Retiree First specializes in the customization, analysis, selection, implementation, and ongoing management of Employer Group Waiver Plans (EGWPs) for plan sponsors. Since it was enacted in 2006, the Retiree Drug Subsidy (RDS) had been the popular approach for providing prescription drug benefits to Medicare eligible retirees. In comparison to RDS, EGWPs present an opportunity for plan sponsors to reduce retiree drug costs through additional federal and manufacturer subsidies and tax advantages.
Leveraging established and integrated partnerships with top-rated Part D carriers and Pharmacy Benefit Managers (PBMs), Retiree First customizes a retiree Part D pharmacy plan tailored to each group’s unique needs.
So why haven’t all plan sponsors made the transition to an EGWP? The answer is simple: EGWP’s are associated with many misconceptions from disruption to true savings. Please read below a listing of the highlights for this benefit solution and continue scrolling for a case example of the financial savings impact when moving to a Part D EGWP plan with Retiree First.
Funds typically save 35-40% when transitioning from RDS to EGWP. An EGWP contains 2 additional subsidies: Federal Catastrophic Insurance & Manufacturer Discounts in the coverage gap.
Our company specializes in seamless transitions to EGWPs with little to no disruption to your members. We can customize the EGWP to mimic the current plan you have in place. EGWPs offer options such as coverage gap protection, custom catastrophic benefits, formulary choices with drugs not covered under Part D, and unlimited customizable copay options. Additionally, our Retiree Advocates offer member support through the transition to an EGWP and beyond to ensure members experience little to no disruption.
Coverage Gap (Donut Hole):
Different from individual Part D plans, group Part D plans (EGWPs) can be customized to include coverage gap protection. Coverage gap protection maintains the designated plan copays with no impact to members in the donut hole.
We converted this client from a self-funded RDS drug plan to a fully-insured Part D EGWP drug plan. We emulated the in-force plan design while adding a Bonus Drug Rider covering Vitamins and Life Style Drugs enhancing the overall benefit for retirees.
|RX Plan Design||Copay|
|In-Force Cost Analysis:|
|In-Force Retiree RDS Annual Cost||$1,853,280|
|Per Member Per Month RDS Cost||$264 PMPM|
|Retiree First Proposed Costs:|
|Retiree First EGWP Annual Cost||$968,760|
|Per Member Per Month Cost||$138 PMPM|
|Savings PMPM||$126 PMPM|
|Total Monthly Savings||$73,710|
|Total Annual Savings||$884,520|