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1. Dialogue Virtual Healthcare now available to add to Equitable Life benefits plans

   We’re pleased to announce we are partnering with Dialogue, Canada’s leading virtual health provider, to offer unlimited and on-demand virtual access to primary healthcare practitioners.   Virtual Healthcare is the latest addition to our HealthConnector suite of health and wellness services. It is available to add to all Equitable Life benefits plans for an additional cost as of July 1, 2023. Features of Dialogue Virtual Healthcare Available 24/7, 365 days a year, Dialogue Virtual Healthcare provides access to unlimited non-urgent medical care for a wide range of health concerns. Plan members get fast access to the largest, most experienced and bilingual medical team in Canada for non-urgent medical issues. They also benefit from in-app prescription renewals and refills, personalized follow-ups after every consultation, and concierge-level navigation support for all referrals to in-person specialists when needed. Dialogue’s industry-leading platform provides an all-in-one patient journey to address health issues, reducing long wait times and time away for doctor appointments. Plan members and their families can access Dialogue Virtual Healthcare through the secure web portal or mobile app. The Dialogue medical team includes doctors, nurse practitioners and nurses. Plan members can use the service even if they’re already receiving care from a family doctor. Benefits of Virtual Healthcare For your clients By providing access to Virtual Healthcare, plan sponsors can help to: Drive employee engagement; Reduce absenteeism related to in-person medical appointments; Manage chronic health issues; Attract and retain top talent; and Build a healthier workforce. For their plan members By providing easier access to primary healthcare practitioners, Virtual Healthcare can offer extra health and wellness support for plan members. It also supports members that may experience barriers to accessing in-person healthcare, such as: Living in a remote location; Work or family obligations during standard medical clinic hours; Mobility challenges related to a disability; and Transportation challenges. Learn more about bringing Dialogue Virtual Healthcare to your clients Click the link to learn more about Dialogue Virtual Healthcare : Welcome to Dialogue! Questions? To learn more about how your clients can add Virtual Healthcare to their benefits plan, please contact your Group Account Executive or myFlex Sales Manager.

2. Responding to Ontario’s biosimilar switch initiative

   We are changing coverage for some biologic drugs in Ontario 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 government policy while providing access to equally safe and effective lower-cost biosimilars.

   Ontario’s provincial biosimilar initiative
   Announced in December 2022, Ontario’s biosimilar switch program ends coverage of eight biologic drugs for Ontario residents covered by the Ontario Drug Benefit (ODB). The transition to biosimilar versions of these drugs began on March 31, 2023. ODB recipients using these drugs will be required to switch to biosimilar versions of these drugs by December 29, 2023, to maintain their provincial coverage

   Equitable Life’s response
   To ensure this provincial change doesn’t result in your clients paying additional and avoidable drug costs, we are changing coverage in Ontario for most biologic drugs included in the provincial initiative.
   
   Beginning October 1, 2023, plan members in Ontario 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 August 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. 

   Will this change impact my clients’ rates?
   Any cost savings associated with the change will be factored in 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 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 Ontario includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
3. 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.

   
   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.
    

   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. 
4. Digital tools for your clients and their plan members

   In this issue:

   • Digital tools for your clients and their plan members*
   • QDIPC updates terms and conditions for 2024*
   *Indicates content that will be shared with your clients.
    

   Digital tools for your clients and their plan members*

   Do your clients know how to use all the available digital tools in their Equitable® benefits plans? With useful features for both plan administrators and their members, it’s even easier for your clients to access their plans online. 

   Tools for plan administrators

   • Our online plan member enrolment tool lets groups and administrators add new plan members online without completing paper forms
   • The EquitableHealth.ca plan administrator portal makes it easy for plan administrators to manage their plan anytime and anywhere. Helpful features include:
     • A premium calculator to calculate monthly costs for plan members
     • A simple process for updating plan member information
   • Digital welcome kits provide personalized information directly to plan members through email
   • Easy, automated payment options help plan administrators avoid missed payments by offering pre-authorized debit or electronic funds transfer

   Tools for plan members

   • Our plan member portal at EquitableHealth.ca provides secure, 24/7 access to claims history and coverage details. It also lets members submit claims, and includes health and wellness resources
   • Electronic notifications and claims payments give plan members claim updates via email and deposit payments directly into their bank account
   • The Equitable EZClaim® mobile app lets plan members submit claims quickly and securely on-the-go from their mobile device
   • Digital benefits cards give plan members the convenience to access their benefits cards easily from a mobile device

   Help with digital benefits tools

   We’ve created a brochure and video guide to help plan members use digital tools for a smoother, more convenient benefits experience. 
   
   Plan members can contact us at 1.800.265.4556 and select the option for Web Support if they need further assistance.
    

   QDIPC updates terms and conditions for 2024*

   Every year, the Quebec Drug Insurance Pooling Corporation (QDIPC) reviews the terms and conditions for the high-cost pooling system in the province.
   
   Based on its latest review, QDIPC is revising its pooling levels and fees for 2024 to reflect trends in the volume of claims submitted to the pool, particularly catastrophic claims. These updates take effect January 1, 2024. You can view the updates here.
   
   We will apply the new pooling levels and fees to future renewal calculations that involve Quebec plan members.
   
   If you have any questions, please contact your Group Account Executive or myFlex Account Executive.
   
    
5. [pdf] DSC/Transfer Fee Recovery Program – FAQ
6. Policy Loan
7. Additions and Increases
8. [pdf] Non-Face to Face Meetings ID Verification
9. Gathering paperwork for a new application
10. Step Up Your Wealth Qualification Requirements