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1. 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*
     *Indicates content that will be shared with your clients

   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.
    
    *Indicates content that will be shared with your clients
    
2. National Pharmacare (Plan NP) takes effect in B.C. on March 1

   In this issue:

   National Pharmacare (Plan NP) takes effect in B.C. on March 1

   Travel coverage details plan members should know if they’re in or going to Mexico*

   *Indicates content we will share with your clients.

    

    

   National Pharmacare (Plan NP) takes effect in B.C. on March 1

    

   The Province of British Columbia (B.C.) will implement the first phase of the National Pharmacare Act, also known as Bill C64 (Act), on March 1, 2026.

    

   The new program will be called National Pharmacare (Plan NP). The province joins Manitoba and Prince Edward Island, who have already implemented the first phase of their own programs. All three provinces, along with Yukon, signed bilateral pharmacare agreements with the federal government last year.

    

   National Pharmacare (Plan NP) coverage details

    

   The federal government has agreed to provide universal coverage for many diabetes drugs and contraceptives, including deductibles, during the first phase of implementation of the Act. Equitable will no longer cover drugs that are eligible for coverage under Plan NP.

    

   Diabetes devices and supplies are not included in the first phase of plan implementation. However, expanded coverage for certain diabetes-related devices and supplies is expected to begin in B.C. on April 1, 2026.

    

   Since B.C. already offers universal coverage of contraceptives through its provincial pharmacare program, the province is using that portion of the federal funding to cover menopausal hormone therapy (MHT), also called hormone replacement therapy (HRT).

    

   Many diabetes medications such as metformin, insulin, sulfonylureas and SGLT-2 inhibitors will be fully covered under Plan NP.

    

   Some diabetes medications and MHTs will only be partially covered when the program takes effect. As well, many diabetes medications will continue to require Special Authority through the province.

   
   
   What will Equitable plan members need to do?

    

   Coverage will be provided automatically at the pharmacy counter. Plan members simply need to present a prescription for a covered medication and their Medical Services Plan of B.C. (MSP) card to their pharmacist. If a plan member isn’t fully enrolled in the MSP yet, their pharmacist will help them secure coverage under Plan NP.

    

   The pharmacist will charge the provincial plan directly for the relevant medications. There will be no direct impact to plan members or their experience at the pharmacy for fully covered drugs.
    

   Where do GLP-1 drugs fit in?

    

   GLP-1 agonist drugs will not be covered under Plan NP. Equitable plan members who are prescribed this type of drug to treat diabetes must try a first-line diabetic treatment before we can deem them eligible for coverage of the GLP-1 agonist.

    

   Plan members who are already taking a GLP-1 agonist to treat diabetes will continue to be eligible for coverage. New plan members or plan members with new prescriptions for GLP-1 agonists must provide us proof that shows they’ve tried a first-line diabetic treatment to confirm eligibility—unless we already have a previous record of their insulin use. Proof can be either a past receipt or a claim statement.

    

   Our priority is supporting the best outcomes for plan sponsors and their members. We are working with TELUS Health, our pharmacy benefits manager, to keep you updated as more details become available.

    

   Travel coverage details plan members should know if they’re in or going to Mexico

    

   Plan members with Travel Assist medical emergency coverage included in their benefits plan should keep the following information in mind if they’re planning travel to Mexico or if they’re in the country now.

    

   Due to recent violence in Mexico, the Government of Canada has issued the following travel advice to anyone in or planning to visit the country.

    

   Plan members are not covered if they receive out-of-province services where the Canadian government had issued a warning to avoid all or non‑essential travel before they entered the country.

    

   Plan members should contact Trident Global Assistance, the company that administers our Travel Assist benefits, before departing if they have questions about their coverage or to confirm if they’re covered for travel to their specific destination.

    

   Here’s how plan members can reach the Trident Global Assistance toll-free 24-hour emergency hotline:
    

   • In Canada or the U.S: 1-800-321-9998

   • Elsewhere: Call collect at 519-742-3287

      

   They should be prepared to provide the following information:

   • Name

   • Group policy number

   • Certificate number

   • Government health insurance plan number

      

   If a plan member arrived in Mexico before the travel advisory was issued and are past their day allowance, they should call Trident if they need to have their day maximum extended past the allowable period. 

    

   Equitable’s Travel Assist medical emergency coverage does not include any trip cancellation or trip interruption benefits.

    

   Communicating to plan members

    

   We are making every effort to share this information with affected plan members. Please encourage your clients who have Travel  Assist coverage included in their benefits plan to share this message with their plan members.

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6. Equitable Life Group Benefits Bulletin – March 2022 In this issue:
   • CLHIA launches industry anti-fraud initiative*
   • Provincial biosimilar update*
   • Quebec decreasing insurance premium tax*
   • Coming soon: A survey to understand how we can better serve your clients’ needs*
   • Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare *
   *Indicates content that will be shared with your clients
    

   CLHIA launches industry anti-fraud initiative*

   In February, the Canadian Life and Health Insurance Association (CLHIA) announced a new anti-fraud initiative that is using advanced artificial intelligence (AI) to further identify and reduce benefits fraud.
    
   Equitable Life is excited to be a part of this important initiative. It will enhance our own fraud detection analytics by using AI to connect the dots across a huge pool of anonymized claims data. This will lead to more investigations and actions to mitigate the impact of fraud on your clients’ plans.
    
   The initiative is being led by the CLHIA and member insurers and is supported by technology provider Shift Technologies. It will be further rolled-out and expanded over the next three years.
    
   Benefits fraud affects more than just insurers. The costs of fraud are felt by employers and their employees as well. We are looking forward to being able to better identify and reduce benefits fraud.
    

   Provincial biosimilar update*

   BC expands its biosimilar initiative
   BC Pharmacare recently announced it is adding two rapid-acting insulins to the list of drugs included in its ongoing initiative to switch patients to biosimilar versions of high-cost biologics. Patients taking Humalog or NovoRapid for Type 1 or Type 2 diabetes will be required to switch to a biosimilar version of the drugs by May 29, 2022 to maintain coverage under the public plan.
   
   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 biologic drugs they are based on, and Health Canada considers them to be equally safe and effective for approved conditions.
   
   How we are responding to protect our clients
   To help prevent this change from resulting in additional costs for our clients’ drug plans while still providing plan members with access to safe and effective medications, we will no longer cover Humalog or NovoRapid for plan members in BC. Effective June 1, 2022, claimants currently taking Humalog or NovoRapid will be required to switch to a biosimilar version of the drugs to maintain coverage under their Equitable Life plan and their BC Pharmacare plan.
   
   We will be communicating this change to plan administrators later this week. And we will be communicating with affected claimants in early April to allow 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.
   
   Nova Scotia and Northwest Territories introduce biosimilar initiatives
   The governments of Nova Scotia and the Northwest Territories each recently announced they are launching biosimilar initiatives to switch patients from certain originator biologic drugs to biosimilar versions of the drugs.
   
   Patients in Nova Scotia using affected originator biologic drugs will have until February 2023 to switch to a biosimilar version of their medications in order to maintain coverage under the province’s public drug plans. Patients in the Northwest Territories will have until June 20, 2022, to switch.
   
   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.
    

   Quebec decreasing insurance premium tax*

   The Quebec Government has announced that it plans to decrease its Insurance Premium Tax rates effective April 1, 2022. The premium tax rates for group life and accident and sickness insurance are expected to decrease from 3.48% to 3.3%. The new tax rates will be applied to premiums for the billing period beginning on or after April 1, 2022.
    

   Coming soon: A survey to understand how we can better serve your clients’ needs*

   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.
    
   In the coming weeks, we will conduct a survey of your clients to help us understand how we can better serve them. On March 28, we will send plan administrators an email with a link to the survey. The survey will remain open until the end of the day on April 11 and 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 may also follow up with plan administrators directly 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 25 prepaid gift cards for $25.
    

   Remind your clients’ plan members in BC, Manitoba and Saskatchewan to register for Pharmacare*

   If your clients have plan members in British Columbia, Manitoba or Saskatchewan, the provincial government offers a Pharmacare program to support prescription drug costs.  Plan members in these provinces must register for their provincial Pharmacare program to maintain coverage under their Equitable Life drug plan.
    
   Registration is easy! We will send two registration reminder messages directly to plan members’ pharmacists and post them on their Explanation of Benefits. We’ve also created a step-by-step guide that your clients can share with their plan members.
    
   English version
   French version
    
   For more information about the provincial Pharmacare programs, including how plan members can register, please visit:
    
   For British Columbia residents: https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents  
    
   For Manitoba residents: https://www.gov.mb.ca/health/pharmacare/apply.html
    
   For Saskatchewan residents: https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/extended-benefits-and%20drug-plan/drug-cost-assistance#eligibility
    
    
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