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  1. January 2023 eNews

    Responding to Saskatchewan’s biosimilar switch initiative*

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

    Saskatchewan’s provincial biosimilar initiative
    Announced in October 2022, the Saskatchewan Biosimilars Initiative ends coverage of ten biologic drugs beginning on April 30, 2023.

    Patients in the province who are using these drugs will be required to switch to biosimilar versions of these drugs by April 30, 2023, in order to maintain their Saskatchewan Drug Plan coverage.
     
    Equitable Life’s response
    To ensure this provincial change doesn’t result in your clients’ plans paying additional and avoidable drug costs, we are changing coverage in Saskatchewan for most biologic drugs included in the provincial initiative.

    Beginning April 30, 2023, plan members in the province 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 February 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. 

    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 Saskatchewan includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
     

    Ontario announces 2023 biosimilar switch program*

    The government of Ontario recently announced the launch of a biosimilar initiative to switch patients from eight originator biologic drugs to biosimilar versions of the drugs.

    Patients in Ontario using affected originator biologic drugs will have until December 29, 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans.

    We are actively monitoring and investigating the impact of this new policy on private drug plans in Ontario. We plan to implement changes to coverage of biologic drugs in the province in 2023 to help prevent this change from resulting in additional costs for our clients’ drug plans. We will provide more details in the coming months.

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

    Dental fee guide updates*

    Each year, Provincial and Territorial Dental Associations publish fee guides. 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.*** 

    Dental fee guide increases over 2022***



    ***Data for all provinces and territories was not available at the time of publication. This chart will be updated on EquitableHealth.ca as more information becomes available.
     

    Equitable Life ranks high with Canadian group advisors*

    Equitable Life ranked second nationally and first in Ontario among major insurers in a recent survey of Canadian group benefits advisors.
     
    NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 130 leading group consultants, brokers and third-party administrators across the country between May and August 2022 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 Life ranked either first or second in four of the six main categories:

    Advisors in Ontario, in particular, scored Equitable Life very favourably. We ranked #1 overall in the province, finishing first in four of the six overall categories, including: Relationship Management, Operational Management, Underwriting and Claims Management and Technology.
     
    “The fact that advisors regard us so highly in so many categories is a testament to our mutual status and our ability to focus exclusively on our clients and advisors,” said Marc Avaria, Senior Vice President of Group. “We are truly working together to build strong, enduring and aligned partnerships.”
     
    “While we are happy with these results, we won’t rest on our laurels,” added Avaria. “We will continue to dedicate ourselves to providing our clients and advisors with a better benefits experience.”

    Here are more of the highlights from this year’s results:
     
    Nationally, we ranked first in all 10 subcategories in Operational Management, including:
    • Overall service to intermediaries,
    • Overall service to plan sponsors,
    • New quote process,
    • Plan implementation,
    • Renewal process,
    • Information shared at renewal,
    • Accuracy and timeliness of reporting and billing,
    • Administration quality and responsiveness,
    • Taking ownership and
    • Management information quality and availability.
    We also ranked first in Relationship Management, getting top marks in 7 of 10 subcategories, including:
    • Company relationship management,
    • Ease of doing business,
    • Account executive capability,
    • Market knowledge,
    • Visit/call quality,
    • Effective coordination and
    • Advice.
    We ranked second in Underwriting and Claims Management, finishing in the top three for all subcategories, including:
    • Fairness and timeliness of disability claims (1st)
    • Fairness and timeliness of health claims (2nd)
    • Fraud management (2nd)
    • Competitiveness of pooling charges (2nd)
    • Group underwriting flexibility (3rd)
    • Health and dental TLR competitiveness (3rd)
    And we ranked second in Technology, finishing in the top three for:
    • Overall technology – Intermediary (2nd)
    • Member experience (2nd)
    * Indicates content that will be shared with your clients.
     
  2. There is still time for your clients to contribute to their Tax-Free Savings Account


    If you have clients that have not contributed to their Tax-Free Savings Account (TFSA) this year, great news… there is still time!

    You know that an Equitable Life® TFSA is a great way to save. Each year residents of Canada who are at least 18 years of age are eligible to invest up to $6,000* into their TFSA, in addition to any previously unused contribution room. Deposits made into a TFSA are made with after-tax dollars. This means that withdrawals can be made at any time on a tax-free basis.

    Interested in increasing an existing Pre-Authorized Debit (PAD) TFSA deposit?
    Clients with an existing PAD (or who had one in the previous six months), can go online to make any adjustments to a scheduled deposit to their TFSA. Clients can simply login to Equitable Life’s Client Access®. Client Access is Equitable’s secure online client site that connects clients to tools and policy information.
     
    Consider a one-time deposit or set up a PAD?
    To get started with one-time deposit, clients simply log in to their online bank account and select the option to add a new bill/payee and search for Equitable Life Savings Plan. The Equitable Life savings plan policy number will serve as the account number.

    Clients that complete their deposits using online banking do not have to worry about mailing a cheque or missing the deadline. Deposits are applied based on the investment direction on file.

    If you have clients that would like to set up a PAD, simply complete Form #378. For details on how to submit forms during COVID-19, refer to the NEW APPLICATIONS & TRANSACTION AUTHORIZATION REQUIREMENTS webpage.
     
    If you have any questions, please reach out to your local Regional Investment Sales Manager or Advisor Services at 1.866.884.7427 Monday to Friday, 8:30 a.m. to 7:30 p.m. ET or email savingsretirement@equitable.ca.
     

    *The annual TFSA limit is set by Canada Revenue Agency (CRA) and is currently $6,000. Your notice of assessment will tell you if you have unused contribution room from previous years. Contributions over the maximum will be charged a monthly penalty of 1% by CRA.
     
    ® denotes a trademark of The Equitable Life Insurance Company of Canada
  3. This year’s RSP contribution deadline is March 1, 2022

     

    Does your client want to contribute or open a new policy this Retirement Savings Plan (RSP) season?  Whether using paper or our recent EZtransact online platform, here are some important things to remember.
     

    Issuing New Policy with EZcomplete®

    • All online applications must be digitally signed and submitted and have a date stamp no later than March 1, 2022.


    Issuing New Policy using Paper Application

    • For contributions to qualify for the first 60 days, all paperwork must be completed and signed by March 1, 2022. Equitable Life must receive all paperwork by March 7, 2022.



     

    Deposits to Existing Policy

    • Advisors can setup a one-time or recurring deposit or edit an existing pre-authorized debit already in place using EZtransact. Online deposits must be made and have a date stamp by March 1, 2022, to qualify for a 2021 tax receipt. New to EZtransact? Try our EZtransact Practice Site to see how EZ it is to use.
    • Clients can make online deposits to Equitable Life® through their financial institution’s online banking service. Online deposits must be made and have a date stamp by March 1, 2022, to qualify for a 2021 tax receipt. 
    • Clients can also make a new deposit to an existing policy by cheque. The cheque must be dated and signed by March 1, 2022. Equitable Life must receive the cheque no later than March 7, 2022.
    If online banking is being used to fund the policy – either topping up an existing policy or opening a new policy – the online banking transaction must be completed by March 1, 2022, to receive a 2021 tax receipt.

    Do not miss your opportunity to have your contributions count for 2021!

    Please note that cheques and other paperwork cannot be backdated.  They must be completed and signed by March 1, 2022, to qualify for a 2021 tax receipt.
     
     
    ® denotes a trademark of The Equitable Life Insurance Company of Canada.
  4. Banking Changes
  5. Equitable Life Group Benefits Bulletin – February 2022 In this issue: *Indicates content that will be shared with your clients

    Update: Alberta biosimilar coverage changes*
    Four originator biologics added to Alberta Biosimilar Initiative

    In 2022, Alberta’s provincial drug plan is adding four originator biologics to its Biosimilar Initiative. It has ended or will end provincial coverage of these drugs for some or all conditions, as follows:
    • Lovenox: Jan. 10, 2022
    • Humalog: Feb. 1, 2022
    • NovoRapid: April 1, 2022
    • Humira: May 1, 2022

    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.

    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 these originator biologic drugs for plan members in Alberta.

    Effective May 1, 2022, claimants currently taking these drugs will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable Life plan.

    This is a continuation of the Alberta biosimilar switch program we launched last March, when the province first introduced its Biosimilar Initiative.

    Do my clients need to take any action?
    No action is required by plan sponsors. Plan members taking these targeted originator biologics will be contacted directly to allow them ample time to transition to a biosimilar. Any cost savings associated with the change will be factored in at renewal.

    Groups that opted out of the biologic coverage changes we made last March will automatically be opted out of these coverage changes, as well as any future changes to our Alberta biosimilar switch program. This means that their drug plans will continue to provide coverage to existing claimants for any originator biologics we stop covering as part of our biosimilar program.

    Advisors with clients who wish to opt out of our Alberta biosimilar program, or who previously opted out and want to opt back in, should speak to their Group Account Executive or myFlex Sales Manager.

    Communication to plan members
    We will be communicating these coverage changes with affected claimants in early March to allow them ample time to change their prescriptions and avoid any interruptions in their treatment or their coverage. Thus far, the transition to biosimilars, has been smooth and continues to be successful.

    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 also biologics. 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.

    Preferred Biosimilar Program*

    As part of our ongoing efforts to help ensure the sustainability of your clients’ drug plans, we continue to engage in strategic partnerships with pharmaceutical manufacturers. 

    We are pleased to announce a partnership to make Hyrimoz our preferred biosimilar for Humira. This partnership will generate additional savings for plan sponsors.

    Plan members will still have the choice to use Humira biosimilars other than Hyrimoz. However, in the absence of alternative sources of reimbursement, this may increase their out-of-pocket amount.

    The Preferred Biosimilar Program will take effect March 1, 2022 for all new claimants across Canada who start using a Humira biosimilar. It will take effect May 1 for existing claimants in Alberta who switch to a Humira biosimilar, to align with changes to the provincial plan.

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

    Responding to Quebec’s biosimilar policy

    Last year, the Quebec government announced it is phasing out coverage of biologic drugs. Beginning April 13, 2022, patients in Quebec using originator biologics will be required to switch to the corresponding biosimilar covered on the province’s public plan in order to maintain coverage.

    The following populations are excepted from this new policy:
    • Pregnant women, who should be transitioned to biosimilars in the 12 months after childbirth.
    • Pediatric patients, who should be transitioned to biosimilars in the 12 months after their 18th birthdays.
    • Patients who have experienced two or more therapeutic failures while being treated with a biologic drug for the same chronic disease.
    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.

    We are actively investigating the impact of this new policy on private drug plans in Quebec. We plan to implement further enhancements to our biosimilar programs in Quebec later this year to help prevent this change from resulting in additional costs for our clients’ drug plans. We will provide more details in the coming months.

    Dental fee guide updates

    Each year, Provincial and Territorial Dental Associations publish fee guides. 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 2022.*

    Dental fee guide increases over 2021*
    Province/Territory Average Fee Increase
    Alberta 3.9%
    British Columbia 7.35%
    Manitoba 5.79%
    New Brunswick 5.9%
    Newfoundland and Labrador 5%
    Nova Scotia 7.05%
    Northwest Territories 3%
    Nunavut 3.1%
    Ontario 4.75%
    Prince Edward Island 4.75%
    Quebec 5%
    Saskatchewan 5.99%
    *Data for all provinces and territories was not available at the time of publication. This chart will be updated on EquitableHealth.ca as more information becomes available.
     

    Reminder: Review manual allocations for HCSAs and/or TSAs*

    If your client’s Health Care Spending Account (HCSA) and/or Taxable Spending Account (TSA) has manual allocations, they need to allocate these amounts to plan members each year. Please review all your plan members’ profiles on EquitableHealth.ca to ensure they have received their allocation(s) for the current benefit year.
     
    If your clients have Plan Administrator update access on EquitableHealth.ca, they can update these amounts online by doing the following:
    • Select “View certificate”
    • Select “Health Care Spending Account” or “Taxable Spending Account”
    • Select “Update Allocation” in Task Center
    • Enter amount in “Revised Allocation Amount”
    • Override Reason – “Plan Administrator Request”
    • Select “Save”
    If your clients have Plan Administrator reporting access on EquitableHealth.ca, they can determine which plan members have a zero allocation by running the “HCSA Totals by Plan Member” report online by doing the following:
    • Select “Reports”
    • Select “New”
    • Select “Next”
    • Select “HCSA” or “TSA Totals by Plan Member”
    • Select “Next”
    • Enter end date of “12/31/2020”
    • Select “Next”
    • Select “Finish”
    • View “Report”
    To provide us with the amounts to be updated, please have your client contact our Group Benefits Administration Team at GroupBenefitsAdmin@equitable.ca.

    Mental health resources for plan members*

    As the COVID-19 pandemic continues to evolve, many Canadians are experiencing increased levels of stress, anxiety, and depression. Through our partnership with Homewood Health®, all of our clients and their plan members have access to a number of health and wellness resources designed to provide guidance and support. These resources include a number of webinars which discuss various COVID-19 and mental health-related topics. The webinars are pre-recorded so plan members can stream them at their convenience.
     
    Understanding the Impact of COVID-19 on Your Mental Health
    English webinar
    French webinar
     
    COVID-19: Loneliness & Isolation Fatigue - Self-Care Strategies 
    English webinar
    French webinar
     
    COVID-19: Dealing with Seasonal Affective Disorder
    English webinar
    French webinar
     
    Reducing Anxiety & Managing the Transition Back to the Classroom - for Teachers
    English webinar
    French webinar
     
    COVID-19: Specialized Mental Health Support for Health Care Professionals
    English webinar
    French webinar
     
    COVID-19: Supporting Children’s Mental Health
    English webinar
    French webinar
     
    Additional resources, including articles, tools, videos and podcasts, are available at Homeweb.ca/Equitable. Please encourage your clients to share these resources with their plan members.
     
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