The ETFO ELHT Benefits Plan announced in May 2022 that plan members or their dependants using Humira, Enbrel, and Lantus would be required to switch to the corresponding biosimilar effective September 1, 2022.  A transition period was provided to December 1, 2022.  Correspondence via email and Canada Post has been sent regularly since June 2022 to affected plan members.  If you still have not made this switch by November 30, 2022, coverage will no longer be available for these three medications effective December 1, 2022. 

What you need to do if you have not already made the switch:

1. Please email the OTIP Facet Prior Authorization Program at claims@facetprogram.ca or call 1-844-492-9105. The OTIP Facet Program Clinical Team will guide you in terms of next steps and help look after any administration required to facilitate the change to the biosimilar drug.
2. Fill out and sign the form titled Biosimilar Switch that you have previously received to provide consent to the OTIP Facet Program Clinical Team to participate in the process. (contact claims@facetprogram.ca if you cannot find your form)
3. Schedule an appointment or contact your doctor or pharmacist to discuss the switch if you have any questions or concerns. Have your doctor complete and sign the form.
4. Submit the completed form by fax to 1-844-446-1575 or email a scanned copy to OTIP@facetprogram.ca

Questions

If you have any questions about this coverage change under the ETFO ELHT Benefits Plan, please contact OTIP Benefits Services at 1-866-783-6847.

To read the notices emailed to plan members on May 18, 2022, and September 8, 2022, please click on the links below:

September 8th:

• Teacher/LTO Benefits Plan  
• Education Worker Benefits Plan (Permanent DECEs, PSPs, ESPs)

May 18th:

• Teacher/LTO Benefits Plan  
• Education Worker Benefits Plan (Permanent DECEs, PSPs, ESPs)