Category: Benefits

Pharmacy Benefit Managers: What Are They and How Can They Help?

Prescription drugs can be exceptionally costly, and prices continue to be on the rise. According to Bloomberg, Americans spend an average of $1,200 per person per year on prescription drugs — more than anyone else in the world. 

But there are ways you can help employees drive these costs down. One of those ways is leveraging a pharmacy benefit manager to control your healthcare spending and make your employee benefits more affordable.

What is a Pharmacy Benefit Manager?

Pharmacy benefit managers (or PBMs) are companies that can help manage your prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers and more. 

By mediating between insurers and other members of the healthcare industry, PBMs can help negotiate customer contracts to get the best rates, ultimately helping employees prioritize their wellness without unnecessary costs. 

How Can a Pharmacy Benefit Manager Help My Business?

At Cornerstone, our clients that are self-funded or have an interest in creating a solution to reduce their prescription drug spend may benefit greatly from working with pharmacy benefit managers. 

PBMs are “behind-the-scenes” negotiators to control drug spending and lower medication costs for your employees. Our clients often see 30 to 35% — often as high as 50% — of their claims costs coming from prescription drugs. An effective PBM and management program can be implemented to save your employees hundreds of thousands of dollars.

How Does Cornerstone Work With Pharmacy Benefit Managers?

As an employee benefits company, Cornerstone works with several PBMs directly to ensure the correct fit for our self-funded clients. We will personally “shop” for the right pharmacy benefit manager for your needs.

You may have lots of questions regarding prescription drug coverage, such as:

  • How are these prescriptions covered? 
  • How are rebates from the manufacturer handled?
  • How do you determine which drugs are eligible for the rebates?
  • What type of clinical management programs are used in conjunction with the prescription drug list to ensure the best fit and correct dosage?

By working with insurance consultants like Cornerstone, we can help you have these conversations — and more — with your PBM. We have access to the tools, knowledge, expertise and relationships to ensure our self-funded clients have the right PBM to keep them as competitive as possible while offering high-quality benefits to their employees.

Cornerstone’s benefits administration specialists also have the technology that can analyze your business’s healthcare claims to know exactly how your benefits are being used so you can rest assured we’re making the best-educated decision for our clients’ programs.

Data analytics continues to be an extremely effective tool for managing claims within a self-funded client and having an efficient PBM can continue to drive your costs down.

Healthcare and employee benefits administration can be complex. Let Cornerstone’s experts help your company find the best rates so your employees can stay happy and healthy. Get in touch today.

What Can Benefits Administration Technology Do For My Company?

Benefits administration is a necessary piece to running a company — but it can be both complex and expensive. There is a good chance you or your human resources team are looking for ways to simplify the benefits administration process and lighten the burden of everyday tasks. 

That’s where benefits administration technology comes in.

Benefits Administration Technology: An Overview

In the past, in order to administer company benefits to employees, companies would have to embark on a very manual process, with a higher risk of reporting errors and employee frustration. 

But with benefits administration technology, companies can implement a simpler, streamlined solution to manage their employee benefits. The tools can automate manual processes and provide a better employee experience.

How Benefits Administration Technology Can Help

Here are other ways in which these tools can help your business run more smoothly: 

Reduce HR’s Workload

By automating processes — such as creating a checklist that sends employees reminders to enroll — HR can spend less time tracking people and information down.

One of the biggest problems that it can solve for HR departments is related to compliance around benefit enrollment. It’s much simpler to look through a system to ensure all employees are compliant than it is to shuffle through papers to do so. 

Benefits administration systems also provide the ability for companies to manage eligibility and easily add, change or terminate employees with the insurance carriers — without having to deal with paper enrollment forms. 

More good news for HR teams: these systems can integrate with various payroll providers which reduces the need for additional information input. 

Better Employee Experience

These systems can incorporate artificial intelligence to help employees make decisions that are best suited to their needs. This boosts their perception of the company creating a happier more informed workforce.

From onboarding a new hire, conducting open enrollment virtually or running different initiatives that are important to your company, this technology can increase the overall efficiency of your office. Benefits administration technology provides a single source that houses all benefit information, can simplify processes and boost ROI on your healthcare spend. 

How Cornerstone Implements Benefits Administration Technology

While human resources departments can utilize this technology themselves, you can also work with a group like Cornerstone to implement the tool for you. We walk through your unique situation and evaluate what solution would be the best fit. These systems are customizable so clients receive what is valuable to their organization. 

Once the platform is chosen, we then take over all of the heavy lifting required to implement and roll this out to your employees. In most cases, we can bring a solution like this to you through our partnerships with various companies.

Interested in implementing benefits administration technology, or have any other questions? Feel free to contact the employee benefits experts at Cornerstone Insurance Group today.

Flu Shots: What You Need To Know

Considering the recent events in 2020, it should be more apparent that the seasonal flu is taken seriously. With the COVID-19 vaccine still in preproduction stages, numerous sources are citing it won’t be available until late in 2021. While we are taking more precautions than ever before due to COVID-19, we still need to keep the approaching flu season top of mind.

Protecting yourself against the flu is more important than ever. This fall there will be two respiratory viruses circulating making it possible to contract a double infection. The influenza vaccine can minimize at least one of the potential respiratory infections. If you were to get sick with influenza your body’s immune system is weakened making it more vulnerable to a possible coronavirus infection. Besides protecting yourself, you help prevent the spread of the virus to your family and those in the community who may not be able to get the vaccine.

By now, I’m sure you’ve seen the reports of people testing positive for COVID-19, without ever having any symptoms. The same thing is possible with the influenza virus, you can spread it without ever having symptoms of being sick. This is the reason healthcare professionals are required to get the flu vaccine every year, protecting themselves and the people around them.

Transmission

The main mode of transmission is by particles in the air and on contaminated surfaces, making washing your hands and using hand sanitizer important to stopping the spread of the flu virus. An infected person can spread the flu virus to an average of 1.3 other people. This number may be higher in families living together and those who are working in close proximity to each other. The virus can be transmitted one day prior to the infected person experiencing any symptoms and can continue to be contagious 5-7 days after the onset of symptoms. Individuals with compromised immune systems may remain contagious for several days longer than that.

Prevention

The most important step you can take to prevent getting and spreading the flu is getting vaccinated every year. Washing your hands and using hand sanitizer often is are also important ways to reduce the transmission of the virus. Take care to help younger children wash and sanitize their hands often as well. The CDC estimates that over 20 million people each year will contract the flu, however, it is estimated that the flu shot will save around 40,000 lives each year. Even if you are young and healthy, the flu vaccine can prevent you from spending 2 long sick weeks in bed and can save the lives of those around you.

Flu Facts

  • The flu infects an estimated 20-40 million people a year in the US alone.
  • Of those infected, over 61,000 deaths occurred in the 2017-2018 flu season.
  • There were a reported 600,000+ flue related hospitalizations in the 2017-2018 flu season.
  • Each year the CDC watches trends and tracks the different strains or mutations of the virus to formulate the most effective vaccine for the current flu season.
  • The best time to get the flu shot is early on in the season and as it takes up to two weeks for your body to build up an immunity to the virus.
  • Once you have the flu, antibiotics will be useless to help with symptoms. Instead, use of antivirals should be taken under doctor supervision as early as possible for best results.

If 2020 has taught us anything, it’s that we need to take care of ourselves and those around us. Be mindful of those who are more vulnerable, or those who can’t get vaccinated due to underlying health issues. Getting vaccinated helps everyone in the long run. For more information on the flu shot, don’t forget to check out our webinar on flu shots.

Navigating Multiple Leaves of Absence Requirements

Navigating the different types of leave available for employees can quickly get confusing. FMLA, ADA, Company Leave, FFCRA, PTO, STD, LTD – it’s a sea of acronyms, each with their own set of rules and guidelines that often overlap or weave together. Keeping track of the various types of leave available can be challenging, but employers would be best suited to strategize which leaves may be applicable to them and develop policies around them. Because employees will inevitably need to take time off, employers need to have a basic knowledge of laws and policies that protect both the employee and protect the company.

Types of Leave

Generally, when looking at the wide variety of time the employee can take off, employers should understand that there are two main functions of defining leave: How does the employee receive pay and How long must the employer hold the employee’s job and/or benefits? Both of these items are very clearly defined in the federal FMLA regulations applicable to employers with 50 or more employees within a 75-mile radius. Outside of the standard FMLA, employers are encouraged to have a company leave policy that defines these same benefits.

Where FMLA protects the employee for not only their own health condition but that of their immediate family member, the ADA may protect just the employee by providing a reasonable accommodation, which could include a short-term leave of absence. The ADA doesn’t require employers to hold the employee’s job or their benefits nor does it require continuation of pay. However, the employee may be eligible to use Short-Term or Long-Term Disability along with company Paid Time Off, Sick Time and or Vacation time during this absence.

Because these leaves can stack together, employers need to closely evaluate every situation to determine what different leave options may apply.

What to Do Now

Take a moment to review your current employee handbook to ensure that you have a clearly defined FMLA policy if applicable.  Even if you are subject to FMLA, all companies should also have a leave policy defined for those employees who are either not yet eligible for FMLA or where FMLA doesn’t apply.  In that company leave policy, the employer can define whether the leave is paid or unpaid and how long the employee is allowed to remain on the company benefit plan during leave.  Additionally, the employer can define how long they will hold the employee’s job during leave.  It is important to be consistent with these guidelines to prevent discriminatory practices.

Employee Benefits …”Can We Talk?”

Employee BenefitsThe late comedy legend Joan Rivers used the catchphrase “Can we talk?” in discussing various topics. She explained her use of the phrase, saying “I always try to be very honest. My humor is truly stripping everything. Bam!” she explained. She went on to describe her approach: “Let’s stop the nonsense.”

One area of Corporate America that could use a similar approach is the area of employee benefits. Insurance companies and consultants would like to talk trends, utilization, probabilities and the like. But what is missing from the conversation is the person. Not “employees,” but the individual person. How the person thinks, what he or she fears, how and what he or she will choose and why.

Read More

Have You Considered a Self-Funded Approach?

Self-Funding for Health BenefitsSelf-funding has been used as a tool to maintain the cost of health-related employee benefits for many years.

Historically, this approach has been utilized by groups of 100 or more employees.

However, due to the Affordable Care Act (ACA), a new market is being created for smaller groups allowing them to take advantage of self-funding health care plans to save money and gain control over costs. As an employee benefits administration company, we’re here to help you understand the different approaches to health care.

Read More

How to Launch a Wellness Program

How to Launch a Wellness Program

Approximately, 80% of the US population is in the workforce or linked through family relationships/retirement putting employers in a key role for health and wellness issues. People spend the majority of their week at the workplace, making the worksite and excellent place to conduct a wellness program. Launching a worksite wellness program doesn’t always mean spending large amounts of money by installing fitness facilities and hiring an on-site wellness coach. However, in order to launch a successful wellness program there are some key steps and planning required. Read More