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1. August 2019 Advisor eNews

   Coming soon:

   Tech updates for plan members

   Technology doesn’t stand still, and neither does your clients' businesses. That’s why we continually invest in technology to make things easier for your clients and their employees.

   Faster claims processing on Equitable EZClaim^® Mobile

   Equitable Life now provides real-time processing of massage therapy, physiotherapy and chiropractor claims submitted via the EZClaim Mobile app.

   That means plan members are able to find out the status of their 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, and the type and amount of the expense, when submitting their claims for these services.

   Equitable Life plan members can submit all types of health and dental claims via EZClaim Mobile, including co-ordination of benefits and Health Care Spending Account claims. Currently, 43% of all claims are submitted through the user-friendly app.

   AS part of our ongoing efforts to improve the mobile claims experience for plan members, we've also added biometric login functionality to allow plan members to sign in to the app using their face or fingerprint. And we've redesigned our landing page on the mobile app to make it easier for plan members to navigate the various features of the app.

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

   Introducing InpatProtect:

   Health coverage for employees who are new to Canada

   For a new employee starting to work in Canada, looking after basic health needs can be difficult.

   There’s a waiting period for provincial health coverage, and group benefits plans don’t cover the physician, hospital or emergency services that they or their eligible dependents may need during their initial months in the country. They could end up incurring significant unexpected health expenses.

   That’s why Equitable Life has launched InpatProtect^TM. InpatProtect provides temporary coverage to look after the basic health needs of employees and their eligible dependents during their transition to Canada. Your clients can recruit from outside the country knowing that their employees will have some protection in the event of a medical need, including an emergency.

   For up to 90 days, InpatProtect will cover employees and their eligible dependents for basic services that would normally be reimbursed under provincial health plans, such as:

   • Physician services
     • Prescriptions for medications
     • Diagnosis and treatment for illness or injury
   • Hospital services
     • In-patient services
     • Drugs prescribed and delivered as an inpatient in-hospital
     • Out-patient services
   • Emergency services
     • Ambulance services
   • Emergency dental services

   Contact your Group Marketing Manager or myFlex Sales Manager for more information about this new product from Equitable Life.

   De-listed service providers

   As part of our ongoing initiative to have Group Benefits plans only reimburse eligible claims, we conduct reviews of the billing and administrative practices of service providers, including clinics, facilities and medical suppliers.

   As a result of these reviews we may de-list certain providers.  We will no longer accept, or process claims for services and/or supplies obtained from those providers. The plan member can still choose to obtain services or supplies from these providers, but Equitable Life will not provide reimbursement for the claims.

   Review Equitable Life’s de-listed service providers

   The delisted service provider list is also posted on EquitableHealth.ca for plan members to review to determine if their claim(s) are eligible for reimbursement under their Group Benefits plan.

   For more information about protecting group benefits plans from abuse, check out our articles.

    

    

   ¹ Based on Equitable Life health and dental claims submitted between January 2019 – March 2019
   
   Google Home and Google Assistant are registered trademarks of Google LLC.
   ^® denotes a trademark of The Equitable Life Insurance Company of Canada unless otherwise indicated.

2. A New Universal Life Insurance Solution for the 21st Century – Available NOW! Introducing a new universal life solution built for the 21st century: Equitable Generations™ universal life insurance is available for sale NOW!

   
   Check out our Equitable Generations universal life splash page: www.equitable.ca/ul

    
   Our new Equitable Generations universal life insurance
   Equitable Generations is a universal life product that offers investment options that resonate with today’s 21^st century client while reducing every fee possible. It also reduces the cost of insurance to help clients maximize their opportunity to purchase coverage and build tax-advantaged wealth.
   
   NEW: EZstart^TM Generations
   Today we are launching EZstart Generations which is:
    
   • A mobile-optimized tool for advisors
   • Designed to start a conversation and provide a possible universal life solution in under one minute
   • Goals based - you can see how Equitable Generations™ universal life insurance can perform at different stages of a client’s life.
   Give it a try and use this tool as you are starting the conversation about universal life solutions with clients. EZstart links directly to the EZcomplete® online application for an easy digital experience.
    
   NEW: SMS
   Effective today, September 26, 2022 when you submit an application, you can opt-in to receive text message updates for your new business applications.
   That’s a text message when:
   • The application is received,
   • A decision has been made by Equitable Life,
   • The policy is ready for delivery, and
   • The commissions have been triggered.
   Please note, this number is not monitored for incoming texts. Please contact Customer Service with any questions.
   Learn more
   
   Find all the exciting details on our virtual launch splash page (www.equitable.ca/ul) and watch our informative videos to get all the information you need to start selling Equitable Generations universal life.

   
   Check out our Equitable Generations universal life splash page: www.equitable.ca/ul

   
   Click on the Marketing Materials tab on EquiNet® for all of our new Equitable Generations marketing materials.

   Please contact your Regional Sales Manager for more information. 

    
   ^TM and ® denote trademarks of The Equitable Life Insurance Company of Canada. 
    
    
3. [pdf] myFlex Options Guide
4. [pdf] Tax-free money does exist, if you know where to look.
5. 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):

   

6. [pdf] Your guide to Coverage2go
7. [pdf] Pivotal Select Contract and Information Folder
8. Path to Success Module 2
9. [pdf] Claimant Statement for Individuals
10. Repositioned Wealth Accumulator available

    Repositioned Equimax Wealth available now

    As we continue to grow to meet the needs of various market segments, our product options for your high net worth (HNW) clients have also been improved. Equimax Wealth Accumulator^® has been repositioned to meet the needs of your high net worth clients by providing more deposit room and competitive early cash values.

    Equimax Wealth is now repositioned for your high net worth clients

    Equimax Wealth Accumulator is now targeted for clients ages 45 to 65 with an insurance need but also looking for tax advantaged growth as an alternative to traditional investments. It allows your clients to achieve both while diversifying their portfolio and saving taxes, particularly for corporations.
    

    Highlights of the repositioned Equimax Wealth Accumulator:

    • More deposit room - Allows for significantly more deposit room by reducing the initial death benefit. This means more money can be paid into the policy to promote the tax-advantaged investment growth.
    • Higher early cash surrender values - We are more competitive on total cash value in years 1 to 10 in the target market ages of 45-65. The higher extra deposit room and early surrender cash value allows the illustration to show an earlier premium offset, which is key for the HNW market.
    • More competitive on life pay - Improvements to life pay more notable than 20 pay. Reduced premiums for most male and female non-smokers in our target market (ages 45-65) as well as 2, 3, and 4 year improvement in illustration of premium offset.
    • More competitive at older ages - A shift in the target market means you can support older clients in the HNW market. The Equimax Wealth Accumulator is now more competitive at ages 45-65.

    Learn more

    For full details on the transition, please see our transition rules.

    For more information on this product, please visit the Equimax page on Equinet.