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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 2020
In this issue:
- Telemedicine now included in Travel Assist*
- Take advantage of our convenient digital options*
- 2021 changes to Maximum Insurable Earnings, Maximum Weekly Insurable Earnings and Short Term Disability Benefit*
*Indicates content that will be shared with your clients
Telemedicine now included in Travel Assist*
Medical emergencies can be particularly stressful while travelling. Making your way to a medical facility can be a struggle. And once you get there, you could face long wait times, language barriers or even the risk of COVID-19 infection.
That’s why Allianz Global Assistance®, our Travel Assist provider, is adding two new virtual care options to provide plan members with timely and appropriate medical support.
As always, when a travel medical emergency strikes, plan members call Allianz for assistance. During the intake process plan members will be guided through a series of questions to triage their unique medical situation. Options for care now include two different virtual care services:
- TeleConsultation – Video and chat consultation with a locally licensed physician. This physician can diagnose simple medical conditions and provide a prescription. Available across Canada and in some high travel states in the United States.
- TeleAdvice – Video and chat consultation for situations which are not likely to require a prescription. The physician can diagnose simple medical conditions and provide medical guidance.
Plan members who use virtual care may benefit from:
- Reduced wait times;
- Care from the comfort of their current location;
- Reduced language barriers;
- No need to arrange transportation to a medical facility;
- Reduced impact on travel itinerary; and
- Reduced risk of exposure.
Both TeleConsultation and TeleAdvice will be available for all Equitable Life plan members beginning January 1st, 2021. There is no additional cost, no changes required to your client’s plans, and no change to the way plan members contact Allianz in the event of a travel medical emergency.
This PDF plan member update will also be included in the eNews to plan administrators.
If you have any questions about these new features, please contact your Equitable Life Group Account Executive or myFlex Sales Manager.
Allianz Global Assistance is a registered business name of AZGA Service Canada Inc. and AZGA Insurance Agency Canada Ltd.
Help your clients take advantage of our convenient digital options*
During this time of physical distancing, people are looking for ways to interact with their providers virtually. We recently enhanced our Online Plan Member Enrolment tool, allowing all groups to add new plan members without the need for paper forms.
Did you know, we have several other 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? Over 71% of plan administrators are managing their plan online and 78% of plan members are already using our digital tools.
For plan administrators:
- Plan Administrator Portal (EquitableHealth.ca) – plan administrators can easily manage their plan anytime and anywhere
- Digital Welcome Kits – personalized welcome kits are delivered to plan members via email
- Easy automated payments – plan administrators can avoid missed payments by setting up pre-authorized debit or electronic funds transfer
For plan members:
- Plan Member Portal (EquitableHealth.ca) – plan members get secure, 24/7 access to their claims history, coverage details and health and wellness resources
- Electronic Claim Payments and Notifications – plan members can get claim updates sooner in their email inbox and payments right into their bank account
- EZClaim Mobile App – submitting claims from a mobile device is fast, easy and secure
- Digital Benefits Cards – plan members no longer have to dig through their wallet – they can download their benefits card on their mobile device
Learn more about how we’re making it easier for your clients to do business with us
2021 changes to Maximum Insurable Earnings, Maximum Weekly Insurable Earnings and Short Term Disability Benefit*
The Canada Employment Insurance Commission and Canada Revenue Agency have announced the 2021 changes to Maximum Insurable Earnings, and premiums for employment insurance. These changes take effect January 1st, 2021.
Maximum Insurable Earnings (MIE)
The MIE will increase from $54,200 to $56,300.
Maximum Weekly Insurable Earnings (MWIE)
The MWIE will increase from $1,042 to $1,083.
EI Benefit (55% of the MWIE, rounded to the nearest dollar)
EI benefit will increase from $573 to $595
Information for Plan sponsors
If your client’s Group Policy with Equitable Life includes a Short Term Disability (STD) benefit which is tied to the EI MWIE, and at least one classification of employees has less than a $595 maximum:
- To comply with the provisions of their policy, their STD benefit will be revised with the maximums updated based on the percentage of EI MEIW shown in their policy.
- The additional premium for any increase from their previous STD amounts and new STD amounts will be show on their January 2021 Group Insurance Billing (as applicable).
If their STD maximum is currently higher than $595 or based on a flat amount (not based on 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 have questions about the process, they can email Kari Gough, Manager, Group Quotes and Issue.
*Indicates content that will be shared with your clients
- [pdf] Equitable GIF Fund Facts
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Get Client Focused: Turning Compliance into Your Advantage
Join Equitable Life and guest speaker, April-Lynn Levitt, CFP, Business Coach, The Personal Coach, to learn how to be compliant in today’s environment and create client-focused review meetings:
• Understand the new requirements and the best practices for implementing the new requirements into your practice.
• Go beyond “ticking the boxes” to build an exceptional client experience.
• Learn to use your review process to stimulate referrals and update compliance documents seamlessly.
We are pleased to provide you with a recorded version of April-Lynn Levitt’s presentation, “Get Client Focused: Turning Compliance into Your Advantage” click here
This webinar is available in English only.
® denote trademarks of The Equitable Life Insurance Company of Canada.
Posted June 6, 2023
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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*
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 Coverage2goNew 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 20th anniversary.
- [pdf] Pivotal Select Application - FHSA
- [pdf] Daily/Guaranteed Interest Account Application - FHSA
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Equitable Life Group Benefits Bulletin – January 2022
Short-term disability coverage for plan members with COVID-19*
Please note: This announcement applies only to groups with short-term disability coverage through Equitable Life
As the COVID-19 pandemic continues, and the situation evolves, we continue to adjust our practices to ensure ongoing support for our plan members.
PCR tests no longer required for COVID-related STD claims
Some provinces have recently restricted access to COVID-19 PCR testing to only high-risk individuals. To ensure your clients' eligible plan members receive their short-term disability benefits in a timely manner, we no longer require a positive PCR test for plan members submitting COVID-19-related STD claims.
Plan members who are experiencing symptoms of COVID-19 or who have tested positive for the virus (either with a PCR test or with an at-home rapid test) and are unable to work from home should complete the Short Term Disability Plan Member COVID-19 Claim Form (#421A).
They should indicate the date of the onset of symptoms or date of their positive test result. Where applicable, they should also indicate the date they have been cleared by public health to end their self-isolation. The form includes an attestation that the information they have provided is accurate.
The employer needs to complete the Short Term Disability Employer COVID-19 Claim Form (#421B). They should indicate the expected return-to-work date according to their provincial health guidelines, or using the date provided by a public health official.
Waiting periods for COVID-related STD claims
To support your clients' plan members during the initial stages of the pandemic, we waived the STD waiting period if a plan member’s absence was due to symptoms or a diagnosis of COVID-19. Now that COVID-19 has become the “new normal,” we are returning to our standard practices and treating the virus as we would any other illness.
Effective Jan. 1, 2022, standard waiting periods will apply for COVID-related STD claims, according to the terms of the Group policy. This ensures that all plan members submitting a STD claim are treated fairly, no matter what the cause of the claim.
Eligible plan members will receive STD benefits up to a maximum of 10 days from the date of the onset of symptoms or a positive COVID-19 test result, minus the waiting period.
For example, if the plan has a five-day waiting period, and the plan member returns to work nine days after a positive test result, they would be eligible for four days of benefits payments.
If the claimant is still unwell after 10 days, then the standard Short Term Disability Claim Form (#421) needs to be completed.
If a plan member is admitted to hospital, benefits will be paid following the waiting period applicable to hospital claims. - [pdf] FeelingBetterNow
- [pdf] Equitable GIF Contract Provisions and Information Folder