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Zero Plan Disruption for Retirees
Zero Plan Disruption for Retirees
EGWP's allow plan retiree's to keep the same pharmacy benefits without interruption or additional costs, while the plan provider realizes significant cost savings.
Retiree Prescription Drug Plans
Retiree Prescription Drug Plans
Under an EGWP the PDP handles main administrative requirements, manages all federal interaction, collects federal Part D plan subsidies and assumes compliance responsibilities.
Employee Group Waiver Plans
Employee Group Waiver Plans
EGWP's are commonly referred to as Egg Whips and provide generous cost savings combined with improved cash management.
 
 

Retiree Prescription Benefit Plans

EGWP Coverage Must Be Wary of Discrimination Under ACA

Coverage for EGWP Retirees Need to Consider Transgender Retirees Egg Whips (Employer Group Waiver Plans) that have transgender retirees must ensure that they provide EGWP coverage under the Affordable Care Act according to a new post by Snell & Wilmer’s Matthew Chiarello. Because EGWP coverage can satisfy both requirements of the nondiscrimination rule under the ACA the plans must consider that they can exclude transgender retirees from the program.  Under the ACA final discrimination rule if either of the following

CMS Final Rate Notice Negatively Affects EGWP Retirees

CMS Eliminates Employer Group Waiver Plans (EGWP) Bidding Process for Retiree Prescription Plans Under Medicare Advantage Plans Recently EGWP retirees, particularly low income recipients covered by their employer were dealt a blow by the CMS in their refusal to reverse their proposal to cut 2.5% from payments for Employer Group Waiver Plans. The proposed changes from the CMS will be implemented over a two year period where plans will see a 1.25% cut per year in EGWP payments. Both Democrats

Vermont State Retired Employees and Teachers Switch to EGWP for Savings

Vermont Retirees Switch to EGWP for Drug Benefits Vermont state retired employees and teachers switch to EGWP for their retiree prescription plan drug benefits.  According to VTDigger.com, federal subsidies provided by a switch to EGWP plan will save the state 2.1 million to 2.6 million annually.  In addition, the state’s future liabilities for OPEB’s will be reduced by over $100 million. According to VTDigger, Vermont state Human Resources Commissioner Kate Duffy is quoted as saying “There’s a lot of talk

CMS Changes PPN Rules

  CMS Changes PPN Rules and Leaves Seniors Holding the Bag CMS changes will cost Part D seniors and additional 20% to nearly 40% out of pocket for prescriptions. Is the CMS neglecting its own report that Preferred Pharmacy Networks (PPN’s) have costs from 3.5 to 24.1 percent less than non-preferred pharmacies.Where branded drugs worked out to be 3.3 percent less expensive, on a claims-weighted average basis; generics prescriptions were 11 percent cheaper. The small community pharmacies have lobbied for

Impending CMS EGWP Changes May Make Supplemental Insurance Unnecessary

April 2014 CMS EGWP +wrap Rule Change Dec. 23, 2013 – According to Crain’s Business Insurance Magazine, CMS EGWP +wrap plans may become unnecessary if the CMS regulations change as anticipated in April of 2014. Migration to CMS EGWP Moving Quickly According to the article, changes to CMS EGWP plans are being readily adopted as changes to the Medicare Part D RDS  subsidies are no longer tax deductible.  Employers implementing an EGWP have seen resulting pretax costs lowered by 20%

Retiree Prescription Benefit Plans Boosted by Lowered Pharmacy Costs

December 18, 2013 – In a report released earlier this year by ExpressScripts, projected costs for 8 of the 10 most popular therapy classes will see the cost of the prescription drugs used to treat them decline.  This is welcome news for companies that support retiree prescription benefit plans. Lower overall prescription costs over the next several years are forecast by several sources including the CMS, Segal Consulting and ExpressScripts.  For employers who provide retiree prescription benefit plans this is

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