor embarks on any investment strategy.

4. April 2024 eNews

   In this issue:

   • Competitive – and easy – benefits plans for your small business clients
   • Simplifying benefits enrolment for your clients*
   • NEW time-off tracking tool from HRdownloads*
   • Focus on benefits fraud: Protecting your clients’ plans from abuse*
   *Indicates content that will be shared with your clients who receive these benefits.
    

   Competitive – and easy – benefits plans for your small business clients

   Supporting your small business clients can be a challenge. It’s tough to find a competitively-priced benefits plan with the features they want. Small business owners may also need more of your time – especially if this is their first benefits plan.
    
   That’s why we created Equitable EZBenefits™, a benefits solution designed with the needs of small businesses in mind. With a range of plan design options and valuable embedded services for plan sponsors and plan members, EZBenefits is available for groups with 2 to 25 employees. And to make things simpler for you, we’ve created an Advisor Concierge Service exclusively for EZBenefits. Whether you have a question about submitting a quote request for a new client or an issue with an in-force client, our Concierge Service is your go-to resource for EZBenefits support.  

   Don’t have any EZBenefits clients yet?

   To learn more about EZBenefits, watch our video to learn more or view our brochure.

   Simplifying benefits enrolment for your clients*

   Navigating the benefits enrolment period can be overwhelming – for you, your clients and their employees. It’s difficult to ensure all plan members complete the necessary paperwork before the enrolment deadline. 

   That’s why we offer our secure Online Plan Member Enrolment tool at no extra cost to plan sponsors. The tool simplifies the onboarding process for your clients and their plan members by eliminating the need for paper enrolment forms.
    
   It also makes enrolment faster and easier for your clients by:

   • Reducing errors and rework that can occur due to spelling mistakes or missing information on paper forms; and
   • Sending automatic enrolment reminders to plan members, resulting in fewer late applicants. 
   Our user-friendly interface allows plan members to:
   • Enrol in their benefits plan in just minutes from their computer or mobile device;
   • Easily enter all their enrolment information, including dependent details, banking information for direct deposit of claim payments and details for coordination of benefits; and
   • Designate their beneficiary electronically. 

   Ready to share our Online Plan Enrolment Tool with your clients? Get them started with these helpful resources:

   • Online Plan Member Enrolment Flyer for Plan Administrators
   • Online Plan Member Enrolment Quick Reference Guide for Plan Administrators
   • Quick Reference Guide for Plan Members

   To learn more about how Online Plan Member Enrolment can simplify benefits enrolment for your clients, contact your Group Account Executive or myFlex Account Executive.

   NEW time-off tracking tool from HRdownloads*

   Through our partnership with HRdownloads®, EZBenefits clients now have complimentary access to Timetastic —a time-off tracking tool that can make it easier to manage employee vacation time, sick days and more.
    
   Timetastic integrates seamlessly with HRdownloads and includes a mobile app to help manage time-off requests from any mobile device.
    
   To see Timetastic in action, check out this demo.
    
   EZBenefits also includes other helpful resources and tools from HRdownloads that can make daily human resources tasks easier, including:
   • A robust, award-winning HR management platform (HRIS);
   • HR documents, templates, compliance resources and articles; and
   • A live HR advice helpline. 
   All of our other Equitable group benefits clients can get a 10% discount on HRdownloads services. Visit the link below or contact your Account Executive for more information.
   
   Learn more about accessing HRdownloads.

   Focus on benefits fraud: protecting your clients’ plans from abuse*

   According to the Canadian Life and Health Insurance Association (CLHIA), benefits fraud costs insurers and plan sponsors millions of dollars each year, which can lead to increased premium costs.
    

   Resources for your clients

   Both plan administrators and plan members play a role in preventing benefits abuse. So, we’ve compiled some resources you can share with your clients to help them understand what benefits fraud is and how to prevent it:
   • CLHIA’s free 15-minute Protect Your Benefits online course for plan administrators and their members
   • CLHIA’s Fraud is Fraud program, including their FAQs on benefits fraud
   • Our online guide to benefits abuse
   • Tips for plan administrators and plan members to protect their plan 
   Encourage your clients to educate their plan members about the potential consequences of benefits fraud, including losing their benefits, losing their job and even jail time. 

   How we’re fighting benefits fraud

   Our Investigative Claims Unit (ICU) works to detect and eliminate benefits fraud. We use a variety of investigative techniques, including CLHIA-led industry tools to detect and eliminate benefits fraud: 
   • Joint Provider Fraud Investigation Program: A robust program that allows insurers to collaborate on fraud investigations that affect multiple insurers;
   • Data Pooling Program: An initiative that pools data between insurers and uses advanced artificial intelligence to further identify and reduce benefits fraud; and
   • Provider Alert Registry: A registry that allows insurers to view the results of other insurers’ anti-fraud investigations into specific practitioners. 
   To learn more about benefits fraud and Equitable’s commitment to protecting our benefits plans, please contact your Group Account Executive or myFlex Account Executive.
5. [pdf] Pivotal Select Application - FHSA
6. About
7. How to talk to clients about CI when they don’t want to
   Does this sound familiar? 
   
   You’re having a chat with your client about Critical Illness insurance. They suddenly interject: “Critical illness insurance isn’t for me.”
   
   “Why is that?” you ask. 
   
   “Because….
   -  Critical Illness insurance is expensive!
   -  I don’t understand what it covers exactly.
   -  I have money to cover me if I get sick, so I don’t need this.
   -  I’m healthy enough.
   -  It’s not life insurance, so I don’t need it right now. 
   -  I already have disability coverage through my work.”
   
   If you’ve heard any of these responses, and didn’t know how to respond, we can help. 
   
   
   Our Path to Success program covers all these objections and more with simple-to-follow PDFs and videos. You’ll learn conversation strategies and tips on how to navigate the sale. Most importantly, you’ll know exactly what to say the next time a client objects to Critical Illness insurance. 
   
   Want to learn more? Check out our CI Path to Success modules here!
   
   Need CE credits? Take our Path to Success program here. 
8. Life Insurance Replacement Disclosure Forms (LIRD)
9. [pdf] myFlex - How it works, what to consider