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Insights from a pandemic: Drug trends during COVID-19
We were expecting drug costs to rise this year due to the increase in “specialty” drugs, the shift to more expensive treatments for common conditions, and the introduction of new, costly medications. The COVID-19 pandemic has caused drug costs to rise even more than expected. While this was partly due to increased claims for certain drug categories, the most significant factor was the increase in dispensing fees as the provinces imposed 30-day refill limits.
Costs and claimants surge, drop, then climb again
Initially, as COVID-19 started to spread, we saw an overall spike in the volume and paid amounts for drug claims in March as plan members rushed to stock up on their medications. On our block, the average amount paid per certificate increased 16% in March, compared with the previous year.
This spike was followed by a drop in April after most provinces put 30-day refill limits in place. This led to a decrease in both average paid amounts and quantity per claim as people were limited to smaller refills. But the dispensing fee portion of drug cost tripled for many plan members who had to refill their prescriptions every month instead of every 90 days.
The April plunge was short-lived. Drug claims started to climb again in May as some provinces removed their 30-day refill limits. We’ve seen a continued increase so far in June as all remaining provinces have lifted their 30-day limits.
Claims for “specialty” drugs increase
There were some notable exceptions to this trend. For example, both claimants and paid amounts for high-cost “specialty” drugs increased in March, April and May. Thirty-day refills are the norm for these drugs, so they weren’t impacted by the re-fill limits.Claims for asthma drugs had the largest surge of any common disease category in March but had no subsequent drop in April. Not surprisingly, claims for mental health drugs increased throughout the pandemic, including a 33% increase in the number of claimants in May.
Going forward, we should see the average quantity per prescription stabilize in future months and return to normal, provided pharmacies return most patients to refills of more than 30 days.
The full impact of COVID-19 remains to be determined. We will continue to provide timely updates on any developments that impact our clients and their plan members or their benefits coverage. In the meantime, please contact your Group Account Executive or myFlex Sales Manager if you have questions.
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Important Information Regarding FHSA Contributions
Many clients have already taken advantage of Equitable’s First Home Savings Account (FHSA), available on Pivotal Select™ Investment Class (75/75) and Pivotal Select Estate Class (75/100).
Below, we answer questions we have received regarding cut-off dates for 2023 FHSA contribution tax receipts.
1. The client submitted an application with a deposit before 11:59 p.m. ET on December 29, 2023. Will they get a 2023 FHSA contribution tax receipt?
Yes, the client will receive a 2023 FHSA contribution tax receipt.
2. The client submitted an application with a deposit on December 30 or 31, 2023. Will they get a 2023 FHSA contribution tax receipt?
No, the client will not receive a 2023 FHSA contribution receipt. The client’s deposit will be made effective the next business day, January 2, 2024. The client will receive a FHSA contribution tax receipt for the 2024 tax year.
However, since the client signed the application on or before December 31, 2023, they are eligible to take advantage of the 2023 contribution room in 2024 (up to $16,000 total*).
3. The client submitted an application with a deposit after January 1, 2024, but it was signed on or before December 31, 2023. Will they be eligible for the 2023 contribution room?
Yes. Any FHSA application received on or before 4:00 p.m. ET on January 12, 2024 that was signed on or before December 31, 2023 will be eligible to take advantage of the 2023 contribution room in 2024*.
4. The client received a confirmation letter stating their deposit was effective in January, but the application and contribution was submitted on or before December 29, 2023, will they receive a 2023 tax receipt for their contribution?
Yes, if the client received a confirmation letter stating their deposit was effective in January but the application and deposit was received at Equitable® on or before December 29, 2023, they will receive a 2023 tax receipt for their contribution. We are currently updating any impacted FHSA policies to reflect a December trade date. The client will receive a revised confirmation letter reflecting the December trade date.
5. When will 2023 FHSA contribution tax receipts be issued?
FHSA contribution receipts for the 2023 tax year will be mailed to clients by February 29, 2024.
If you have further questions, please contact your Regional Investment Sales Manager or one of our Client Services Representatives at 1.866.884.7427.
*Clients must consider all eligible FHSAs with any other institutions to determine their remaining contribution room.
® or ™ denotes a trademark of The Equitable Life Insurance Company of Canada.
Posted January 2, 2024 - Banking Changes
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