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Managing Pharmacy Costs Is Key for Employers

Viewpoints from Briana Loff Every year, Express Scripts (ESI), one of the nation’s top leading pharmacy benefit managers (PBMs), releases its annual drug trend report. Their report for 2019 analyzed costs and spending for over 33.6 million members currently enrolled in one of their drug plans. Express Scripts noted this is the third year in a row they’ve been able to keep drug spend under 3%, which is a huge deal. The top cost drivers for 2019? Inflammatory conditions such as psoriasis and rheumatoid arthritis, which drove 43.7% of spending. To give you some reference, diabetes …

https://www.epicbrokers.com/insights/managing-pharmacy-costs-is-key-for-employers/

The Biden Healthcare Blueprint Has Been Released

Healthcare, no doubt, will be a critical election issue. President Trump continues to press for the complete repeal of the Affordable Care Act (ACA). This, despite the fact that 500,000 Americans have acquired coverage on the exchanges since the onset of COVID-19. Americans are very concerned about healthcare and it seems this will be an area of vulnerability in November. The president sees this, announcing three upcoming executive orders on drug pricing. Meanwhile, Joe Biden, the presumptive Democratic presidential nominee, has rolled out his vision of changing healthcare by introducing his plan, which claims will increase enrollment to …

https://www.epicbrokers.com/insights/the-biden-healthcare-blueprint-has-been-released/

COVID-19 Pharmacy Update

Summary The world continues to attempt to control the spread of Coronavirus (SARS-CoV-2, COVID-19), which was declared a global pandemic or indirect immunity by the World Health Organization (WHO) on March 11, 2020. Over 100 vaccines are currently in development, and none of them have been approved by the U.S. Food and Drug Administration (FDA). Realistically, commercial availability of a vaccine is likely at least 12 to 18 months away. However, treatment of the disease currently centers on managing symptoms and supportive care for patients, while pharmaceutical companies, universities, and government agencies around the world are …

https://www.epicbrokers.com/insights/covid-19-pharmacy-update/

Covering Coronavirus: Risk Considerations Volume 1, Issue 18

EPIC Risk Advisory Bulletin Volume 1, Issue 18 The global COVID-19 (coronavirus) pandemic remains both dynamic and fluid. We continue to see unprecedented disruptions at home and abroad. In this issue, we take a focused look at: General Information on Coronavirus Supply Chain and Business Risks U.S. DOL Acts to Help American Workers and Employers FMCSA Notice on Random Drug and Alcohol Testing Compliance Insurance Products and Coverage Information Business Interruption Litigation Update Liability Immunity Measures Move Forward News of Note Human Resources and Employee Benefits Coronavirus Testing Raises Questions Presumptive Compensability Legislation Update Coronavirus-Related Claims Rise …

https://www.epicbrokers.com/insights/covering-coronavirus-risk-considerations-volume-1-issue-18/

Community Wellness: A Lesson in Social Distancing

Viewpoints from Claire Letourneau Let me tell you what keeps me up at night. I’m a risk-averse person by nature, so when the officials said to stay home, I surely did. I only went out for food and to walk my four-legged fur baby. When I did venture into public, I was thrilled to see the measures Trader Joe’s had taken to keep everyone safe! They were only letting 10 people in at a time and we had the full length of a disinfected shopping cart between us as we waited in line outside! It was …

https://www.epicbrokers.com/insights/community-wellness-a-lesson-in-social-distancing/

Departments Propose Rule to Help Plans Maintain Grandfathered Status

The U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) today issued a proposed rule to amend the requirements for grandfathered group health plans and grandfathered group health insurance coverage to preserve their grandfather status. First, the proposed rule would clarify that grandfathered group health coverage that is a high-deductible health plan (HDHP) may increase fixed-amount cost-sharing requirements, such as deductibles, to the extent necessary to maintain their status as an HDHP without losing grandfather status. This change would ensure that participants and beneficiaries enrolled in that coverage remain eligible to …

https://www.epicbrokers.com/insights/departments-propose-rule-to-help-plans-maintain-grandfathered-status/

Flight to Quality

For more of our coronavirus coverage, visit epicbrokers.com/coronavirus  Viewpoints from Adam Okun On March 23, 2010, when the Affordable Care Act was signed into law, I remember my initial sense of resignation. There was so much uncertainty as to what its impact would be on our industry. Putting aside the broader social debate over whether the law would be beneficial for the country (hint: it varied based upon your economic and employment position), as a young actuarial healthcare consultant, I was looking at the 30-year+ career ahead of me and wondering if this would change everything – perhaps …

https://www.epicbrokers.com/insights/flight-to-quality/

2021 Healthcare Cost Trends Are Rising

The EPIC actuarial team and many others have projected 2020 employer-based medical cost trends to be relatively unscathed by the COVID-19 pandemic. However, we highlighted the potential bounce-back of costs due to deferred medical care. While we haven’t been as specific with 2021, trends are starting to emerge. For more of our coronavirus coverage, visit epicbrokers.com/coronavirus  Viewpoints from Craig Hasday A recent PwC report expects costs to rise by 4% to 10% in 2021, a sharp increase from recent years. The survey points to mental health utilization and specialty drugs as two big drivers …

https://www.epicbrokers.com/insights/2021-healthcare-cost-trends-are-rising/