SAVINGS IN PLAIN SIGHT with ARISTA

7 Genius Ways to Save on Prescription Drugs. Small steps that can add up to big savings.

Prescription drug costs are growing faster than any other health care expenditure in the U.S. For most of us, these medications are not optional. Nearly 60% of adults take a daily prescription to help manage their health. The good news is that you can make a dent in your monthly out-of-pocket costs with a just a little research and action on your part. Check out these six steps you can take to help lower your costs.

1. Get your prescriptions free

The proliferation of online discount eyeglass providers has made it easier than ever to get your frames for less. You’ll typically pay 50-75% less with online sellers versus traditional retailers. Sites like Zenni Optical, Warby Parker and other online retailers have perfected the art of buying online by offering generous home try-on and return programs.

Stores like Giant Eagle, Meijer and Publix offer some common generic prescriptions for allergies, diabetes infections and high blood pressure at no cost.

2. See if it’s cheaper to pay out of pocket

Believe it or not, many chain and big-box stores such as Kroger, Publix and Walmart offer common generic drugs for less than your co-pay from your insurance company. For instance, Walmart offers a list of common generic prescriptions for $4 for a 30-day supply and $10 for a 90-day supply.

In other cases, “clawbacks” from Pharmacy Benefit Managers (PBMs) such as Caremark, Express Scripts and Optum have contracts that allow pharmacies to charge patients with insurance more than the retail cost of the prescription. An investigation in New Orleans exposed an example of this swindle. A pharmacy patient was charged her full $50 co-pay for a drug that had a retail cost of $11.65, meaning it would have been much cheaper to purchase outside the patient’s prescription drug plan.

3. Request a 90-day prescription

For prescription drugs you’ll be taking long term, ordering 90-day supplies in not only more convenient, it can save you a third of your copays – which will help lower your annual costs.

4. Compare prices

Use apps like GoodRX and OneRx to compare prices and see where you can get your prescription for the lowest price. For instance, researching Lipitor on GoodRX showed local prices ranging from $18-$144 and listed additional options to lower costs further with links to coupons.

5. Maximize your benefits

Always see if you are eligible for refills at the end of the calendar year. If you’ve already satisfied your out of pocket maximum, your refills will be free.

6. Use generics whenever possible

Generic drugs contain the same active ingredients and produce the same effects as their brand-name equivalents, but at a lower cost. According to the U.S. Food and Drug Administration, the cost of a generic drug can be as much as 85% lower on average.

7. Take advantage of special programs

Check with your pharmacist, GoodRx and OneRx about special programs, coupons or discount cards. If you use an expensive drug, see if the pharmaceutical manufacturer has a patient assistance program to help lower costs for people who have trouble affording treatment.

BENEFITS BUZZ

Qualified Sick Pay Plans 

A Qualified Sick Pay Plan (QSPP) is an agreement for employers to continue to pay an employee’s salary during a period of disability resulting in an absence from work. The employer is responsible for determining what employees qualify for QSPP and how long they will qualify for QSPP. These factors may change depending on the employee and the employee’s rank within the company.

Administration and Design 

When creating a QSPP, you should consider the following:

• Which employees are covered
• How long these employees will be paid
• When the benefits will begin
• How the benefits will be determined, if a covered employee becomes disabled
• Which company representative will approve claims and administer benefits on behalf of the plan
• How the benefits will be funded under the plan

Insured Plans 

By purchasing insurance on a QSPP, the insurance company determines the validity of a disability claim as well as when the employee has recovered. The insurance company also holds financial liability for benefit payments and takes care of tax reporting and claims service.

Self Funded Plans 

If you choose to self-fund the plan, you either pay the employee directly with current profits or set up a trust for payments. Under this option, your company determines the validity of claims and proper Federal Insurance and Compensation Act (FICA) and Federal Unemployment Tax Act (FUTA) tax withholdings and reporting requirements. Your company must also shoulder the benefit liability on financial statements under the Financial Accounting Standard (FAS) 112.

Communication to Employees 

Once the plan is in place, covered employees will be notified of this option in the event that they become disabled and cannot work. The ultimate benefit of QSPPs is that they eliminate the risk of unnecessary tax consequences for the company and covered employees when the company chooses to financially support employees while they are disabled.

To learn more about these plans, contact Arista Consulting Group today.

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Court Orders EEOC to Reconsider Wellness Rules

The U.S. District Court for the District of Columbia has directed the Equal Employment Opportunity Commission (EEOC) to reconsider its final wellness rules under the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA).

The final rules allow employers to offer wellness incentives of up to 30 percent of the cost of health plan coverage. The court held that the EEOC failed to provide a reasonable explanation for adopting the incentive limit. Rather than vacating the final rules, the court sent them back to the EEOC for reconsideration.

It is unclear how the EEOC will respond to the court’s decision. Due to this new legal uncertainty, employers should carefully consider the level of incentives they use with their wellness programs. Employers should also monitor any developments related to the EEOC’s rules.

Final Wellness Rules?

Federal laws affect the design of wellness programs, including two laws that are enforced by the EEOC-the ADA and GINA.
For many years, the EEOC did not definitively address whether incentives to participate in wellness programs are permissible under the ADA and, if so, in what amount. Earlier this year, the EEOC issued long-awaited final rules, but the court has now remanded the final wellness rules back to the agency for reconsideration.
Arista Consulting Group will keep you updated with any developments on this matter. In the meantime, please contact your representative with any questions about how these rules may affect you.
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