I just completed the webinar with Empire on this. THESE ARE EXTENSIVE and dramatic changes, so please read carefully. Here are the main takeaways:
*- ALL normal Blue Cross plans will be affected and have a change to their drug plan when they renew, starting on November 1.
*- You will NOT be allowed to keep your current plan.
*- Your Rx premiums will decrease
*- Third tier drugs will not have a copay. They will be paid after a deductible and coinsurance. Remember that these are the most expensive drugs. If you are on the most popular plan ($10-$35-$70) you will 35% coinsurance on the most expensive drugs. Empire states the following facts:
– 97 of the top 100 drugs are Tier 1 and 2 and would not be affected.
– 90% of all prescritpions are on Tiers 1 and 2 and would not be affected.
– 22 of the top 25 tier 3 drugs will have a cost less than the current $70 copay, and an average of $4 per Rx. However, their is a $350 maximum per Rx per month on this plan.
– Specialty drugs are taken by 1% of the population, but account for 25% of all Rx Cost, with costs running between $5k-$300k per year. The most an employee would pay a maximum of $350 (plus the annual deductible) per month for these drugs.