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1. [pdf] Equitable’s Legacy Products: Pivotal Select
2. Equitable Life Group Benefits Bulletin - November 2022

   The importance of timely plan member eligibility updates*

   Effective Dec. 1, 2022, we are implementing a revised process for managing plan member and dependent health and dental claims that have been incurred and paid after coverage has been terminated. This new process is consistent with industry practices.
    
   If health or dental claims have been incurred and paid after a plan member’s termination date but before we received notice of the termination, we will align the plan member’s or dependent’s termination date with the service date of the last paid claim, retaining premiums up until that date.
    
   If no claims have been incurred and paid after the termination date, Equitable Life will process the termination as requested and refund any excess premium, subject to a maximum premium refund credit of three months.
    
   Currently, we process the termination as requested and attempt to recover any claim overpayments directly from the plan member. We then refund any excess premiums that have been paid, subject to the maximum refund credit amount.
    
   To avoid claims being incurred and paid after a plan member’s termination date, it is important for your clients to update plan member and dependent eligibility dates on or before the effective date of the change.
    
   If you have any questions about the process your clients should follow for updating plan member eligibility, please contact your Group Account Executive or myFlex Sales Manager.

   QuickAssess®: Absence and accommodation request review services*

   It can be difficult to navigate chronic or complex cases of absenteeism or accommodation requests. That’s where QuickAssess® can help.
    
   QuickAssess is an optional, fee-per-use service that can provide your clients with an unbiased, timely assessment of complex plan member absences and workplace accommodation requests. Our disability experts can provide recommendations to help your clients manage:
   • Workplace absences
   • Chronic or patterned absenteeism
   • Requests to modify workplaces or duties
   • Return-to-work coordination
   • Employee Insurance sick leaves
   Based on a thorough review of information provided by the plan sponsor, the plan member, and their physician, our QuickAssess specialists provide a recommendation within two business days on how to manage the absence or accommodation request.** Your clients can then decide how to manage the plan member request and communicate their decision accordingly.
    
   For more information on using QuickAssess, including eligibility requirements, please contact your Group Account Executive or myFlex Sales Manager.
   
   **Within two business days of receiving a completed QuickAssess Absence and Accommodation Review Referral Form and all required information. For more complex referrals, more time will be required.

   Finding a health care provider with TELUS eClaims direct billing*

   By visiting TELUS’s Find a Provider page, your clients’ plan members can now easily search for paramedical and vision providers who are registered on the TELUS Health eClaims network and who can submit claims directly to us on behalf of their patients. Searches can be filtered by postal code to help plan members find the most convenient provider options.
   
   As our direct billing provider for pharmacy, vision and paramedical claims, TELUS Health has an extensive network of 70,000 health care providers that provide direct billing to streamline the claims process.
   
   Please note, plan members should always check Equitable Life’s list of de-listed providers before selecting a health care provider. The list is available for your clients and their plan members on EquitableHealth.ca, and is updated regularly.
   
   For more information about TELUS eClaims, please contact your Group Account Executive or myFlex Sales Manager.

   First phase of the Canada Dental Benefit proposed for Dec. 1, 2022*

   The federal government’s new Canada Dental Benefit is proposed to take effect on Dec. 1, 2022, subject to Parliamentary approval. The program will cover eligible expenses retroactive to Oct. 1, 2022, and this first phase would apply to Canadians under 12 years of age.
   
   If implemented, the Canada Dental Benefit will provide dental care to Canadian families with under $90,000 adjusted net income annually. By 2025, the federal government expects to extend the benefit to children under 18, senior citizens and Canadians with disabilities.
   
   Parents or guardians will be required to apply for this coverage through the Canada Revenue Agency (CRA) and must not have private dental coverage for the child(ren).
   
   This new program will have no impact on your clients’ dental coverage and no action is required on their part.
   
   * Indicates content that will be shared with your clients.
    
3. April 2023 eNews

   Vision care discounts from Bailey Nelson for Equitable Life plan members*

   We are pleased to announce we are partnering with Bailey Nelson to provide Equitable Life plan members with discounts on prescription and non-prescription eyewear. Bailey Nelson is a leading provider of prescription glasses, contact lenses and sunglasses with locations across Canada, as well as an online store.
    
   All Equitable Life plan members will have access to the following discounts from Bailey Nelson:
   
   
   *Includes anti-reflection and anti-scratch treatment. Glasses offers are based on 2 pairs of single vision or 1 pair of premium progressive lenses. Lens add-ons, such as high-index lenses and prescription tinted lens tints may involve additional costs.
   
   **Non-prescription glasses only. Cannot be combined with 2 for $200 discount.
    
   Plan members can provide their Equitable Life discount code in-store or at online checkout. Your clients may wish to distribute this convenient flyer with an overview of the available discounts to their plan members.
    
   Plan members can bring their prescription to a Bailey Nelson location or provide it online to order glasses and contact lenses. Bailey Nelson also provides eye exams in-store for $99.
    
   If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
    

   Equitable Life helps tackle benefits fraud through Joint Provider Fraud Investigation (JPFI) initiative*

   Protecting your clients’ plans is important to us. That’s why Equitable Life is working with other Canadian life and health insurers to conduct joint investigations into health service providers that are suspected of fraudulent activities through the Canadian Life and Health Insurance Association’s (CLHIA’s) Joint Provider Fraud Investigation (JPFI) initiative. This collaborative initiative between major Canadian life and health insurers through the CLHIA is a major step toward reducing benefits fraud in the life and health benefits insurance industry. 

   How the JPFI works

   The JPFI builds on the 2022 launch of a CLHIA-supported industry program. The program uses advanced artificial intelligence to help identify fraudulent activity across an industry pool of anonymized claims data. Joint investigations will examine suspicious patterns across this data.
    
   Through this project, Equitable Life can initiate a request to begin a joint fraud investigation when we: 
   • See suspected provider fraud in our own data or the pooled data, or
   • Receive a substantiated tip about potential provider fraud 
   Other life and health insurers that have joined the JPFI will then have the option to join the investigation if they are also impacted by the provider under investigation. By sharing expertise and resources across insurers, the participating carriers will be able to determine the most appropriate next steps. 

   How Equitable Life protects your clients’ benefits plans from fraud

   Benefits fraud is a crime that affects insurers, employers and employees and puts the sustainability of workplace benefits at risk. CLHIA estimates that employers and insurers lose millions each year to benefits fraud and abuse.
   
   Our Investigative Claims Unit (ICU) consists of security and fraud experts who use data analytics and artificial intelligence to proactively identify and investigate suspicious billing patterns or claims activity to open investigations. We de-list healthcare providers who are engaged in questionable or fraudulent practices, pursue the recovery of improperly obtained funds, and report practitioners to regulatory bodies and law enforcement where appropriate.
   
   Learn more about benefits fraud, or contact your Group Account Executive or myFlex Sales Manager for more information.

   Second phase of TELUS eClaims transition*

   In June 2022, we switched to TELUS Health eClaims as our digital billing provider to give our plan members a faster and more convenient option for submitting paramedical and vision claims. The switch has allowed our plan members to take advantage of TELUS’s extensive network of over 70,000 paramedical and vision providers.
    
   We’ve now begun the second phase of our TELUS Health eClaims implementation. This phase will focus on improving the experience for paramedical and vision providers. We will begin issuing reconciliation statements for the claims they submit on behalf of their patients. These statements will make it easier for them to use the TELUS Health eClaims portal and provide incentive for even more providers to sign up.
    
   Please encourage your clients to remind their plan members about this convenient option. We have created a helpful one-pager that plan members can bring with them next time they have an appointment with their healthcare provider. 
    
   If you have any questions about TELUS Health eClaims, please contact your Group Account Executive or myFlex Sales Manager.
    

   Changes to STD application process for COVID-19 cases*

   As the COVID-19 situation evolves, we continue to adjust our disability management practices to ensure ongoing support and a fair experience for all our plan members.
    
   As of May 1, 2023, we will begin managing COVID-19-related short-term disability (STD) claims the same way that we manage disability claims for any other illness or condition. If a plan member is unable to work due to COVID-19 symptoms or a positive COVID-19 test, they must now use the standard STD application, including the Attending Physician Statement portion.
    
   Once we receive the claim, we will adjudicate it according to our standard process.
    
   If you have any questions, please contact your Group Account Executive or myFlex Sales Manager.
   
   * Indicates content that will be shared with your clients.
   
   
    
4. [pdf] Now it’s even easier to grow your savings online!
5. Equitable Life Group Benefits Bulletin - September 2020

   In this issue:

   Enhancements to Equitable EZClaim Mobile
   New reports available on EquitableHealth.ca

   * Indicates content that will be shared with your clients.

   Enhancements to Equitable EZClaim^® Mobile*

   We’ve updated our Equitable EZClaim mobile app to process vision claims faster, to provide a new option for submitting documents and to increase password security.

   Faster vision claims processing and payment

   Equitable Life now provides faster processing of vision claims submitted via EZClaim Mobile.

   This means plan members can find out the status of their vision claim almost instantaneously. And, for approved claims, they will receive payment even sooner – often in as little as 24 hours.

   In order to allow for instant processing and faster payment, plan members will be prompted to enter some additional information, including their practitioner’s name, the date of the expense, the type of expense and amount of the expense when submitting their claims for these services.

   Equitable Life plan members can submit all vision claims via Equitable EZClaim, including coordination of benefits and Health Care Spending Account claims.

   Submit documents from a mobile device

   We have added our Document Submission tool to EZClaim Mobile so plan members can conveniently submit documents directly from their mobile device. Applications, change forms, statement of health forms and more can all be easily uploaded whenever and wherever they are.

   Improved security with stronger passwords

   To help you, your clients and plan members better protect personal information, we have increased the maximum length of passwords for both EZClaim Online and EZClaim Mobile from 12 to 32 characters. This longer character limit makes it easier to create stronger and more secure passwords.

   There is no change for plan members, plan administrators or advisors. All existing passwords will continue to function. However, if you choose to update your password you will now be able to choose longer passwords or passphrases.

   Why should I change my password?

   Changing your password frequently helps keep your information safe. The longer and more random the password, the more secure it is. To improve security even more, a passphrase is recommended.

   A passphrase is a series of words or other text used like a password. Because it is much longer, a passphrase is more secure. Although the words in the phrase may be meaningful to you and easy to remember, they can be random enough that the full phrase is difficult for someone else to guess. It’s even better if you use numbers or other characters in your passphrase.

   Your passphrase should be:

   • Long enough to be hard to guess;
   • Not a famous quotation;
   • Easy to remember and type; and
   • Not used in multiple places.

   To change your password:

   1. Log in to EquitableHealth.ca
   2. Click on My Information > User Profile
   3. Click Edit
   4. Confirm your information and enter your new password
   5. Click Save

   We will be announcing this enhancement to plan members on EquitableHealth.ca.

   New reports available on EquitableHealth.ca*

   Plan administrators and advisors with reporting access can now download three additional reports any time via the plan administrator and advisor websites on EquitableHealth.ca:

   • Premium and Tax – This report provides a breakdown of premiums and taxes paid per plan member for any specific time period for all applicable benefits.
   • Occupation and Earnings – This report provides current plan member earnings and occupation information and gives plan administrators an efficient way to report updates to us.
   • Employee listing – This report lists all plan members’ information, including name, certificate number, date of birth, province, occupation and salary, as well as benefit coverage currently in place and HCSA allocations.

   These reports can be downloaded in Excel format for easy updating, filtering or sorting.

   For more information, please contact your Client Relationship Specialist.

    

   *Indicates content that will be shared with your clients

6. Equitable Life of Canada ends 2020 in a position of financial strength

   Equitable Life of Canada is pleased to report that our strategic approach continued to serve us well in 2020, despite operating in a global pandemic.

   Equitable Life, one of Canada’s largest mutual life insurance companies, closed out 2020 with strong earnings and solid growth.

   The Company reported earnings of $153 million, equating to a return on policyholders’ equity of 16%. This result was driven by strong sales, investment performance, positive impacts from favourable expense ratios and reserve assumption changes.

   “There is no doubt the global pandemic has had, and continues to have, a profound impact on the lives of Canadians and created challenges for all of us in 2020 that we could never have envisioned,” said Ron Beettam, Equitable Life’s President and Chief Executive Officer. “Thanks to the resiliency and commitment of our entire team, we effectively responded to unfavourable impacts caused by the pandemic, including market volatility, and continued to achieve a high growth rate on most key measures, ending 2020 in a position of financial strength.”

   Equitable Life reported premiums and deposits of $1.7 billion in 2020, contributing to $6.0 billion of assets under administration. This growth was supported by very strong sales during the pandemic, as more Canadians turned to insurance to protect the financial security of their families. Dividends to participating policyholders increased by 24% over the prior year.

   The Individual Insurance business reported 2020 sales of $149 million, reflecting the third consecutive year of double-digit sales growth. Savings & Retirement reported sales of $401 million, driven by sales of segregated funds. Group Benefits delivered sales of $46 million, despite competitive industry pricing strategies and the impact the pandemic had on businesses.

   Equitable Life finished the year with an impressive LICAT ratio of 166%, well above the regulatory target and one of the highest in the industry. This capital result demonstrates that we are well-positioned to continue meeting our commitments to our policyholders. In addition, DBRS Limited (DBRS Morningstar) upgraded our Financial Strength rating to A (high) with Stable Trends in September.

   “While we don’t yet know what future impacts the global pandemic could have on our business, we know we can face the future with confidence,” said Beettam. “I am very proud of all that we have accomplished together, especially throughout this unpredictable year, and I know the Company is very well positioned to meet the challenges ahead and will continue building on those achievements by focusing on organic and profitable growth across all lines of business, with a continued emphasis on meeting the needs of our policyholders and distribution partners.”

   2020 Financial Highlights

   • Net income of $153 million, for a return on policyholders' equity of 16%
   • Capital strength, as measured by the LICAT ratio, ended the year at 166%
   • Participating policyholders' equity surpassed $1 billion
   • Premiums and deposits increased by 6.8% to $1.7 billion
   • Sales of $149 million in Individual Insurance, $401 million in Savings and Retirement, and $46 million in Group Benefits
   • Assets under administration grew 17.6% to $6 billion
   • Benefits and payments to policyholders of $820 million
   • Dividends to participating policyholders increased by 24% to $61 million

   About Equitable Life of Canada

   Canadians have turned to Equitable Life since 1920 to protect what matters most. We work with independent advisors across Canada to offer individual insurance, savings & retirement, and group benefits solutions to meet your needs.

   Equitable Life is not your typical financial services company. We have the knowledge, experience and ability to find solutions that work for you. We’re friendly, caring and interested in helping. As a mutual company, we are not driven by shareholder pressures for quarterly results. This allows us to focus on management strategies that foster prudent long-term growth, continuity and stability. We are dedicated to meeting our commitments to customers – now and in the future.

7. Equitable Life Group Benefits Bulletin - April 2021

   In this issue:

   • Alberta biosimilar coverage changes*
   • New Humira biosimilars approved*
   • Saskatchewan and Manitoba delist biologics for some conditions*
     *Indicates content that will be shared with your clients

   Update: Alberta biosimilar coverage changes take effect*

    
   In our November 2020 edition of eNews, we announced we are changing coverage for some biologic drugs in Alberta in response to the province’s Biosimilar Initiative.
    
   As of March 15, 2021, several originator biologic drugs are no longer covered for plan members in Alberta. Plan members taking these biologics are required to switch to the biosimilar versions of these drugs to maintain eligibility under their Equitable Life plan.
    
   Affected drugs and conditions – Remicade remains eligible
   We initially announced that Remicade would be among the biologic drugs no longer covered in Alberta.
   We have since determined a method to maintain ongoing eligibility of Remicade while reducing or eliminating any Coordination of Benefit risk associated with the provincial change. As such, Remicade will continue to be eligible for coverage. 
    
   Communication to plan members and plan sponsors
   We communicated directly 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. The transition to biosimilars, when required, has been smooth and continues to be successful.
    
   Plan sponsors were notified even earlier to allow ample time to opt-out of this change. The vast majority have accepted the changes and are benefiting from a smooth plan member transition. 
    
   Looking ahead
   We are one of the few insurers taking a comprehensive and proactive response to the Alberta Biosimilars Initiative. We will continue to monitor developments related to the coverage of biologics in Alberta and other provinces and will continue to take steps to protect your clients’ drug plans.
    
   Questions?
   If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.
    
    

   New Humira biosimilars approved*

   Beginning in February, Health Canada approved seven new biosimilars for Humira, a biologic drug for the treatment of rheumatoid arthritis, psoriatic arthritis, Crohn's disease and many other conditions. Most of these biosimilars have already been launched and are available in pharmacies.
    
   Humira is one of the highest ranked drugs in terms of total annual cost. All the Humira biosimilars are priced 40% lower than Humira and represent a savings opportunity for private drug plans.
    
   BC Pharmacare has already announced that, effective October 7, 2021, all claimants for most conditions will only be eligible for Humira biosimilars.
    
   We have implemented national controls to ensure the use of Humira biosimilars for new claimants. As with all biosimilar programs at Equitable Life, they will continuously evolve such that our clients are provided appropriate risk protection. 
    
    
    

   Saskatchewan and Manitoba change coverage for some biologics*

   The Saskatchewan government recently announced that, effective March 1, 2021, new patients will no longer be eligible for coverage of Enbrel under its public plan. New patients will only be eligible for biosimilar versions of Enbrel.
    
   Similarly, the Manitoba government announced changes to its tiered biologics program. Currently, claimants are expected to try biosimilars listed under Tier 1 of the program before they can be considered for coverage under the public plan for either Enbrel or Remicade, which are Tier 2 drugs. Effective April 1, 2021, Brenzys, an Enbrel biosimilar, has been added to Tier 1 for some additional medical conditions. As well, Avsola has been added as another Tier 1 biosimilar for Remicade. These changes further expand the Manitoba government’s utilization of biosimilars as preferred therapies over originator 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.
    
   Equitable Life actively monitors and investigates  all biosimilar policy changes and the ongoing evolution of biosimilar drugs entering Canada.  We will keep you informed of any impact on private drug plans and how we are responding.
    
    *Indicates content that will be shared with your clients
    
8. MER + TER = FER: what it means for clients
9. [pdf] Online Plan Member Enrolment Quick Reference Guide
10. 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 (1^st)
    • Fairness and timeliness of health claims (2^nd)
    • Fraud management (2^nd)
    • Competitiveness of pooling charges (2^nd)
    • Group underwriting flexibility (3^rd)
    • Health and dental TLR competitiveness (3^rd)
    And we ranked second in Technology, finishing in the top three for:
    • Overall technology – Intermediary (2^nd)
    • Member experience (2^nd)
    * Indicates content that will be shared with your clients.