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What Does Blue Shield of California’s New Unbundled Pharmacy Model Mean to Employers?

… quo. So, what does this news mean to employers? Employers seeking lower costs should proceed cautiously. This new model is a great opportunity to request stronger guaranteed discounts, rebates, and even trend guarantees. These types of guarantees are not generally available in traditional carve-in models, where medical and pharmacy benefits are bundled together. Pharmacy carve-out is likely necessary, and a market check is essential even if there is no intention to change PBMs. By negotiating for these guarantees, employers can ensure they are receiving the best possible pricing for their employees’ prescription medications. Additionally, employers should request the …

https://www.epicbrokers.com/insights/blue-shield-unbundled-pharmacy-model-and-employers/

Compliance Matters Newsletter | September 2023

Let our team help you navigate the ever-changing benefits compliance landscape each month. Check out this month’s latest alerts, additional updates, and resources – hot off the press: Employee Benefits Compliance Alerts The Facts About Potential California Long-Term Care Legislation State-managed Long-Term Care (LTC) programs are a focus of many state legislatures, including California. California released the results of a Long-Term Care Task Force feasibility study in December 2022 and intends to release an actuarial study in January 2024. While no legislation has been introduced in California yet, employers and employees should be aware of …

https://www.epicbrokers.com/insights/compliance-matters-newsletter-september-2023/

Legislation to Reform the ACA’s Employer Reporting Requirements

Employers have long sought relief from the burden of the reporting requirements under Sections 6055 and 6056 of the Affordable Care Act (ACA) for enforcement of the individual and employer mandates. Currently, employers and health insurance providers that provide minimum essential coverage must report information for each covered individual to the Internal Revenue Service (IRS), including the covered individual’s social security number. Employers and providers must also send a copy of this information to the covered individual (through tax forms 1095-B and 1095-C) by January 31 of each year. The error rate of 82% is indicative of …

https://www.epicbrokers.com/insights/legislation-reform-acas-employer-reporting-requirements/

Market Pulse Survey: 2023 Cost Containment and Non-Traditional Benefits

How does your company balance increasing benefits costs while meeting evolving employee needs? Increased claims and medical cost inflation are back with a vengeance after the suppression experienced during the pandemic. Simultaneously, employers need highly competitive benefits and perks to find and keep talent. We’d like to invite you to take our 2023 Cost Containment and Non-Traditional Benefits survey to see how other companies are addressing this challenge. TAKE THE SURVEY The survey will take about 3 minutes to complete. Participate to get insights into strategies for cost containment and make better decisions for your company and team …

https://www.epicbrokers.com/insights/2023-cost-containment-market-pulse-survey/

Way to Wellness Newsletter | September 2023

Burnout-Free Volunteering & Caregiving Evidence shows that helping others can benefit mental health and wellbeing. Many organizations are seeing a rise in mental health claims and concerns. Encouraging volunteerism and a sense of purpose among your employees is one way to combat the problem. Effective leaders often use empathy-based communication and sponsor volunteering initiatives. It’s important to show employees how they can spread kindness without experiencing burnout. Share these tips with your employees to help build a culture of service that promotes employee wellbeing.  Copy the Employee-Facing Email Burnout-Free Volunteering & Caregiving Download the Word file, then …

https://www.epicbrokers.com/insights/way-to-wellness-newsletter-september-2023/

PBM Drug Pricing Practices Under Increased Scrutiny from Senate HELP Committee

Bipartisan Support for PBM and Prescription Drug Reform On Thursday, May 11, 2023, the Senate Health, Education Labor and Pensions (HELP) Committee approved four new bills and eight bipartisan amendments by a vote of 18-3. One of the bills introduced, the Pharmacy Benefit Manager Reform Act (S. 1339), establishes new requirements for pharmacy benefit managers (PBMs) as well as associated civil penalties. The committee aims to increase transparency, improve employer decision-making and reduce prescription drug costs. PBMs are important intermediaries between drug manufacturers, pharmacies, insurers and plan sponsors. PBMs negotiate drug rebates and fees with drug manufacturers, reimburse …

https://www.epicbrokers.com/insights/pbm-drug-pricing-practices-under-increased-scrutiny/

August Is National Wellness Month

Many Americans are getting ready for pool season and fun in the sun. Unsurprisingly, we’ve seen an increase in the popularity of GLP-1 agonists for their effectiveness at weight loss. Obesity rates continue to rise nationwide. According to the Centers for Disease Control and Prevention, over 40% of Americans are obese (BMI >30). An additional 31% of the population is overweight (BMI 25-29.9). This is a major public health concern as weight issues can lead to other chronic conditions like diabetes, musculoskeletal concerns, hypertension, and some forms of cancer. Not only is obesity dangerous if left …

https://www.epicbrokers.com/insights/national-wellness-month/

Compliance Matters Newsletter | August 2023

Let our team help you navigate the ever-changing benefits compliance landscape each month. Check out this month’s latest alerts, additional updates, and resources – hot off the press: Employee Benefits Compliance Alerts Washington State Long-Term Care Is Now in Effect Originally established in 2021, the Washington Cares Fund provides long-term care for Washington workers. Payroll deductions of .58% of wages began July 1, 2023. Most employees can no longer apply for a private-plan exemption, although some exceptions are available. Workers who contribute the required length of time may apply for benefits starting in July 2026. Learn …

https://www.epicbrokers.com/insights/compliance-matters-newsletter-august-2023/