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October 2019 Advisor eNews
Coverage of Remicade, Enbrel and Lantus in BC
As we announced in August, BC PharmaCare recently introduced a new Biosimilars Initiative that ends coverage of three biologic drugs, including Remicade, Enbrel, and Lantus. These drugs will no longer be eligible in British Columbia for most conditions for which lower-cost biosimilar versions are available. Patients in the province with these conditions will be required to switch to biosimilar versions of these drugs by Nov. 25, 2019 in order to maintain their coverage under BC PharmaCare. Patients taking Remicade for Crohn's Disease or Ulcerative Colitis will not be required to switch to a biosimilar until March 6, 2020.
Biologics are drugs that are engineered using living organisms, such as yeast and bacteria. Biosimilars are highly similar to the originator drugs they are based on and most have been shown to have no clinically meaningful differences in safety or efficacy.
To ensure this provincial change doesn’t result in your clients’ plans paying additional drug costs, we have aligned our drug eligibility for these three biologic drugs with that of BC PharmaCare.
As previously announced, effective Nov. 25, 2019, Remicade and Enbrel will no longer be eligible for BC plan members with conditions for which lower-cost biosimilar versions of the drugs are available. These plan members will be required to switch to the biosimilar versions of these drugs in order to maintain eligibility on the Equitable Life drug plan. We have communicated with Plan Administrators about this change, and we have informed affected claimants of the need to switch medications.
As well, effective Feb. 3, 2020, the drug ingredient cost for Lantus will no longer be eligible for BC plan members; only the dispensing fee may be eligible under their Equitable Life plan. Plan members taking Lantus will be required to switch to Basaglar, the lower-cost biosimilar version of the drug, in order to maintain coverage under their Equitable Life plan. We will be communicating with Lantus claimants in the coming weeks to allow them ample time to change their prescription and avoid any interruptions in their treatment or their coverage.
If you have any questions about this change, please contact your Group Account Executive or myFlex Sales Manager.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.
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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.
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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*
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.
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