Northwest Savings Bank Challenge The Northwest Savings Bank offered its some 600 employees prescription drug benefits through the company-sponsored health plan. At the time, employees paid for their prescriptions in full and then submitted the claim for reimbursement. The third party administrator (TPA) processed the claim in accordance to the insurance plan's deductibles and co-payments. When Northwest implemented an across-the-board acquisition and retention program, the bank decided to enhance the prescription benefit program through a prescription drug card as a means to attract and retain key employees while staying within its budget. We pointed out some important considerations, including: Prescription drug card programs can result in an increased amount of prescription benefit claims The existing health plan design minimized the overall exposure to drug claims The medical claim system in place provided only dollar amounts—there was not enough detail to make accurate claim projections Strategy We conducted extensive research and reviewed Northwest's drug data and gross medical claim information from the past 24 months. We also worked with Northwest to gain a complete understanding of their goals and objectives, as well as to address their concerns, which were primarily: To maintain costs at a reasonable level To increase employee satisfaction with the overall benefit program Ease of communication with multiple locations (more than 25) in rural communities Minimal administrative hassles We prepared financial models and plan design alternatives, projecting costs both under the current program and under the plan alternatives. Based on our research, we provided the client with two possible options: A prescription drug discount card, providing discounted prices, drug utilization review and strong data. This option would work just like a traditional card program except that the employee would pay 100% of the discounted price. Claims would still be submitted to the TPA for reimbursement. This option was appealing because of its ability to gather data for the purpose of projecting drug costs and trends for Northwest. A prescription drug card program, with a co-payment and plan design that included controls on days' supply and limitations for certain products (e.g. Viagra or Imitrex). This option also included a physician-oriented utilization program that offered assistance in selecting the most cost-efficient yet effective products for the employees. We did not recommend any punitive programs such as a closed formulary or mandatory generic program. Both of these recommendations came with cost projections and an evaluation of the potential impact on the employees' perception of the company, employee communication and administrative requirements. Results Northwest chose the second option. We worked with them to implement the program over a 60-day period that allowed for effective communication with employees, coordination with the TPA and a custom-designed prescription ID card. Costs increased by only 8% during the first 15 months—less than half of the standard industry cost increases rates. Northwest Savings Bank increased its number of employees by 50% during this period, and they equate a portion of their excellent employee relations with the introduction of the new prescription plan. In addition, the human resources department received nearly a dozen complimentary letters about the plan from employees, and the TPA has reduced administrative tasks by removing prescription claims processing from their workload.	Inteq  MDNY Healthcare  VitaRx  Northwest Savings Bank  America's Family Benefit Plan
Last updated: © Arxcel, Inc.