Intro
Renowned American businessman James Cash Penney was quoted as saying, “Growth is never by mere chance; it is the result of forces working together.” Employers Health has seen record-setting growth over the past several years, and 2023 was no exception. We have grown in several key areas, greatly increasing our
purchasing power.
Our unwavering commitment to excellence and strategic vision, along with your trust in our organization, has allowed us to continue to achieve milestones. This year, we welcomed 60 new clients and an additional $550 million in pharmacy spend, surpassing $3 billion in total. We now have clients headquartered in 40
states, covering more than 1.6 million lives in all 50 states.
This immense growth necessitates the addition of talented team members and office space. In the past year, we have created new roles and hired 25 team members to ensure you are receiving the support and service you expect from Employers Health. Soon, some of the team will move into our new corporate headquarters, conveniently positioned next to our existing Canton office with ample space and accommodations for
client meetings and large gatherings.
We regularly ask our clients to evaluate their satisfaction with our organization, and we are delighted to report that 97% of respondents said Employers Health improves the PBM experience. While our annual client satisfaction ratings are high, we remain committed to continuously enhancing our services and addressing client needs. Our team takes client feedback seriously and strives to implement suggestions wherever possible. Please let us know if there is any way we can be of assistance.
As we continue to welcome new employees and clients, our mission remains the same, “to provide resources, tools and advice to help plan sponsors deliver high-quality health care benefits at a sustainable cost.” Our team stays ahead of the curve, continuously learning, researching and adapting to meet your needs. We are your advocates and are here to help.
We thank you for your continued trust and support in Employers Health. It is because of you, we can continue to bring affordable pharmacy benefits to employers nationwide.
Best Regards,
Joe Chaddock & Chris Goff
Joe Chaddock
CHAIRMAN OF THE BOARD
“ Employers Health is an excellent partner in managing our pharmacy benefits. They are proactive, professional and consistent. ”
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 on:
- 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”
Board of Directors
Better outcomes, better experiences, better costs
Clients By Region
Clients by Region
Clients by Industry
23%
manufacturing
24%
education and government
13%
health care
7%
financial and professional services
33%
other
Pharmacy Benefit Management Providers
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 30 days’ supply on specialty drugs
96%
utilize the national retail network
97%
utilize the Advance Control Specialty Formulary
JANUARY 2013 RELATIONSHIP START
Optum Rx is a pharmacy care services company going beyond traditional pharmacy benefit management. With synchronized engagement, PreCheck MyScript and personalized care through Optum Specialty Pharmacy, Optum Rx provides customized solutions to employers.
96%
utilize the exclusive specialty strategy
100%
limit 30 days’ supply on specialty drugs
100%
limit new-to-market drugs
Client Satisfaction Scores
“ They can be trusted to provide well-thought-out feedback that touches both the employee’s and the employer’s perspectives. ”
Clinical
As managing pharmacy spend becomes even more complicated, employers are seeking innovative ways to tackle rising costs head-on. At Employers Health, our dedicated clinical team proactively monitors the pharmaceutical pipeline and analyzes our book of business. Their goal? To recommend and implement tailored clinical solutions that promote appropriate utilization and cost management of high-price, low-value drugs. By staying one step ahead, we help employers achieve better adherence rates and consistently maintain flat-to-negative trend on targeted products.
Since 2016, our clinical team has identified over 1,000 unique drugs, multivitamins and combination products where custom clinical interventions could be implemented. These strategies primarily target medications that contribute to inefficient spending, focusing on strengthening the clinical criteria surrounding the appropriate use of costly drugs with a limited patient population. For the 2023 plan year, the team has introduced specific strategies for high-cost generics, obesity medications and acne treatments. By developing comprehensive reporting, they assess the savings achieved versus any potential disruption and offer valuable guidance to clients, ensuring the selected strategies align with their unique plan philosophy.
Beyond our custom management solutions, our clinical team provides value through:
- Weekly reviews of high-cost claims to check for clinical appropriateness
- Participation in client plan reviews
- Engaging blog posts and articles available at employershealthco.com
- Expert presentations at conferences and webinars
The Employers Health clinical team is here as your resource for all of your clinical concerns. Don’t hesitate to reach out at [email protected] with any questions. Together, we can navigate the complex landscape of pharmacy benefits and achieve optimal outcomes for your organization.
Client Solutions
The client solutions team at Employers Health is dedicated to enhancing results and achieving your goals all while improving the participant experience. As a testament to their dedication to the industry, over half of Employers Health’s client executives have obtained or are in the process of earning their Certified Employee Benefit Specialist (CEBS) designation. In addition, all client executives must receive their accident, health and life insurance licenses from the Ohio Department of Insurance.
We’ve constructed a team of benefits experts to navigate the complexities of the pharmaceutical industry. Employers Health client executives serve as a conduit to the vast resources within Employers Health and your chosen PBM. Our size and scale allow us to take an active management approach in identifying proactive strategies for employers seeking to maintain a flat-to-negative trend in their drug spend. The team facilitates implementations, monitors spend and trend and delivers innovative solutions tailored to your unique needs.
In today’s complex benefits environment, increasingly intricate knowledge is required of human resource professionals to effectively manage the benefits offered to plan members. PBMs are complex organizations that can be difficult to navigate without the assistance of an experienced professional. We strive to reduce or eliminate those complexities for our clients to create a better experience for the plan and its members. Our team aids our clients in the day-to-day management of their pharmacy plans allowing our clients to direct their focus on overarching benefits strategies.
“ They frequently bring positive clinical insights and strategies to help us drive our strategy around positive member experience and lower company cost. ”
Contract Management
For more than 25 years, Employers Health has been improving the pharmacy benefit purchasing experience for self-insured employers. Employers Health’s dedicated team of pharmacists, data analysts, business intelligence professionals, lawyers and employee benefits experts develop and maintain a straight-forward contract free of elaborate pricing games and confusing terms. Through comprehensive contract negotiations, clients participating in our pharmacy benefits group purchasing program have exclusive access to market-leading pricing guarantees, diverse network and formulary management options and robust service and performance guarantees.
One of the key components of the contractual arrangements between Employers Health and its PBM suppliers is the annual market check. The market check provision in Employers Health’s PBM arrangements allows Employers Health to annually renegotiate the terms of its contractual arrangements to add service offerings, clarify terms, strengthen financial and non-financial guarantees and, in a nutshell, adjust for market dynamics. Many PBM arrangements are three-years long with no formal vehicle for adjustment based on market dynamics. Over a three-year period, significant changes occur in the health care space, and the PBM industry is no exception. An annual market check is critical to ensuring that Employers Health clients have a contract that stays abreast of current market dynamics.
The market check process integrates market intelligence and data analysis, where a significant portion of the market intelligence is derived from participating in competitive bids. In 2023 alone, Employers Health’s PBM contracts underwent over 300 evaluations, making them some of the most scrutinized contracts in the industry. Regardless of the results of these evaluations, the insights gleaned from our participation in the evaluation process help to identify areas of strength or weakness.
The challenge with competitive intelligence from participation in competitive bids is the information gained from that process tends to be overly specific or broad. To get a complete picture of the competitiveness of Employers Health’s PBM offerings, each year Employers Health engages at least one national pharmacy practice to benchmark the aggregate value of the financial arrangements within its PBM contracts against competitive offerings. Additionally, Employers Health leverages its data analytics and business intelligence
teams to identify trends that will impact financial guarantees. With these data, long-term relationships and the collective size of the Employers Health book of business, our in-house legal team annually negotiates with our PBM suppliers to ensure every group in an Employers Health pharmacy benefit management program achieves aggressive pricing and best-in-class contract terms.
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“ [With Employers Health] we have purchasing power that we would not otherwise have and access to subject matter experts. ”
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