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Patient Right to Know Drug Prices Act

Category: Employee Benefits & Strategies
Published: October 11, 2018
On October 10, 2018, President Trump signed into law the “Patient Right to Know Drug Prices Act”. The Act removes the ability for a PBM to enforce a contractual clause prohibiting a pharmacy from telling a covered individual the difference between his/her out-of-pocket cost for a medication and what the cost of the medicat... read more

100 Days of Action: What the American Patients First Blueprint Means for Member Organizations and Self-Funded Plan Sponsors

Category: Employee Benefits & Strategies
Published: September 20, 2018
100 days have passed since President Trump introduced the American Patients First Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs. Dan Best, senior advisor to the secretary for drug pricing reform for the U.S. Department of Health and Human Services recently authored a report on progress the administration has ma... read more

2018 Flu Vaccine Info

Category: Wellness / Employee Well-being
Published: September 12, 2018
Protect your employees and workplace from the flu! Check out this infographic and share it with your employees to learn: Why people should get the flu vaccine How the vaccine works How you can protect your employees and workplace Who should get vaccinated and more read more

5 Tips for Open Enrollment Season

Category: Employee Benefits & Strategies
Published: September 7, 2018
Open enrollment season is upon us! So, we’re giving you five easy-to-follow tips and tricks to help your benefits team stay in the right frame of mind and ensure a successful open enrollment, from Employers Health Account Management Executive, Meghan Dougherty.  1). Start early – Your team prepares early for open enrollme... read more

Continuing to Consolidate: Health Care Mergers & Acquisitions

Category: Employee Benefits & Strategies
Published: August 9, 2018
Edited 10/4/18 With prescription drug prices rising, the spotlight is shining brightly on the health care industry. Consumers and politicians alike have questioned how best to curtail rising prices. Consolidation is a central strategy of managed care organizations, pharmacy benefits managers, pharmacies, wholesalers and insure... read more

Where Policy Meets Culture: Aligning for Mental Health at Work

Category: Mental Health / Depression
Published: August 9, 2018
Change is hard, and many benefits professionals may not feel empowered or equipped with the resources needed to be on the cutting edge of adopting and implementing innovations. Benefits professionals routinely ask: Who else is doing “it”? What exactly are others doing? What results are those other employers experiencing? ... read more

Migraine Meds: An Employer’s Next Big Headache in Drug Spend

Category: Pharmacy Benefits / Specialty Pharmacy
Published: August 9, 2018
In 2014, it was hepatitis C drugs while 2015 brought us PCSK9 inhibitors. Could 2018 be the “blockbuster” year of calcitonin gene-related peptide (CGRP) inhibitors for migraines? As was the case with those previous therapies, CGRP drug uptake will depend on a plan sponsor’s population and how efficiently the class is man... read more

Human Resource Professional: An Agent for Change

Category: Cancer / Oncology Benefits
Published: July 24, 2018
A Human Resource (HR) professional wears many hats in his or her organization. They recruit and train staff, manage payroll, benefits, rewards and compensation, address performance issues… …the list could go on and on. But an HR professional as an agent for change? That’s new. Add that to the long list of job responsibil... read more

2018 Excellence in Benefits Award Winner

Category: Employers Health News
Published: May 21, 2018
Employers Health, a professional benefits organization, is announcing the 2018 recipient of its Excellence in Benefits Award. The award is intended to recognize annually, an individual who has made meaningful impact in the field and/or delivery of employee benefits.   This year’s winner is Violet Vernon, senior manager in ... read more

Now or Later: Rebate Considerations for Plan Sponsors

Category: Pharmacy Benefits / Specialty Pharmacy
Published: May 3, 2018
In the era of high deductibles and co-insurance, what plan sponsors do with rebate dollars generated from brand drug utilization has come under more intense focus.  Today, many plan sponsors utilize rebate dollars received from the Pharmacy Benefit Manager (PBM) to offset total plan costs, thereby factoring into the rate-sett... read more

The Tax Cuts and Jobs Act: What Does it Mean for You?

Category: Employee Benefits & Strategies
Published: March 15, 2018
It’s hard to believe that we’re almost through the first quarter of 2018. With the start of the new year, and the signing of the Tax Cuts and Jobs Act (TCJA) in December 2017, we have seen many changes regarding tax reform. I have been reading various articles and talking to other CPA’s on the topic to understand the imp... read more

Employers Health is a Great Place to Work

Category: Employers Health News
Published: March 3, 2018
Employers Health was certified as a great workplace by the independent analysts at Great Place to Work®. Employers Health earned this credential based on extensive ratings provided by its employees in anonymous surveys. Great Place to Work® is the global authority on high-trust, high-performance workplace cultures. Surveys w... read more

In-Focus: A Snapshot of the Pharmacy Benefit Industry

Category: Pharmacy Benefits / Specialty Pharmacy
Published: November 15, 2017
The pharmacy benefit marketplace has been at the center of attention lately due to a combination of factors, including the growing list price of brand medications and the impact their prices have on the participant, particularly those enrolled in high deductible health plans. The outrage over Mylan’s price inflation of its E... read more

Coming Soon: Million Dollar Drugs – How can employers prepare for gene therapies?

Category: Pharmacy Benefits / Specialty Pharmacy
Published: November 8, 2017
A new age of medicine is upon us, and it comes in the form of personalized gene therapy. Recent developments have pushed the single-dose, potentially curative treatments with high projected price tags closer to launch. Thus, the benefit design and coverage for engineered genes to treat, prevent and cure diseases are a rapidly ... read more

The American Health Care Act and Beyond

Category: Health Care Reform
Published: June 1, 2017
The Trump Administration and Republican controlled Congress have begun an attempt to advance certain objectives that have become dogmas during the election. One such objective is to repeal and/or replace the Affordable Care Act (ACA). Unlike prior GOP efforts related to funding restrictions and legal challenges that were met w... read more

2017 Excellence in Benefits Award Winner

Category: Employers Health News
Published: May 25, 2017
Employers Health, a professional benefits organization, is announcing the first-ever recipient of its Excellence in Benefits Award. The award is intended to recognize annually, an individual who has made meaningful impact in the field and/or delivery of employee benefits. This year’s winner is Jessica Ward, benefits manager ... read more

What is the Deal With Drug Price Inflation

Category: Pharmacy Benefits / Specialty Pharmacy
Published: May 4, 2017
Providing affordable and sustainable benefits is a primary goal for employers that offer prescription drug coverage. Recent press and public scrutiny over rapidly rising drug prices has revealed the struggle many plan sponsors experience in their efforts to achieve that goal. It is not a secret that annual drug price inflation... read more

A collaborative benefits management strategy for total population health

Category: Employee Benefits & Strategies
Published: January 5, 2017
Benefits Accelerator® is a value-based strategy that harnesses a robust technology platform, preferred vendors with proven concepts and results that emphasize heightened health status and well-being. This collaborative approach can accelerate a plan sponsor’s objectives to control health care costs, improve health outcomes ... read more

Recent Wellness Program Regulations: ADA & GINA

Category: Compliance / Reporting
Published: December 1, 2016
As plan sponsors prepare for open enrollment, attention should be given to the Equal Employment Opportunity Commission’s (EEOC) new wellness regulations under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA). With final rules, released May 16, 2016, regarding notice and finan... read more

Biosimilar Basics for Plan Sponsors

Category: Pharmacy Benefits / Specialty Pharmacy
Published: November 16, 2016
The rise of specialty pharmacy spend and trend can be traced back to the work of pharmaceutical manufacturers determined to provide targeted biological treatment for complex medical conditions. We must now count on these same manufacturers to create the competition necessary to provide these innovative treatments in an afforda... read more

Tailor-Made: Uniquely Personal Well-Being

Category: Wellness / Employee Well-being
Published: October 8, 2016
The saying goes “sometimes you have to go back to the beginning in order to move forward.” The well-being industry progresses from one trend to the next with new vendors constantly emerging with the latest and greatest unproven solution, claiming this is the one to transform the health of your workforce or build your cultu... read more

Medical Marijuana Laws Still Hazy: Does the Legalization of Medical Marijuana Mean it Must be Covered by Your Health Plan?

Category: Compliance / Reporting
Published: May 7, 2016
Ohio recently became the 25th state to legalize the use of medical marijuana for certain qualifying diseases and conditions. Despite the “growing” popularity of these state laws, marijuana remains classified as a Schedule I substance and is illegal under federal law. According to the Drug Enforcement Administration, Schedu... read more

Healthy Organizations Creating Well Workforces

Category: Wellness / Employee Well-being
Published: May 5, 2016
The link between workforce health and a healthy organizational bottom line has been repeatedly made through research. According to one study, companies with high employee engagement had a 19 percent increase in operating income and nearly a 28 percent growth in earnings per share. read more

ACA Employer Mandate and ERISA Implications

Category: Compliance / Reporting
Published: May 4, 2016
Many in the legal community warned of possible Employee Retirement Income Security Act of 1974 (“ERISA”) implications and litigation risk surrounding scheduling decisions made by employers in order to avoid being subjected to an Affordable Care Act (“ACA”) penalty for failure to offer coverage to full-time employees. read more

Why is My PBM Pushing a Multi-Year Pricing Contract?

Category: Employee Benefits & Strategies
Published: April 5, 2016
Most plan sponsors evaluate the pricing competitiveness of their pharmacy program the same way – by going out to bid for a new pharmacy benefits manager (PBM). But, running a bid process can be expensive and difficult to manage. Therefore, plan sponsors tend to avoid the process all together. PBMs use this to their advantage... read more

EH Pharmacy Trend Less Than 1% in 2015

Category: Employers Health News
Published: April 3, 2016
For 2015, clients in the Employers Health pharmacy benefit management (PBM) solution experienced an overall average per member per year (PMPY) cost trend of nine-tenths of one percent. While drug price inflation, utilization of expensive specialty medications to treat diseases such as hepatitis C and greater utilization increa... read more

The Impact of Opioid Addiction to Plan Sponsors

Category: Pharmacy Benefits / Specialty Pharmacy
Published: March 4, 2016
Car crashes are no longer the leading cause of injury death in the United States. That morbidly-esteemed title now belongs to overdose deaths due to opioids either by prescription or heroin that claims the lives of seventy-eight Americans daily. The abuse and overprescribing of opioid analgesics is an epidemic that requires al... read more

Survey Says Employers Continue Efforts to Reduce Health Benefit Costs

Category: Employee Benefits & Strategies
Published: March 3, 2016
The “Cadillac Tax” is a 40 percent excise tax on the cost of employer-sponsored health coverage that exceeded certain cost thresholds. As originally enacted by the Affordable Care Act (“ACA”), the Cadillac Tax was non-deductible and scheduled to begin in 2018. Although the tax was intended to only impact “high-cost... read more

Nominate an Outstanding Benefits Professional Today

Category: Employers Health News
Published: January 3, 2016
Employers Health, a professional benefits organization, is currently accepting nominations for the Excellence in Benefits Award. The award seeks to recognize an individual annually who has made meaningful impact in the field and/or delivery of employee benefits. Nominations for the award will be accepted now through January 31... read more

Cultures of Health and Engagement – Small Steps, Big Rewards

Category: Wellness / Employee Well-being
Published: November 1, 2015
Organizations commit millions of dollars each year to designing the optimal compensation and benefits packages for their workforces. They spend considerable resources providing perks to attract and retain high-performing employees in their marketplaces. Top talent is hired to lead the charge, forming strong human resource and ... read more

2015 Fall Medication Approval and Strategy Update

Category: Pharmacy Benefits / Specialty Pharmacy
Published: October 10, 2015
Employers Health is pleased to provide this seasonal medication update! the goal of this piece is to inform our members about the latest pharmaceutical industry news relevant to employers while providing analyses and strategies to best manage these trends. Please send any questions or comments to our clinical pharmacist, Matth... read more

PBM Annual Market Check

Category: Pharmacy Benefits / Specialty Pharmacy
Published: September 15, 2015
Member organizations that participate in an Employers Health PBM program enjoy an uncommon feature known as an annual “Market Check.” What is the Market Check and what role does it play in delivering value to plan sponsors? Customary PBM Contracts The pharmaceutical marketplace is dynamic. However, most agreements between... read more

ACA Reporting – How are employers managing the new requirements?

Category: Compliance / Reporting
Published: August 3, 2015
In a recent survey completed by Employers Health, 32 percent of employers reported their organizations were unprepared for the Sections 6055 and 6056 reporting requirements under the ACA. For large, self-insured employers, not only are these requirements burdensome, with an estimated time of 12 minutes to complete each Form 10... read more

Managing the Complexity of Specialty Pharmacy Benefits

Category: Pharmacy Benefits / Specialty Pharmacy
Published: May 13, 2015
Defining specialty Specialty drugs do not have a consensus definition across all stakeholders in the specialty space, but they can generally be thought of as high-cost medications used to treat complex conditions. Often, these medications are biologically developed from a living organism into products such as hormones, protein... read more

Cancer as a Chronic Condition

Written By: Employers Health
Category: Cancer / Oncology Benefits
Published: May 10, 2015
In the past several years, cancer has become an important focus for employers, for a number of reasons. Perhaps most significant is the fact that an increasing number of cancers are being identified in the workforce. Better diagnostic testing, elimination of patient financial barriers to cancer screening, and an aging workforc... read more

Depression: The Unexpected Threat to Your Company

Category: Mental Health / Depression
Published: May 4, 2015
As a first-of-its-kind initiative, Right Direction has received national attention for its leadership in addressing depression in the workplace. To validate the societal and economic burden of how depression impacts employers, Employers Health launched the results of The Impact of Depression at Work Audit (IDeA)* survey (Ipsos... read more

Recent Wellness Program Litigation and the Cadillac Tax

Category: Compliance / Reporting
Published: April 1, 2015
As plan sponsors grapple with rising claims cost, many have turned to wellness programs to not only reduce costs, but also to improve the well-being of their plan participants. With the impending Cadillac Tax threatening a 40 percent excise tax on high-cost health coverage, wellness programs could be a key element in plan spon... read more

Voluntary Means Voluntary? AARP Prevails in Challenge to EEOC’s Interpretation of Voluntary and How Plans Should Respond

Category: Compliance / Reporting
Published: February 13, 2015
A December 2018 court ruling dealt many incentivized wellness programs a serious blow. This comes as wellness programs continue to lose some of their luster for many plan sponsors. The ruling itself is generally summed up as a condemnation of the Equal Employment Opportunity Commission’s (EEOC’s) definition of voluntary re... read more

Female Libido Drug Raises Clinical and Legal Considerations

Category: Pharmacy Benefits / Specialty Pharmacy
Published: January 4, 2015
With the recent approval of Addyi (flibanserin) for the sudden and unexplained loss of libido for premenopausal women, plan sponsors must weigh clinical and legal considerations. There are very important questions over Addyi’s low efficacy, concerning side effects, and the potential for gender discrimination. read more

Clocked In, Checked Out

Category: Mental Health / Depression
Published: December 2, 2014
Numerous studies have illustrated the cost of unhealthy workers to their employers in terms of increased medical, pharmacy and disability claims. In 2006, more than $2 trillion was spent on health care with three fourths of that amount focused on treating chronic conditions (Goetzel, 2009). Research in abundance demonstrates n... read more

Understanding the Hepatitis C Virus and its Impact on Employers

Category: Pharmacy Benefits / Specialty Pharmacy
Published: October 4, 2014
Making it the most common chronic bloodborne infection in the US, an estimated 3.2 million people are impacted by the Hepatitis C virus (HCV). Many are concerned about the approved HCV medications and high-cost therapies. To better understand the benefit implications of HCV, it is important to grasp the risk factors and clinic... read more

Obesity in the Workplace

Category: Obesity
Published: October 4, 2014
Are you doing all you can to combat this disease? The American Medical Association (AMA) defines a disease as an impairment of the normal functioning of some aspect of the body, with characteristic signs and symptoms that result in harm or morbidity to the entity affected. In June 2013, the AMA officially declared obesity a di... read more

Thinking About a Private Exchange? Here are some helpful considerations when making a selection

Written By: Employers Health
Category: Employee Benefits & Strategies
Published: September 3, 2014
Over the past 10 years, employer expenditures for employee health care were perceived as a “necessary evil,” as employers used health benefits as part of their attraction and retention strategies. With health care costs rising faster than the general inflation rate, employers and plan sponsors have been faced with the chal... read more

IRC Section 6055 and 6056 Reporting: Fast Facts

Category: Compliance / Reporting
Published: September 3, 2014
Applicable large employers (“ALE”) and employers who provide minimum essential coverage will have to file additional tax forms in 2016 for the 2015 plan year. Listed here is a brief overview of the information that employers and plan sponsors will be required to provide. 6055: • Name, address and EIN of the plan sponsor... read more

Total Well-being: Moving Past the Physical Domain

Category: Wellness / Employee Well-being
Published: April 1, 2014
In a recent Employee Benefits News article, Jeffrey Pfeffer, a professor of organizational behavior at Stanford University’s graduate school of business, was quoted at the annual Great Place to Work conference in New Orleans as saying, “Health and wellness programs are virtually meaningless if a workplace culture is bad.... read more

The Importance of Immunization

Category: Wellness / Employee Well-being
Published: September 13, 2013
Since the creation of the smallpox vaccine over two hundred years ago, immunization from viruses has been one of the most cost-effective strategies to protect the public from illness. From polio to tuberculosis, many of the world’s once-feared diseases have been eradicated or substantially weakened due to the ability of a va... read more

Moving Beyond Biometrics

Category: Obesity
Published: April 11, 2013
To date, many corporate wellness programs have been created with the Biomedical Model at their foundation. This conceptual model of illness which excludes psychological and social factors and includes only biologic factors in an attempt to understand a person’s medical illness or disorder (Stedman’s Medical Dictionary, 201... read more