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February 2020 Advisor eNews
In this issue:
Provincial biosimilar update
Legislative changes for Alberta’s Coverage for Seniors program
Coming soon: enhancements to Equitable EZClaim® Online
Provincial biosimilar update
Alberta Biosimilar Initiative
On December 12, 2019, the Alberta government introduced the launch of the Alberta Biosimilar Initiative. This program will require patients using several originator biologic drugs to switch to a biosimilar, and patients using a non-biologic complex drug (NBCD) to switch to its subsequent entry version before July 1, 2020 in order to maintain coverage.
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” drug. Biosimilars 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.
Alberta Health will initially cover both the originator and biosimilar or subsequent entry version of a NBCD drug as patients start the switching process.
The following table outlines the affected originator drugs, their biosimilars or subsequent entry, and the conditions affected by the program.
Biosimilar Drug Originator Biosimilar/Subsequent Entry Indications Affected etanercept Enbrel Brenzys Ankylosing Spondylitis
Rheumatoid ArthritisErelzi Ankylosing Spondylitis
Psoriatic Arthritis
Rheumatoid Arthritisinfliximab Remicade Inflectra
RenflexisAnkylosing Spondylitis
Plaque Psoriasis
Psoriatic Arthritis
Rheumatoid Arthritis
Crohn’s Disease
Ulcerative Colitisinsulin glargine Lantus Basaglar Diabetes (Type 1 and 2) Filgrastim Neupogen Grastofil Neutropenia pegfilgrastim Neulasta Lapelga Neutropenia glatiramer* Copaxone Glatect Multiple Sclerosis *Glatiramer is a non-biologic complex drug where the originator is Copaxone and the subsequent entry is Glatect.
Equitable Life is actively investigating the benefit, risk and appropriate plan changes associated with this new policy on private drug plans and will keep you informed.
For more information about the Alberta Biosimilars Initiative, consult the Alberta government website.
British Columbia
In 2019, BC Pharmacare introduced a Biosimilars Policy that impacted coverage of three biologic drugs – Remicade, Enbrel and Lantus. As of November 25, 2019, these drugs were no longer eligible in BC for most conditions for which lower cost biosimilar versions are available. Patients in the province with these conditions were required to switch to biosimilar versions of these drugs in order to maintain their coverage.
The second phase of the BC Biosimilar Policy takes effect March 6, 2020 when Remicade will be delisted for Crohn’s Disease and Ulcerative Colitis. Patients in the province with these conditions will be required to switch to Inflectra or Renflexis in order to maintain their coverage.
Biosimilar Drug Originator Biosimilar Indications Affected infliximab Remicade Inflectra
RenflexisCrohn’s Disease
Ulcerative ColitisWe have communicated with the affected plan members, informing them of the need to switch medications. If plan members have any questions or concerns, our Customer Care team is here to help and support them through the transition.
If you have any questions about this policy, please contact your Group Account Executive or myFlex Sales Manager.
Ontario
In November 2019 Ontario Minister of Health Christine Elliot indicated that the government was planning to launch consultations to explore solutions in managing biologics.
Equitable Life will continue to monitor these developments and keep you informed of any impact on private drug plans.
Legislative changes for Alberta’s Coverage for Seniors program
The government of Alberta has announced that as of March 1, 2020, seniors’ family members (such as spouses and dependents) who are younger than 65 will no longer be covered by the provincial Coverage for Seniors program. Albertans 65 years of age and older will continue to be covered under the provincial plan.
Equitable Life plan members and their dependents will continue to be covered under the parameters of their group benefits plan.
For more information, please see the Alberta Seniors Health Benefits website.
Coming soon: enhancements to Equitable EZClaim® Online
Faster vision claims processing and payment
Equitable Life will soon provide real-time processing of vision claims submitted via EZClaim Online.
This means plan members will be able to 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 instantaneous processing and faster payment, plan members will be prompted to enter some additional information including the 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 EZClaim, including coordination of benefits and Health Care Spending Account claims.
This enhancement will be coming to our EZClaim Mobile app in the coming months.
New printable claims extract
As part of our ongoing efforts to improve customer experience for plan members, we will also offer a claims extract in a printable format within the plan member site. Plan members will be able to select a date range and claimant, then generate and download a detailed list of health and dental claims. This is a helpful way to keep track of claims, especially when reviewing them in preparation for income tax filing.
Once these enhancements are live you will be notified in an eNews, and an announcement will be posted on the plan member section of EquitableHealth.ca.
Elimination of Out-of-Country Travellers Program in Ontario
Effective January 1, 2020, the Ontario government eliminated OHIP coverage for emergency services for Ontarians travelling outside of Canada.
Previously, the Out-of-Country Travelers Program provided some reimbursement for services required to treat conditions that are acute, unexpected, arose outside Canada and require immediate treatment. The program covered between $200 and $400 per day for inpatient services and $50 per day for outpatient and doctor services.
For groups who have out-of-country coverage from Allianz, this change will not impact the cost to your plan members, or the process plan members follow in the event of an emergency while travelling.
Plan members should still call Allianz in the event of an out of country emergency. Allianz will deal with their claim as usual and will now pay for the portion of the claim previously paid by OHIP. Plan members will not have any additional out-of-pocket costs.
We will be sharing this information with plan members as a news item on our plan member website, equitablehealth.ca.
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February 2023 eNews
Responding to Nova Scotia’s biosimilar switch initiative
We are changing coverage for some biologic drugs in Nova Scotia 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.Nova Scotia’s provincial biosimilar initiative
Announced in February 2022, the Nova Scotia Biosimilar Initiative ends coverage of seven biologic drugs for residents enrolled in Pharmacare programs.
Pharmacare patients in the province using these drugs will be required to switch to biosimilar versions of these drugs by February 3, 2023, in order to maintain their Nova Scotia Pharmacare 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 Nova Scotia for most biologic drugs included in the provincial initiative.
Beginning June 1, 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.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 Nova Scotia plan members can submit a policy amendment. Amendments must be submitted no later than April 1, 2023. Advisors with myFlex Benefits clients who wish to maintain coverage of these originator biologics for Nova Scotia plan members should speak to their myFlex Sales Manager to confirm their eligibility to opt out of this change.
Groups that choose to maintain coverage of these originator biologics for existing claimants will also maintain coverage for any originator biologics that we subsequently add to our Nova Scotia biosimilar initiative.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.Communicating this change to plan members
We will inform any affected plan members in April 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 Nova Scotia includes more biologic drugs in its biosimilar initiative, as new biosimilars come onto the market, and as we make changes in drug eligibility.
Changes to New Brunswick drug interchangeability rules
We are introducing changes to help ensure that your clients with voluntary or mandatory generic pricing for their drug plans will benefit more from the cost savings of these two features, regardless of the province where the drugs are dispensed.
Currently, when determining whether a lower-cost alternative is available for a brand-name drug, most insurers only consider drugs that the provincial drug plan identifies as interchangeable.
However, the public drug plan in New Brunswick does not identify a drug as interchangeable if the drug is not listed on its formulary – even if Health Canada has deemed the drug interchangeable.
As a result, plans with mandatory or voluntary generic pricing have continued to reimburse some drugs in New Brunswick based on the cost of the brand-name drug, even if a lower-cost generic alternative is available.
Effective March 20, 2023, if your clients have drug plans with mandatory or voluntary generic pricing, we will adjudicate any drug claims in New Brunswick using the lowest cost alternative that Health Canada approves as bioequivalent. This will occur even if the public drug plan has not identified the drug as interchangeable.
To benefit from this more robust drug plan control, plan sponsors must have mandatory or voluntary generic pricing in place.
For more information about this change or about implementing mandatory or voluntary generic pricing for your clients, please contact your Group Account Executive or myFlex Sales Manager.
New template: plan members eligible for additional coverage
Often, based on salary, some plan members may become eligible to apply for extra Life, Accidental Death & Dismemberment (AD&D), Short Term Disability or Long Term Disability coverage. If this occurs, your clients receive a notification from Group Benefits Administration. We have now developed a template that your clients can provide to applicable plan members if they become eligible for extra coverage. The template makes it simpler for your clients to pass on these details to their plan members efficiently.
The new template is available for download under the Quick Links section of EquitableHealth.ca. It is a fillable PDF form that your clients can complete and provide to their plan members when necessary. The document is called Over the Non-Evidence Limit for Plan Members Notification.
If you have any questions about the template, please contact your Group Account Executive or myFlex Sales Manager. -
Canada Post Labour Strike: What you need to know
No postal service? No worries. Equitable® has electronic options that make doing business with us easy and seamless and will help to prevent delays in the event of a postal strike.
Online tools for advisors through EquiNet® (Login to EquiNet to access):
● Use EZcomplete®to submit your individual wealth, individual life and critical illness insurance applications electronically.
● Use Policy/New Business Inquiry and EZtransact™ to keep your business running. You will continue to receive your online correspondence so that you can keep clients up to date with lapses or premiums due.
● Use EZ Upload to submit scanned applications though a secure online connection. Easily upload applications and related documents, all at the click of a button. EZ Upload saves you time and courier costs and can be used for your life insurance, critical illness and savings and retirement business.
Online tools for clients:
● Equitable Client Access® By setting up an account, clients can access their investment and insurance policy information, statements, letters, and payment details, whenever it’s convenient for them. Encourage them to sign up now!
● Online banking: Clients can make deposits to their Equitable savings policies, or make annual premium payments to their insurance policies through online banking. It’s fast and easy … and there’s no need for you to pick-up or deliver a cheque.
● Direct deposit withdrawals: Requests for cash withdrawals can be sent directly to clients’ bank accounts provided we have their banking information on file.
● Courier service: Contracts will continue to be sent via courier. Policy Disbursement cheques, cancellation letters, decline letters or cheques and other urgent correspondence will be couriered to the servicing MGA office for delivery/pickup. All other non-urgent correspondence will be held at Head Office.
Equitable works for you to make it business as usual!
Date posted: September 26, 2025 - [pdf] Underwriting cover letter template
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Easier group enrolment and more group benefits updates
Make enrolment easier for your clients with online plan member enrolment (OPME)
Enrolling new plan members can be overwhelming – for both you, your clients and their employees. It’s time-consuming to manually load new members and challenging to ensure they complete the necessary paperwork before the enrolment deadline.
Our Online Plan Member Enrolment (OPME) tool is available at no extra cost for all your Equitable Life clients and offers a more secure and efficient alternative to traditional paper enrolment. Using their computer or mobile device, employees can enrol in their benefits plan in just minutes.
The user-friendly tool allows plan members to easily enter all their enrolment information, including:- Dependent details
- Banking information for direct deposit of claim payments
- Details for coordination of benefits
- Beneficiary designation
The days of chasing plan members for their paper enrolment forms are gone. Once plan administrators enter a few employee details, our system automatically sends an email to each plan member, inviting them to enrol in their benefits program. And there will be no need for your clients to send reminders or follow up with employees about their benefits enrolment. It’s all done automatically.Support with using OPME
To learn more about the benefits of using OPME, check out our Online Plan Member Enrolment Flyer. We also encourage you to share more information with your clients: We also have helpful reference guides for plan members, to help them use the tool:- Online Plan Member Enrolment Quick Reference Guide
- myFlex Online Plan Member Enrolment Quick Reference Guide
Help your clients spend less time administering group benefits. Contact your Group Account Executive or myFlex Sales Manager to learn more about our online plan member enrolment.
Coming soon: A survey to help us serve your clients better*
We are committed to providing your clients and their plan members with industry-leading service. We’ve introduced several enhancements over the past year to make it easier to do business with us. And we’re continually looking for ways to improve.
This month, we will conduct a survey of your clients to help us understand how we can better serve them. Plan administrators will receive an email with a link to the survey, which will take between five and 10 minutes to complete.
Please encourage your clients to participate. Their feedback will be confidential, and their responses will help us improve our service and ensure we’re meeting their expectations. We will also allow them to provide their name so that we can follow up with them to address any concerns they’ve identified.
We know your clients’ time is valuable. So, each plan administrator who completes the survey will be entered into a random draw for a chance to win one of 3 prepaid gift cards for $200.
Improved mental assessment features for FeelingBetterNow®*
Mensante has enhanced its FeelingBetterNow® online platform to make it easier for plan members to assess the state of their mental health and talk to their health care provider about treatment options. FeelingBetterNow is part of our Equitable HealthConnector suite of wellness solutions and is available for an additional cost. It can help plan members easily identify if they are at risk for a number of common mental health issues, including depression, anxiety and substance abuse.Upgrades to the platform include:
- New features to help plan members better gauge their progress in the assessment.
- A printable Action Plan that plan members can share with their health care provider to initiate conversations about managing their mental health challenges.
- A new “follow-up” module to help plan members assess the care they’ve received from their health care provider and identify care gaps.
- An Assessment Outcome Page, which allows plan members to view their diagnostic risks across mental health disorders for a more holistic picture of their health.
Over-age dependants losing coverage?*
Your clients’ plan members may have dependants approaching the maximum age for eligibility under their group benefits plan. If so, members should be aware of their options for dependant coverage.Coverage for full-time students and dependants with disabilities
The dependants of your clients’ plan members may be eligible to continue their coverage under the current plan if:- The dependant is attending a post-secondary school full-time; or
- The dependant is disabled.
Coverage2go for over-age dependants
Dependants who aren’t eligible for continued coverage under the plan can apply for Coverage2go®, a month-to-month health and dental plan for individuals losing their group coverage.**
Coverage2go is affordable, reliable and allows the over-age dependants to choose the level of coverage and protection that suits their personal situation. With no medical questions required as long as they apply within 60 days of losing their coverage, your clients’ plan members can ensure that their over-age dependants have the coverage they need.
Plan members can receive a quote within minutes. Please direct your clients to Coverage2go on Equitable.ca to learn more.
**Quebec residents are not eligible for Coverage2go.Forfeiture reports for HCSAs and TSAs on EquitableHealth.ca*
As a reminder, your clients can access forfeiture reports for their Health Care Spending Account (HCSA) and Taxable Spending Account (TSA) usage on EquitableHealth.ca.HCSA summary by plan member
HCSA summary reports provide an overview of each plan member’s account activity and balances. These reports include the total amounts allocated, the amount claimed to date, the net balance, and the amount of funds that will be forfeited based on claims paid to date. Please note that plan members’ claim submissions will remain confidential and will not be viewable by the employer on this summary.
Your clients can provide each plan member with their HCSA summary, if they wish.HCSA account forfeiture by plan member
HCSA forfeiture reports detail the amount that each member will forfeit if they do not use it. The amount is based on claims that have been paid to date within the benefit year period.HCSA account totals by plan member
Your clients may wish to access the HCSA account totals reports, which reflect the information in each plan member’s HCSA summary report. For terminated employees, the Funds Available field will display as zero, regardless of the balance in the account when terminated.
At least three months before the end of the benefits period, your clients should remind their members to use their allocated HCSA and TSA amounts.
If your clients need help accessing these reports, they can reach out to their Regional Office Service team for assistance.
* Indicates content that will be shared with your clients.
- [pdf] Pre-Authorized Debit (PAD)
- [pdf] Cloud DX FAQ
- [pdf] Termination for Internal Replacement
- [pdf] Equitable’s Legacy Products: Pivotal Select
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EAMG Market Commentary July 2023
Posted July 27, 2023
July 17, 2023
Rates & Credit - The rates market was volatile in Q2 as investors focused on inflation, central bank interest rate decisions, and recession probabilities. Persistent strength in U.S. consumer spending and labour markets have surprised investors and prompted further interest rate tightening from central banks. In Canada, corporate bonds outperformed government bonds and the broader FTSE Canada Universe Index during the quarter, with a total return of 0.2%, versus a loss of 1.0% for government bonds and 0.7% for the overall Index. The corporate bond outperformance was driven by a broad risk-on tone to the market, most notably in April as the market recovered from the banking sector liquidity crisis that developed during March. That said, the market tone remained cautious, with the improved risk premium on corporate bonds tempered by lingering concerns around sticky inflation, high interest rates, and the potential for slower economic growth into the latter half of the year.
Dominance of U.S. Equities – U.S. equity markets posted another strong quarter with the S&P 500 returning 8.7%, outperforming Canada and other major international equity markets. The S&P/TSX Composite, returned 1.2% in CAD. Major developed economies from Europe, Australasia, and Far East (EAFE) returned 3.2% in local currency terms. The highly anticipated re-opening of the Chinese economy has failed to materialize with economic data indicating less strength than previously forecasted. Amid sluggish Chinese growth, closely interconnected economic partners such as the European Union, as well as commodity-driven markets like Canada, have all underperformed the U.S. on a relative basis.
U.S. Fundamentals – Earnings continued to contract versus prior year, albeit at a slower pace than forecasted. Forward earnings guidance improved quarter-over-quarter with corporate sentiment returning to neutral levels. Based on our analysis, we observed that 31% of major companies expect deteriorating financial performance, while 33% expect improved performance, with the remaining expecting no material change. Overall, major U.S. companies remain well capitalized with strong operating margins. However, company guidance indicates a prioritization of cost controls amid increased consumer indebtedness and concerns about the health of the consumer.
Artificial Intelligence (AI) Mania – Despite concerns that the U.S. economy is at a late stage in its economic cycle, that monetary tightening by central banks could go too far, and the fact that earnings contracted on a year-over-year basis, equity markets became more expensive during the quarter with price-to-earnings multiples expanding. This expansion was driven by investors crowding into AI focused technology companies, with the seven largest AI/technology themed companies averaging a 26% return while the other 493 members gained only 3%. Investors rewarded businesses with contributions to AI development (hardware and software components), as well as those with the ability to implement synergies from leveraging the technology. A crowded market surge is not uncommon at this point in the economic cycle, where positive economic surprises, in this instance, strong employment and consumer spending can lead to an upswelling in investor confidence.
U.S. Quant Factors – Using our investment framework, we currently favour exposures to large cash-rich companies with innovative product offerings, which we believe offer the strongest risk-adjusted returns in the current market environment. While the valuation of AI companies seems to defy traditional rationales, the momentum has continued to push the group higher. Consequently, the Quality factor (companies with higher return-on-equity, strong operating performance, and healthy leverage levels) participated in the AI trend and consistently outperformed throughout the quarter. The Low Volatility factor (stocks with lower sensitivity to broad market movement, and lower price volatility) underperformed through the quarter. While the Low Volatility factor typically performs well at this stage of the economic cycle, the fact that a small number of stocks were responsible for much of the market’s return hurt this factor. Lastly, the Momentum factor (stocks with a recent history of price appreciation) initially underperformed during the quarter before rebounding in June. This factor’s recent outperformance suggests that the market is becoming complacent and possibly signals that rotations within the market are slowing as current trends remain in favour.
Canadian Fundamentals – Top line revenue missed forecasts while bottom line earnings were consistent with expectations. Softer-than-expected results out of Canadian financials, as well as underwhelming results from the materials sector, dragged on the aggregate index performance. Earnings forecasts for the rest of the year have been revised downward with analyst expecting index aggregate earnings to detract 2% to 3%. Meanwhile, the Bank of Canada raised its overnight interest rate by 25 basis points, bringing it to 4.75% on the backdrop of robust economic data releases including Q1 GDP and April CPI.
Canadian Quant Factors – The most notable dislocation in Canada was the convergence of the dividend yield of High-Dividend ETFs and Equal-Weight Bank ETFs. We believe that the drag from Canadian banks following the U.S. regional banking concerns in March resulted in a discount of the Quality factor as the performance of the group is sensitive to the movements of banks. While banks did recover around 35% of their SVB-induced underperformance, the nature of banking has attracted investor scrutiny given the view that we are in the late-stage of the economic cycle. That said, this environment is an attractive environment to add variants of the Quality factor, which would gain exposure to a rebounding industry that offers a similar dividend yield to the high dividend stocks.
Views From the Frontline
Rates – On an outright basis, bond yields across the curve continue to look attractive. Economic data remains strong however we are beginning to see the first signs of weakness in spending, jobs and inflation. Slower growth, a more balanced labour market, declining inflation, and tighter credit conditions will likely drive interest rates lower throughout 2023. Market participants remain focused on the extent of interest rate hikes and the duration of a pause required to bring inflation back to the 2% target. With inflation remaining more persistent than previously expected forecasts around the timing, pace and extent of the removal of monetary policy have been pushed into 2024.
Credit – The uncertain economic outlook and risks around slower economic growth later this year merit caution about corporate bonds and a bias towards higher-quality, shorter-dated credit where we think the risk / reward dynamic are more favourable. That said, the “soft-landing” narrative, now more pervasive in the market, could continue to provide support to risk assets, which we view as an opportunity to further pare down higher beta exposure.
Equities – Given the direction of the current economic and company fundamental data, we continue to favour high quality growth segments of the market with strong operating margins. As such, the late cycle conditions in the market reinforce our preference for large cap stocks over smaller, more U.S. domestically focused businesses. The U.S. Low Volatility factor’s underperformance is unlikely to reverse in the short term given the resilience of the U.S. economy. Furthermore, after a steep decline last quarter, we expect that cyclical value will find support in the near term, echoing the increased chance of slowing inflation without stalling economic growth. In Canada, equities are typically more cyclical in nature, which coupled with the potential for an earnings contraction, makes us view the Low Volatility factor as more likely to outperform. Like the U.S., we prefer Canadian high-quality companies to navigate through the late cycle environment. On the heels of poor Chinese economic data and underwhelming stimulus, we are maintaining our overweight to the U.S. relative to Canada and EAFE.
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ADVISOR USE ONLY
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.