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1. Equitable Life Group Benefits Bulletin – May 2021

   In this issue:

   • Graduating dependents losing coverage?*  
   • New Brunswick expands the use of biosimilars*
   • Proposed changes to federal recovery and EI benefits*
   • Removal of plan administrator access to update plan member banking*
   • BioScript recognized as one of Canada’s Best Managed Companies*
   *Indicates content that will be shared with your clients
    

   Graduating dependents losing coverage?

   Let plan members know about Coverage2go

   As we reach the end of spring, some of your clients’ plan members may have dependents who are graduating from university or college and will no longer be eligible for coverage under the benefits plan.
    
   Fortunately, we offer Coverage2go®. It allows individuals who are losing their group coverage to purchase personal month-to-month health and dental coverage that is affordable, reliable and works like their previous group benefits plan. They can choose the level of coverage and protection that suits their personal situation.
   
   There are no medical questions – they simply need to apply within 60 days of losing their health coverage under their group benefits plan.*
    
   Help your plan members and their dependents who are losing coverage by letting them know about Coverage2go. They can visit our website to learn more about Coverage2go and to get a quote.
    
   *Quebec residents are not eligible for Coverage2go

   New Brunswick expands the use of biosimilars

   The New Brunswick government recently announced that it will be implementing a biosimilar transition program.
    
   Patients using originator biologic drugs for diseases such as inflammatory arthritis, inflammatory bowel disease, diabetes and psoriasis, will have until November 30, 2021 to switch to the biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. This process will be completed in consultation with the patients’ physicians.
    
   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.

   Proposed changes to federal recovery and EI benefits

   In its recent 2021 budget, the federal government proposed a variety of changes to its benefit programs.
   
   The proposed changes include providing up to 12 additional weeks of the Canada Recovery Benefit to a maximum of 50 weeks. The first 12 weeks of this benefit would be paid at $500 per week and the remaining eight weeks at $300 per week. 
   
   Multiple changes have also been proposed to make Employment Insurance (EI) more accessible to Canadians. The changes include: maintaining uniform access to EI benefits across all regions, supporting multiple job holders and those who switch jobs by ensuring that all insurable hours and employment count towards their eligibility, and simplifying many rules around EI to ensure Canadians can receive benefits sooner. It has also been proposed that the regular EI benefits be extended to no later than November 20, 2021, if needed.
   
   We are analyzing the impact these changes may have to disability benefits. We will provide more details later in the year. 

   Removal of plan administrator access to update plan member banking

   In early June, plan administrators will no longer be able to update banking information for their plan members on EquitableHealth.ca after their initial enrolment. This change has been made to allow plan members to have full control over where they want their claim payments deposited.

   Plan members can update their banking information online through their plan member web portal or through the EZClaim mobile app. They will continue to be notified via email if and when they make any changes.

   BioScript Solutions recognized as one of Canada’s Best Managed Companies

   Congratulations to our partner, BioScript Solutions, for being recognized as one of Canada’s Best Managed Companies of 2021 by Deloitte.
    
   We have partnered with BioScript since 2016 for our Specialty Drug Preferred Pharmacy Network (PPN). This partnership offers cost savings while providing comprehensive, best-in-class patient care.
    
   BioScript is one of Canada’s leading specialty pharmacies and recently celebrated its 20^th anniversary.
    
2. [pdf] First Home Savings Account
3. New “Update Payment” feature for banking changes has launched! Great news! Equitable^® has launched a new self-serve "Update Payment" feature in Client Access and on EquiNet^®. This new online process enables clients and advisors to easily submit key banking change requests for eligible insurance policies*, with no need to complete a physical form.
   
   What’s new?
   
   A new "Update Payment" feature is now available on Client Access and on EquiNet under Policy Inquiry. It allows clients (and advisors) to easily submit requests for the following three transactions online:
   
   1.  STOP pre-authorized payments.
   
   2.  RESUME pre-authorized payments on overdue accounts.
   
   3.  CHANGE which bank we withdraw money from.
   
   
   
   
   The new "Update Payment" feature replaces the previous "Edit" button in Client Access. The old banking change options are still available in the client’s Profile section. They can be used to request a change to the payment withdrawal date, as that option is not yet available with the new Update Payment feature. 
   
   How it works!
   
   When a change is requested using the new Update Payment feature, our Operations team receives it online.  They will review and process the changes within three business days, as per Equitable’s current service standards. 
   
   The Update Payment feature in Client Access is a self-serve process. However, if a client prefers, their advisor or an Equitable Customer Service associate can assist them by submitting the request on their behalf. Clients will be asked to sign to approve any such requests that are submitted by someone other than the owner of the policy.
   
   *The Update Payment transactions are only available for eligible policies: those that have not lapsed, are not on Automatic Premium Loan, and are not owned by a corporation or other entity.
   
   We trust that these digital enhancements will help make the client and advisor experience even simpler and more efficient.
   
   Need more information? Please contact your Equitable wholesaler.
   
   ^® or ^TM denotes a trademark of The Equitable Life Insurance Company of Canada.
4. Equitable Life Group Benefits Bulletin – December 2021 In this issue:
   • Supporting plan members affected by the flooding in Nova Scotia and Newfoundland*
   • Update: Changing certificate numbers on EquitableHealth.ca*
   • Help plan members take advantage of convenient digital options*
   • Ontario optometrists and government to restart negotiations*
   • QDIPC updates terms and conditions for 2022*
   *Indicates content that will be shared with your clients

   Supporting plan members affected by the flooding in Nova Scotia and Newfoundland*

   The recent flooding in Nova Scotia and Newfoundland is having a devastating impact on the province’s residents.
   
   Here are some of the ways we can help support your clients’ plan members who are affected by the flooding.
    
   Prescription refills
   Until Dec. 31, our pharmacy benefit manager, TELUS Health, will allow early refills for plan members who have been evacuated and/or lost their medication due to the flooding.
    
   Replacement of medical or dental equipment and appliances
   If plan members in Nova Scotia or Newfoundland need to replace any eligible medical or dental equipment or appliances (e.g. prescription eyeglasses, dentures, etc.) due to the flooding, they can call us at 1.800.265.4556 before incurring additional expenses to see how we can support them.
   
   Disability or other benfit cheques
   If plan members affected by the flooding are receiving disability benefits or other benefit reimbursements by cheque, they can visit www.equitable.ca/go/digital for easy instructions on how to sign up for direct deposit. It’s easy and takes just a few minutes. They can call us at 1.800.265.4556 if they need help. We can also arrange for a different mailing address or replacement cheques if necessary.
    
   Mental Health Support
   A natural disaster can also take a serious toll on people’s mental health. All of our plan members have access to the Homeweb online portal and mobile app, including numerous articles, tools and resources designed to provide guidance and support in difficult times. Homewood has put together some suggestions on how to help employees affected by a natural disaster. 
    
   For your clients with an Employee and Family Assistance Program, remind them that their plan members have 24/7 access to confidential counselling through a national network of mental health professionals. Whether it’s face-to-face, by phone, email, chat or video, plan members will receive the most appropriate, most timely support for the issue they’re dealing with.
    
   If a client wishes to add the EFAP to their plan, we can do this quickly – often in just a few days. Simply contact your Group Account Executive or myFlex Sales Manager.
    
   Plan Administrator support
   We realize that the flooding may also be having an impact on the regular business operations of your clients in Nova Scotia and Newfoundland. If any of your clients are unable to carry out day-to-day plan administration, they can call us at 1.800.265.4556 to see how we can support them.
    
   We know this is a challenging time for many of your clients and their plan members. We will continue to monitor the situation and provide additional updates as appropriate. 
    

   Update: Changing certificate numbers on EquitableHealth.ca*

   Effective Dec. 10th, plan administrators will no longer be able to update or change plan members’ certificate numbers on EquitableHealth.ca. This change will ensure we can manage these changes more effectively to provide a smoother plan member experience.
    
   If your clients need to update a plan member’s certificate number, please have them reach out to Group Benefits Administration for assistance at groupbenefitsadmin@equitable.ca.
    

   Help plan members take advantage of convenient digital options*

   We have several digital options available to make it easier for your clients to do business with us and for their plan members to access and use their benefits plan.
    
   To help build awareness among plan members, we’ve created two posters that your clients can post on their intranet sites or in their office. The posters provide easy instructions on how to activate our secure, digital options.
    
   Please click on the links below to download the posters.
    
   EquitableHealth.ca posters:                                         EZClaim mobile app posters:
   EquitableHealth.ca English                                             EZClaim mobile app English poster                   
   EquitableHealth.ca French poster                                  EZClaim mobile app French poster
    

   Ontario optometrists and government to restart negotiations*

   The Ontario Association of Optometrists (OAO) announced it has paused its job action and will restart negotiations with the Ontario Ministry of Health on funding for optometry services.
    
   In September, Ontario optometrists began withholding services from patients covered by OHIP, including children, senior citizens and other patients with certain medical conditions, after negotiations with the Ministry of Health over compensation broke down.
    
   Residents of Ontario between the ages of 20 to 64 who aren’t eligible for coverage of eye services under OHIP were not affected by the job action. They were able to continue to receive eye exams from their optometrist and submit eligible claims to their benefits plan.
    

   QDIPC updates terms and conditions for 2022*

   Every year, the Quebec Drug Insurance Pooling Corporation (QDIPC) reviews the terms and conditions for the high-cost pooling system in the province. Based on its latest review, QDIPC is revising its pooling levels and fees for 2022 to reflect trends in the volume of claims submitted to the pool, particularly catastrophic claims.
    

   Size of group (# of certificates)	Threshold per certificate 2022	Annual factor (without dependents	Annual factor (with dependents)
   Fewer than 25	$8,000	$276.00	$771.00
   25 – 49	$16,500	$188.00	$527.00
   50 – 124	$32,500	$97.00	$328.00
   125 – 249	$55,000	$66.00	$223.00
   250 – 499	$80,000	$51.00	$173.00
   500 – 999	$105,000	$39.00	$153.00
   1,000 – 3,999	$130,000	$34.00	$133.00
   4,000 – 5,999	$300,000	$18.00	$71.00
   6,000 and over	Free market – Groups not subject to Quebec Industry Pooling

    
   We will apply the new pooling levels and fees to future renewal calculations that involve Quebec plan members.
5. Get the Straight Talk on Equitable’s par account performance

   Real answers to big questions

   At Equitable, we understand how important it is to make confident decisions when dealing with large cases. When you have questions, you need concise, direct insights from leaders and subject matter experts.

   Introducing the Straight Talk video series

   Today, we are thrilled to share the first episode of Straight Talk. This episode features Mark Arruda, VP of Individual Insurance Pricing and Finance.
   
   Mark talks about how Equitable’s par account is built to perform in all kinds of conditions, with strong governance, disciplined risk management, and prudent capital practices that ensure stability even when large life insurance claims are paid out.
   
   Watch Straight Talk for straight answers to the questions that matter most.
   
   Contact your Equitable Wholesaler to learn more about Equimax.
   
    

    

6. 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):

   

7. [pdf] Equitable GIF Contract Provisions and Information Folder
8. How to talk to clients about CI when they don’t want to
   Does this sound familiar? 
   
   You’re having a chat with your client about Critical Illness insurance. They suddenly interject: “Critical illness insurance isn’t for me.”
   
   “Why is that?” you ask. 
   
   “Because….
   -  Critical Illness insurance is expensive!
   -  I don’t understand what it covers exactly.
   -  I have money to cover me if I get sick, so I don’t need this.
   -  I’m healthy enough.
   -  It’s not life insurance, so I don’t need it right now. 
   -  I already have disability coverage through my work.”
   
   If you’ve heard any of these responses, and didn’t know how to respond, we can help. 
   
   
   Our Path to Success program covers all these objections and more with simple-to-follow PDFs and videos. You’ll learn conversation strategies and tips on how to navigate the sale. Most importantly, you’ll know exactly what to say the next time a client objects to Critical Illness insurance. 
   
   Want to learn more? Check out our CI Path to Success modules here!
   
   Need CE credits? Take our Path to Success program here. 
9. Dialogue Virtual Healthcare now available to add to Equitable Life benefits plans

   We’re pleased to announce we are partnering with Dialogue, Canada’s leading virtual health provider, to offer unlimited and on-demand virtual access to primary healthcare practitioners.   Virtual Healthcare is the latest addition to our HealthConnector suite of health and wellness services. It is available to add to all Equitable Life benefits plans for an additional cost as of July 1, 2023. Features of Dialogue Virtual Healthcare Available 24/7, 365 days a year, Dialogue Virtual Healthcare provides access to unlimited non-urgent medical care for a wide range of health concerns. Plan members get fast access to the largest, most experienced and bilingual medical team in Canada for non-urgent medical issues. They also benefit from in-app prescription renewals and refills, personalized follow-ups after every consultation, and concierge-level navigation support for all referrals to in-person specialists when needed. Dialogue’s industry-leading platform provides an all-in-one patient journey to address health issues, reducing long wait times and time away for doctor appointments. Plan members and their families can access Dialogue Virtual Healthcare through the secure web portal or mobile app. The Dialogue medical team includes doctors, nurse practitioners and nurses. Plan members can use the service even if they’re already receiving care from a family doctor. Benefits of Virtual Healthcare For your clients By providing access to Virtual Healthcare, plan sponsors can help to: Drive employee engagement; Reduce absenteeism related to in-person medical appointments; Manage chronic health issues; Attract and retain top talent; and Build a healthier workforce. For their plan members By providing easier access to primary healthcare practitioners, Virtual Healthcare can offer extra health and wellness support for plan members. It also supports members that may experience barriers to accessing in-person healthcare, such as: Living in a remote location; Work or family obligations during standard medical clinic hours; Mobility challenges related to a disability; and Transportation challenges. Learn more about bringing Dialogue Virtual Healthcare to your clients Click the link to learn more about Dialogue Virtual Healthcare : Welcome to Dialogue! Questions? To learn more about how your clients can add Virtual Healthcare to their benefits plan, please contact your Group Account Executive or myFlex Sales Manager.

10. Get the Straight Talk from Equitable’s public investments expert Real answers to big questions
    When you have questions about par whole life insurance, you need concise, direct insights from leaders and subject matter experts. And that’s where Straight Talk can help!
    
    Straight Talk with Mark Warywoda
    What’s really behind consistent long-term performance? Find out in this next episode of Straight Talk, hosted by Rob Hollingsworth, Head of Insurance Distribution.
    
    Watch Mark Warywoda, VP of Public Investments, break down how disciplined sourcing and a scalable strategy help sustain Equitable’s long-term par fund performance.
    
    In case you missed it .... Straight Talk with Mark Arruda
    In the first episode of Straight Talk, Mark Arruda, VP of Individual Insurance Pricing and Finance, talks about how Equitable’s par account is built to perform in all kinds of conditions, with strong governance, disciplined risk management, and prudent capital practices that allow Equitable’s par account to perform at top-tier levels.
    
    
    
    Learn more
    Learn how Equimax^® whole life insurance can benefit clients. Contact your individual insurance wholesaler today.