2020 Annual Report
We ended our 2019 Annual Report letter by stating, “2020 will present additional challenges and opportunities for our clients and teams and our work in 2019 positions us well to navigate these changes.” While our statement sounds prophetic, it’s safe to say we could not have predicted the extent of those changes, but our collaborative work most certainly prepared us for the challenges we faced.
Even with these changes, one thing remained constant: health care costs continue to rise, and plan sponsors and their participants are striving for ways to save money while improving their experience. The team at Employers Health is here to help! Our commitment to our clients’ success remains steadfast as we continue to deliver on our promises for better outcomes, better experiences and lower costs. To that end, our existing clients ranked their satisfaction with Employers Health at a 4.75 on a 5.0 scale, our best result to date! To build on this success, we continue to make improvements to our solutions, grow our team and seek out new and innovative products and services that our clients find valuable.
On the growth side, we are proud to share that our sales team achieved a record-breaking year in 2020. We added 37 new clients to the organization, surpassing our goal by securing $260 million in new pharmacy spend. Thank you to the many consultants who afforded us the opportunity to participate in competitive evaluations and to those who continue to place their trust in us by awarding us new business. While industry consolidation continues at a record pace, consultants and their clients see the value that collaborative purchasing through Employers Health can have both now and in the future.
As we progress through 2021, we will once again be confronted with the need to change as we consider return to work challenges, employee vaccinations and a host of legislative, regulatory and employment law updates. We’ve built resilience and learned from our experience in 2020 and are appreciative of our strong relationships with each of our clients, colleagues and solutions providers. We look forward to tackling the challenges of 2021 with each of you, together!
Best Regards,
Greg & Chris
Gregory T. Troy
CHAIRMAN OF THE BOARD
Christopher V. Goff, Esq.
CEO & GENERAL COUNSEL
The pharmacy world is complicated. With EH’s navigational and purchasing support we are able to provide a valuable benefit package to employees at a reasonable cost.
employee benefits manager
Mission
Employers Health is committed to providing resources, tools and expertise to help plan sponsors deliver high-quality health care benefits at a sustainable cost.
How we accomplish our mission:
- Managing group purchasing strategies.
- Benchmarking and data interpretation.
- Building physically and mentally healthy workforces.
- Sharing ideas and best practices.
- Collecting and analyzing market intelligence.
- Supporting population health improvements.
- Creating an environment where all team members bring their best selves.
Vision
Employers Health will be a premier, nationally recognized employer-led organization with a focus of:
- Earning the trust of our clients and their consultants as a reliable and consistent resource for unbiased, objective resources and expertise.
- Managing a variety of growing and market-leading collective purchasing solutions including pharmacy, medical and ancillary benefits.
- Achieving consistently-high levels of client and participant satisfaction and loyalty by delivering on our promises and helping employers achieve their desired results.
Value
Employers Health brings value through a host of solutions that help our clients achieve:
- Affordable, high-quality health care benefits.
- Healthier employees who are more productive in their individual jobs, thereby creating better organizational performance.
- An informed workforce that interacts with the health care delivery system more effectively, leading to better health outcomes and lower costs.
- Fully engaged, resilient employees who can more effectively meet the challenges of today’s work and family environments.
- Work cultures with aligned incentives that produce employee loyalty and create “great places to work.”
Our relationship has been a tremendous help since I’ve joined the organization. EH’s ability to assist with the management of our PBM has been of great value, especially as I go through my first cycle with my employer. Their help in planning for 2021 benefit changes has been wonderful.
employee benefits manager
Better Outcomes. Better Experiences. Lower Costs.
1.3K
podcast downloads
11K+
eNotes viewed
230+
clients
3
benchmarking surveys
1.7B+
annual pharmacy spend
clients HQ in
34
states
50+
outside speakers
1.1M+
total lives in all 50 states
42
team members
2K+
event attendees
4900
average member group size
172K+
website views
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new clients
Working with EH has helped my company maintain a competitive advantage through effective pricing in our PBM contract. Year-over-year strategies help us to minimize increasing costs.
employee benefits manager
January 1998 Relationship Start
CVS Caremark is a leading pharmacy benefit manager. Together our dedicated account management teams work to reduce spend, increase adherence and improve outcomes.
88%
limit days’ supply on specialty drugs
91%
utilize the national retail network
95%
utilize the Advance Control Specialty Formulary
January 2013 Relationship Start
OptumRx is a pharmacy care services company going beyond traditional pharmacy benefit management. With synchronized engagement, PreCheck MyScript and personalized care through OptumRx Specialty, OptumRx provides customized solutions to employers.
100%
limit days’ supply on specialty drugs
89%
limit new-to-market drugs
89%
utilize the exclusive specialty strategy
January 2020 Relationship Start
Elixir was founded on the idea of providing an alternative to the traditional pharmacy benefit management (PBM) model and aligning interests with those of clients and their employees.
100%
utilize the standard formulary
100%
utilize the standard retail network
75%
utilize the exclusive specialty strategy
The biggest single area where EH provides value is through the group purchasing opportunities. Participation has resulted in both favorable financial outcomes and enhanced service.
director, total rewards
Contract Management
With more than 20 years of pharmacy benefit purchasing under our belts, Employers Health’s dedicated team of lawyers, pharmacists and employee benefits professionals have developed a straight-forward contract free of elaborate pricing games and confusing terms. As a result of our comprehensive contract negotiations, clients participating in our group purchasing program for pharmacy benefits have exclusive access to market-leading pricing guarantees, diverse network and formulary management options and robust service and performance guarantees.
Employers Health ensures that groups which participate in its PBM programs receive the most aggressive pricing and contractual terms available in the market through the annual market check process it undertakes with each of its PBM suppliers. Evaluated more than 180 times in 2020, the Employers Health pharmacy benefit management contracts are among the most scrutinized in the industry. In addition, each year Employers Health engages at least one national pharmacy practice to benchmark its pricing against generally available market pricing. With these data, long-term relationships with the PBM and the collective size of the Employers Health book of business, our in-house legal team annually negotiates with each PBM supplier to ensure that every group participating in an Employers Health pharmacy benefit management program achieves aggressive pricing and best-in-class contract terms.
The market check process that Employers Health undertakes on behalf of its participating groups has led to an overall consistently-negative trend and helped Employers Health participating groups offset the costs associated with changing drug mix and price inflation on brand drugs – specifically, treatments for diabetes, rheumatoid arthritis and chronic preventative medications. Moreover, an independent third-party audits the performance of each of its PBM suppliers relative to each Employers Health participating group to ensure contractual compliance. While findings through the audit process are rare, Employers Health participating groups receive 100% of any audit recoveries.
The market check and independent third-party audit are critical differentiators enjoyed by all Employers Health participating groups. They ensure that each participating group continuously experiences market-competitive pricing and contractual terms. These facets of Employers Health’s PBM programs, when combined with the unparalleled clinical and client solutions support, create a holistic solution that is second to none.
UnitedHealthcare’s Collaborative Ventures Group works with aggregators—predominantly composed of employer groups of 3,000+ eligible employees—to help create a strong value proposition for your company. A differentiated strategy is designed to help engage employees, improve outcomes and control costs. We do this by aligning with your objectives and demonstrating how we can help positively impact your business performance.
EyeMed Vision Care knows that your eyes – and the eyes of your employees – are amazing. They see everything, everywhere and everyone. That’s why EyeMed offers Employers Health clients the network employees want with vision benefits that redefine expectations, all while making the experience easy for both you and your employees.
ComPsych Corporation is the world’s largest provider of employee assistance programs and is the pioneer and worldwide leader of fully integrated EAP, employee wellness and work-life services under its GuidanceResources® brand. By creating “Build-to-Suit” programs, ComPsych helps employers attract and retain employees, increase employee productivity and improve overall health and well-being.
Smiles are important, and since dentists can detect more than 120 symptoms of non-dental diseases, it’s essential to follow good oral health habits for better overall health. Delta Dental is the largest and most experienced dental benefits carrier in the U.S. and is committed to oral and overall health.
ELMCRx Solutions understands the complexity of specialty drug management. Its unique method eliminates costs from the pharmacy benefit delivery system by combining powerful clinical management with real-time oversight to control costs and prevent unnecessary payments. Through an unbiased, review ELMC helps deliver the best outcome for the plan sponsor and member.
Us-Rx Care is the only single source of fully-integrated, fiduciary-compliant pharmacy risk management solutions. It delivers valuable, independent clinical solutions that work in conjunction with your existing PBM and provide both additional savings and ongoing protections against high cost and specialty pharmacy claims with little or no disruption.
Client solutions is the gold standard - proactive, responsive, optimal resource.
lead benefits representative
Clinical
As employers struggle to deal with a growing pharmacy spend, strategies to manage these rising costs are increasingly important. The Employers Health clinical team continuously monitors our book of business, often recommending and implementing custom clinical solutions to ensure appropriate use and exclusion of high-price, low-value drugs.
Our clinical team proactively identifies potential formulary issues and develops custom clinical strategies resulting in better adherence and ultimately a consistently flat to negative trend. Since 2016, the team has discovered opportunities to implement custom clinical interventions on more than 1,000 unique drugs, multivitamins and nutritional supplements. These strategies typically targeted low-value, high priced drugs and strengthened clinical criteria around the appropriate use of high priced drugs with a narrow patient population. Additionally, two strategies for dry eye and probiotics were implemented for the 2020 plan year.
Client Solutions
The client solutions team at Employers Health is dedicated to helping enhance results and achieve goals all while improving the participant experience. A testament to their dedication to the industry, eight of 14 client solutions executives have obtained or are in the process of earning their Certified Employee Benefit Specialist (CEBS) designation.
We’ve constructed a team of benefits experts to navigate the complexities of the pharmaceutical industry. Employers Health client solutions executives serves as a conduit to the vast resources within Employers Health and the PBM. Our size and scale allow us to take an active management approach in identifying proactive strategies for employers seeking to maintain a flat or negative trend in their drug spend.
The team coordinates implementations, monitors spend and trend and delivers innovative solutions for your unique needs.
Employers Health
An employer-led group purchasing coalition, our interests are aligned with those of employers. Employers Health is governed by a board of directors comprised of employers like you.
We’ve built a dedicated team to help you enhance results and achieve your goals all while improving the participant experience.
Employers Health provides value by auditing our drug spend and maintaining oversight of the PBM that we do not have the time or resources to do.
senior HR generalist
Audited Financials
Period Ending: September 30, 2020
| Current Assets | 131,705,279 |
| Net Fixed Assets | 4,308,234 |
| Other Assets | 426,500 |
| Total Assests | 136,440,013 |
| Current Liabilites | 124,760,308 |
| Other Liabilities | 2,170,759 |
| Equity | 9,508,946 |
| Total Liabilities & Net Assets | 136,440,013 |
| Total Revenue | 419,234,482 |
| Total Disbursements | 416,434,270 |
| Net Income | 2,800,212 |