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Update: Employment Insurance (EI) Sickness Benefit Extension
As it proposed in its 2022 Budget, the federal government has confirmed it is extending the Employment Insurance (EI) Sickness Benefits period from 15 weeks to 26 weeks later this year. The official implementation date and details have not yet been confirmed by the government and we will share further details once they are available. In the meantime, here’s what you need to know.
We will not require or implement any changes to our disability plan designs based on this extension. However, plan sponsors may wish to amend their short-term disability (STD) and long-term disability (LTD) plans and policies to align with the new 26-week EI period.Impact to short-term disability (STD) benefits integrated with EI
Plan sponsors with EI-integrated STD may wish to adjust their benefits to line up with the new 26-week extension.
Impact to plans with no STD benefits
For plan sponsors who do not offer STD, they have the option of adjusting their LTD plans to the new 26-week elimination period if members claim EI prior to LTD. This adjustment would help to avoid the plan member receiving disability and EI payments at the same time and potentially being required to return funds due to overpayment.Considerations for plan sponsors
Plan sponsors who amend their STD or LTD policies to align with the new 26-week EI period should note that there may be inadvertent delays to their employees’ return to work. While collecting EI, injured or ill employees do not benefit from our early intervention services or rigorous claims management practices that could help them get back to work sooner. So, by delaying the availability of STD or LTD coverage, the advantages that these programs are intended to provide could also be delayed.Impact to Premium Reduction Program (PRP)
The Premium Reduction Program (PRP) allows employers with eligible short-term disability plans to pay lower EI premiums. The eligibility criteria have not changed at this time. The government plans to review the PRP in 2024.Questions
If you have questions about these changes or what they mean for your clients’ disability plans, please contact your Group Account Executive or myFlex Sales Manager.
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January 2024 eNews
In this issue:
- Equitable scores high marks with group advisors*
- REMINDER: Equitable's National Biosimilar Program starts in March*
- 2024 dental fee guide updates*
- Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*
Equitable scores high marks with group advisors*
Equitable ranked first for operational service among major group insurers in a recent study of Canadian group benefits advisors.
NMG Consulting, a leading global consulting firm, conducted in-depth interviews with 146 Canadian group benefits brokers, consultants, MGAs and third-party administrators between May and August 2023 for its annual Canadian Group Benefits Study. Based on these interviews, NMG ranked group insurers in six categories, ranging from operational management to technology.
Nationally, Equitable ranked among the top three in five of the six main categories, including number one for Operational Management:Category Ranking Operational management 1st Initiatives (including seminars & training) 2nd Technology 3rd Underwriting & claims management 3rd Relationship management 3rd
“Advisors regard us highly in many categories. That’s a testament to our mutual status and ability to focus exclusively on our clients and advisor partnerships,” said Marc Avaria, Executive Vice President, Group Insurance Division. “We are truly working together to build strong, enduring and aligned partnerships with our clients and advisors.”
“We’re delighted with these results and are committed to continuously advancing our delivery of a better benefits experience for our clients and advisors,” added Avaria.More highlights from the latest NMG survey
Nationally, we ranked first in seven subcategories in Operational Management, including:- Overall service to intermediaries,
- Overall service to plan sponsors,
- New quote process,
- Plan implementation,
- Renewal process,
- Accuracy and timeliness of reporting and billing, and
- Administration quality and responsiveness
And we were rated strongly in Technology, finishing in the top three for:- Overall technology for Intermediary (2nd)
- Member experience (3rd)
- Quality of technology for the plan sponsor (2nd)
- Quality of mobile application (2nd)
REMINDER: Equitable's National Biosimilar Program starts in March*
In October 2023 we announced the upcoming launch of our national biosimilar program. Starting March 1, 2024, we are expanding our biosimilar switch initiatives to provide a single, nationwide** program.
Why we’re making the switch
Over the past few years, most provinces have introduced policies to delist some originator biologic drugs. They require most patients to switch to biosimilar versions of those drugs to be eligible for coverage under their public drug plans. Soon, it is expected that all provincial drug plans will cover only biosimilars.
Equitable’s National Biosimilar Program simplifies drug plan coverage by replacing our provincial programs. It also protects clients from additional drug costs while offering access to lower-cost biosimilars deemed equally safe and effective by Health Canada.
How will this affect clients' drug plans?
Because we have already introduced biosimilar switch initiatives in most provinces, the impact of this change will be minimal. It will primarily affect plan members in provinces or territories where we haven’t already required the switch to biosimilars. It will also affect plan members who are taking biosimilars that were not originally included in the switch initiative for their province.
Regardless of where they live, plan members across Canada will no longer be eligible for most originator biologic drugs if they have a condition for which Health Canada has approved a lower-cost biosimilar version of the drug. Plan members already taking the originator biologic will be required to switch to a biosimilar version of the drug to maintain coverage under their Equitable plan. We will support their transition with education, personalized communication, and resources.
Advance notice for plan members
We contacted affected claimants in early December to give them enough time to change their prescriptions 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 Account Executive.
** Excludes plan members in Quebec who participate in a separate provincial program.
2024 dental fee guide updates*
Each year, Provincial and Territorial Dental Associations publish fee guides. Equitable uses these guides to help determine the reimbursement limits for dental procedures.
For your reference, you may wish to refer to the 2024 list of the average dental fee increases for general practitioners.
Homewood Health wins HR Reporter Reader's Choice award for EFAP excellence*
Equitable is proud to congratulate our Employee and Family Assistance Plan (EFAP) partner, Homewood Health®, for winning the Canadian HR Reporter 2023 Reader’s Choice Award in Employee Assistance Plan services. Homewood’s EFAP provides confidential support for a range of health, family, money, and work issues through face-to-face, phone, email, chat, or video counselling. The award recognizes their high standards in counselling and mental health support services.
The annual Reader’s Choice Awards identify organizations that provide outstanding expertise and services for HR professionals and employers across Canada. Those organizations provide valuable information on useful, innovative HR and employee benefits products and programs, in categories such as recruitment, mental health services, employee engagement programs, and more.
Sharing Homewood Health with your clients
Since 2019, we have worked with Homewood to provide mental health services for Equitable benefits plan members.
Your clients can access Homewood Health’s award-winning EFAP for an additional fee by adding it to their benefits plan. Services are available 24/7, 365 days a year.
All Equitable clients also have free access to Homewood Health Online in their benefits plan. Homewood Online provides a variety of helpful wellness resources, including:
- Homeweb, an online and mobile health and wellness portal,
- Health Risk Assessment, a group of assessment tools to help plan members identify and overcome health and wellness barriers, and
- Online Internet-based cognitive behavioural therapy (iCBT) through Sentio to manage symptoms of anxiety and/or depression.
Questions
To learn more about Homewood Health’s services, contact your Group Account Executive or myFlex Account Executive.
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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 *
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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Equitable Life Group Benefits Bulletin - November 2022
The importance of timely plan member eligibility updates*
Effective Dec. 1, 2022, we are implementing a revised process for managing plan member and dependent health and dental claims that have been incurred and paid after coverage has been terminated. This new process is consistent with industry practices.
If health or dental claims have been incurred and paid after a plan member’s termination date but before we received notice of the termination, we will align the plan member’s or dependent’s termination date with the service date of the last paid claim, retaining premiums up until that date.
If no claims have been incurred and paid after the termination date, Equitable Life will process the termination as requested and refund any excess premium, subject to a maximum premium refund credit of three months.
Currently, we process the termination as requested and attempt to recover any claim overpayments directly from the plan member. We then refund any excess premiums that have been paid, subject to the maximum refund credit amount.
To avoid claims being incurred and paid after a plan member’s termination date, it is important for your clients to update plan member and dependent eligibility dates on or before the effective date of the change.
If you have any questions about the process your clients should follow for updating plan member eligibility, please contact your Group Account Executive or myFlex Sales Manager.QuickAssess®: Absence and accommodation request review services*
It can be difficult to navigate chronic or complex cases of absenteeism or accommodation requests. That’s where QuickAssess® can help.
QuickAssess is an optional, fee-per-use service that can provide your clients with an unbiased, timely assessment of complex plan member absences and workplace accommodation requests. Our disability experts can provide recommendations to help your clients manage:- Workplace absences
- Chronic or patterned absenteeism
- Requests to modify workplaces or duties
- Return-to-work coordination
- Employee Insurance sick leaves
For more information on using QuickAssess, including eligibility requirements, please contact your Group Account Executive or myFlex Sales Manager.
**Within two business days of receiving a completed QuickAssess Absence and Accommodation Review Referral Form and all required information. For more complex referrals, more time will be required.Finding a health care provider with TELUS eClaims direct billing*
By visiting TELUS’s Find a Provider page, your clients’ plan members can now easily search for paramedical and vision providers who are registered on the TELUS Health eClaims network and who can submit claims directly to us on behalf of their patients. Searches can be filtered by postal code to help plan members find the most convenient provider options.
As our direct billing provider for pharmacy, vision and paramedical claims, TELUS Health has an extensive network of 70,000 health care providers that provide direct billing to streamline the claims process.
Please note, plan members should always check Equitable Life’s list of de-listed providers before selecting a health care provider. The list is available for your clients and their plan members on EquitableHealth.ca, and is updated regularly.
For more information about TELUS eClaims, please contact your Group Account Executive or myFlex Sales Manager.First phase of the Canada Dental Benefit proposed for Dec. 1, 2022*
The federal government’s new Canada Dental Benefit is proposed to take effect on Dec. 1, 2022, subject to Parliamentary approval. The program will cover eligible expenses retroactive to Oct. 1, 2022, and this first phase would apply to Canadians under 12 years of age.
If implemented, the Canada Dental Benefit will provide dental care to Canadian families with under $90,000 adjusted net income annually. By 2025, the federal government expects to extend the benefit to children under 18, senior citizens and Canadians with disabilities.
Parents or guardians will be required to apply for this coverage through the Canada Revenue Agency (CRA) and must not have private dental coverage for the child(ren).
This new program will have no impact on your clients’ dental coverage and no action is required on their part.
* Indicates content that will be shared with your clients.
- Advisor Guide
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Paramedicals are Re-opening Shortly
We are pleased to announce that face-to-face insurance testing paramedical services, including the collection of vitals & fluids, are resuming shortly. Our service providers, Dynacare and ExamOne, have been monitoring the public health standards and have established standards they will operate under to protect the health of both the applicant and health professionals.
Our commitment to your client’s safety
It is Equitable Life's commitment that both clients and advisors will be provided clear and thoughtful communication before initiating any testing. Clients should fully understand the potential risks associated with having a paramedical test taken at this time and are always able to choose not to attend the appointment if they do not feel comfortable or safe.
How will paramedical services be conducted?
Dynacare is conducting appointments at fixed site facilities where clients will travel to the health professional for their appointment. The paramedical questions will be covered by video or telephone to minimize the time spent in the fixed site facility. For more information, see Dynacare’s COVID-19 client guide that will be provided to the client directly.
ExamOne examiners will travel to the client’s home for their appointment and the entire paramedical will be conducted at that time. Information about ExamOne’s COVID-19 processes and their Preparing for my exam client guide will also be provided to the client directy.
When are paramedical services re-opening?
In person paramedical services for Equitable Life cases will begin opening gradually. We have worked closely with our service providers, the CLHIA & provincial governments and believe it is prudent to begin re-opening services in the provinces that have a lower incidence of COVID-19. We will expand the schedule as the incidence of COVID-19 lowers or is expected to lower in specific regions.
Please note if you had an order in process prior to services shutting down, the provider will be looking to re-open and complete those orders. If requirements are no longer needed given the non-med limit changes, the order will remain closed.
Schedule for re-opening paramedical services:Province Start Date Saskatchewan June 1-Dynacare, June 11-ExamOne New Brunswick June 8-Dynacare, June 11-ExamOne PEI and Newfoundland June 15, Dynacare and ExamOne Manitoba June 15, Dynacare and ExamOne Alberta June 18, Dynacare and ExamOne British Columbia June 22, Dynacare and ExamOne Nova Scotia June 22, Dynacare and ExamOne Ontario* By June 30, Dynacare and ExamOne Quebec * By June 30, Dynacare and ExamOne
Note: Start dates are subject to change based on the progress of COVID-19.
*Ontario & Quebec to re-open regionally (starting with areas with lower incidence of COVID-19). Specifics for Ontario and Quebec will be communicated closer to the implementation dates for these provinces. Further details can be found in this communication. -
Meghan Vallis named head of distribution for myFlex Benefits and other group benefits updates
Meghan Vallis named head of distribution for myFlex Benefits
We are pleased to announce that Meghan Vallis, our Group Sales Vice President for Western Canada, will head national distribution for myFlex Benefits in addition to her existing responsibilities.
As part of her expanded role, Meghan will lead the myFlex Benefits sales team and develop and implement strategies to achieve the growth of this offering. Meghan and the myFlex team will continue to focus on delivering market leading services for our clients and advisors.
Meghan joined Equitable Life in 2020 and brings more than 15 years of experience in the group benefits industry to her expanded role. She is passionate about helping Advisors succeed to transform their clients' employee benefit experience.
myFlex Benefits is one of the most unique and versatile benefits solutions for small businesses in Canada. It is fully pooled, includes a two-year renewal and features a user-friendly portal for plan members to make their benefit selections. And it’s simple to use: Plan sponsors set a budget and choose from a selection of benefit options. Plan members then use flex dollars to select from the options offered by their employer. Any leftover flex dollars are saved in a health care spending account (HCSA).
If you have any questions or are interested in learning more about myFlex Benefits, please contact your Group Account Executive or myFlex Sales Manager.Changes to Short Term Disability (STD) benefit calculations for 2023*
The Canada Employment Insurance Commission and Canada Revenue Agency have announced the 2023 changes to Maximum Insurable Earnings and premiums for employment insurance.
The following changes to Employment Insurance (EI) will come into effect on Jan. 1, 2023:
How does this affect your clients?
Your clients’ STD benefit will be revised with the updated maximums based on the percentage of EI Maximum Weekly Insurable Earnings shown in their policy if:- Their Equitable Life Group Policy includes an STD benefit that is tied to the EI Maximum Weekly Insurable Earnings, and
- At least one classification of employees has a maximum of less than $650.
If their STD maximum is currently higher than $650 or based on a flat amount instead of a percentage or regular earnings, no change will be made to their plan unless otherwise directed.
If your clients wish to provide direction regarding revising their STD maximum, or if they have questions about the process, they can email Kari Gough, Manager, Group Issue and Special Projects.Coming soon: Survey for Plan Administrators with recent disability claims*
We’ve enhanced our communication processes to help your clients with disability plans manage their workplace absences more effectively. In early December, we will distribute a short survey to plan administrators who may have submitted an approved disability claim in the past six months. The survey will ask recipients about their satisfaction with the frequency and detail of our disability management communications.
The email will come from GBClientFeedback@equitable.ca, and the survey will remain open until the end of the day on December 16, 2022. All responses will be confidential. We plan to use the feedback to help ensure that we’re meeting your clients’ expectations and delivering industry-leading service.
We may also follow up with survey respondents directly, to address any concerns they’ve identified.
* Indicates content that will be shared with your clients. -
Homewood Health COVID-19 Resources
As the COVID-19 situation continues to rapidly evolve, you may need information from a trusted source to support your clients, their organizations and their employees.
Through our partnership with Homewood Health, the Canadian leader in mental health and addiction services, all of our clients and their plan members have access to a number of tools and resources designed to provide guidance and support.
Online Cognitive Behavioural Therapy
For plan members dealing with increased anxiety during these uncertain times, Homewood’s Online Cognitive Behavioural Therapy tool, i-Volve, can help. Through self-paced, web-based therapy, i-Volve can help plan members identify, challenge and overcome anxious thoughts, behaviours and emotions.
All Equitable Life clients and their plan members have access to i-Volve. It’s available 24 hours a day, seven days a week, wherever you choose to access it.
Learn more about Online CBT or access i-Volve at Homeweb.ca/Equitable.
COVID-19 Support Resources
Drawing on their expertise in mental health, as well as guidance from trusted sources including Health Canada, the Public Health Agency of Canada and the World Health Organization, Homewood has created a number of resources to help support your clients and their plan members.
- Self-isolation and quarantine: What you need to know
- Quelling COVID-19 Anxiety
- Managing stress and anxiety
- How to speak to children
- How to stay productive and motivated when working from home
- The COVID-19 Pandemic: Managing the Impact
- Support for First Responders, Front Line Workers and Public Facing Employees
- Financial tips for your financial health
- Increases in Domestic Violence
- Those with family members in long-term care facilities
- Parenting during a pandemic
- COVID-19: Employee Fatigue, Isolation and Loneliness
- COVID-19 Back to School - Considerations and tips for parents and caregivers
- COVID-19: Back to School Support for Kids
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