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Path to Success Module 3
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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 26^th)
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.

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.
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.

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):

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.
Ways to reduce net income after age 71 with Equitable Life
Your client is contacting you to ask how to reduce net income after age 71. While each client’s situation is unique, here are a few options to consider.
1. Clients with a spouse under the age of 71 can contribute to a spousal Retirement Savings Plan (RSP) up until December 31^st of the year the spouse turns 71; provided contribution room is available. This option can also work for those clients over the age of 71 with employment income. This can be useful for small business owners who are still making money over the age of 71 and forced to convert their RSP to a Retirement Income Fund (RIF) or Life Income Fund (LIF).
1. For clients with a RIF or LIF, they can strategically elect to use their spouses’ age to calculate the minimum RIF income payment (minimum and maximum for LIF). The idea being that if there is an age gap between spouses:
- Your client makes a RIF/LIF minimum payment lower by using the age of the younger spouse. This is beneficial to clients who do not need a lot of income from their RIF/LIF.
- Your client makes a LIF maximum payment higher by using the age of the older spouse. This is beneficial to clients who want to withdraw as much as possible from their LIFs each year.
To learn more, contact your Regional Investment Sales Manager.

® and ^TM denote trademarks of The Equitable Life Insurance Company of Canada

Changes to Short Term Disability Benefit Calculations The Canada Employment Insurance Commission and Canada Revenue Agency have announced the 2022 changes to Maximum Insurable Earnings, and premiums for employment insurance. These changes take effect January 1, 2022.

	2021 Amount	As of Jan. 1, 2022
Maximum Insurable Earnings (MIE)	$56,300	$60,300
Maximum Weekly Insurable Earnings (MWIE)	$1,083	$1,160
EI Benefit (55% of the MWIE, rounded to the nearest dollar)	$595	$638

How does this affect your clients?

If your client’s Group Policy with Equitable Life includes a Short Term Disability (STD) benefit which is tied to the EI Maximum Weekly Insurable Earnings, and at least one classification of employees has less than a $638 maximum, then to comply with the provisions of their policy, their STD benefit will be revised with the maximums updated based on the percentage of EI Maximum Weekly Insurable Earnings shown in their policy.

The additional premium for any increase from their previous STD amounts and new STD amounts will be show on their January 2021 Group Insurance Billing (as applicable).

If their STD maximum is currently higher than $638 or based on a flat amount (not based on a percentage or regular earnings), no change will be made to their plan unless otherwise directed.

If your clients wish to provide direction regarding revising their STD maximum, or have questions about the process, they can email Kari Gough, Manager, Group Quotes and Issue.