02/18/2021 (2) - Laserfiche WebLink

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Recommendations for plan changes are evaluated and made with an emphasis on minimizing disruption to members and maintaining an affordable, competitive, and sustainable plan. Recent cost savings measures that have been implemented include: • Carve out of pharmacy benefit from Prime Therapeutics (BOBS) to RX Benefits (Express Scripts). Improved RX pricing and rebates. • Implementation of additional RX savings programs. o Manufacturer's coupon (SaveOn SP). $293,743 net savings in 2020. o High Dollar Claims Review. $127,552 cost avoidance in 2020. o Low Clinical Value drug exclusion. $63,825 cost avoidance in 2020. • Added the Silver Plan which is a lower premium health plan with higher deductibles, out of pocket maximums, and copays. • Increased ER copays (waived for admission)to encourage non-emergent use in more appropriate setting (urgent care). • Added Telemedicine benefit for low cost visits ($10 In-Network General Medical Copay/$20 In-Network Dermatology Copay). Other Options Explored • In 2018, Lockton marketed the health plan's administrative services. Blue Cross Blue Shield of Florida was ranked #1 and was awarded the Administrative Services Only (ASO) agreement in May 2018. • SurgeryPlus analysis of savings underway. SurgeryPlus is a supplemental benefit for non- emergent surgeries using Surgeons of Excellence Network and bundled pricing for procedures. Performance guarantee for savings. Member deductible and copays are waived. Nationwide access to network to serve all enrolled members. • Marketing of pharmacy underway to explore other Pharmacy Benefits Manager (PBM) models and possible savings. Distribution of Plan Costs Rx Claims less Rx Medical/Rx Rebates Administration 20% 6% 3s Stop Loss Premium 4% Medical Claims Net of ISL & t 70% y D Medical/Rx Administration D Stop Loss Premium ❑Medical Claims Net of ISL D Rx Claims less Rx Rebates 2