Recently we launched a program in Coffeyville, Kansas. Working with Prescription Shop owner Alan DeFever, we presented our program and … well, here are excerpts from the email he sent out after our presentation:
I wanted to thank you all for attending today and I want to offer any help I can in moving forward. Howard presented my alternative options to me for my Prescription Shop after our luncheon. It was even more educational and appears to be a viable option for my company. Howard will be coming back to Coffeyville in the next few weeks and will run the numbers for you specifically. I can see no downside to investing a little more time investigating this option and a lot of upside. So go for it!!! Here are a couple of important points that I am taking away:
- Once I reached a point of seriously considering this option, they offered me other references. I spoke with a colleague I already knew in Chillicothe, MO who owns three pharmacies. He has been using the program for two years. He validated that he has not paid a higher amount than his prior premium, and in fact has $40,000 in the bank now in reserve. He also validated that nothing significant had changed for his employees and their coverage was just as good as it had been.
- Currently I don’t have a clue what I am paying for in any detail at all and United Healthcare is not willing to share any details at all. They are only willing to show me how big the premium is and how much it increased. Under the plan that Howard shared with me today, I would have a detailed accounting for what I paid for each month. This is one of those un-learning things for me. Why is it that I only sign the checks that have a detailed invoice except in this area of my business??? I have been conditioned into thinking that they don’t need to give me any detail.
- I can tell you without any doubt that the amount we receive as reimbursement for prescription drugs is not what the employer is getting charged. I can’t sit down and review it on a claim by claim basis because of my contracts with them, but I have seen lots of examples where it is ridiculous what the spread is that they are keeping in the middle. Remember, OptumRX (United Healthcare’s own Pharmacy Benefit Manager) reported $2.2B in NET earnings in one quarter recently. That is their own reporting and we are all funding it.
- I would only pay for what was used under the new program and not just a monthly premium regardless.
- I have been paying around 19-20% just for administrative cost and that is way more than I need to pay.
- My employees would have an identical plan if I choose – this would include:
-
- Same deductibles
- Same copays
- Same max out-of-pocket $$
- An insurance card in their pocket that would be accepted at the same doctors’ offices & hospitals
- A pharmacy card in their pocket with the same pharmacy copays
- In my case, I would save around 30-40% off of my current cost and that is even if there are some reasonably big claims.
- There is Stop-Loss Insurance so that not only will my employee have a max out-of-pocket, but so will Prescription Shop.
I wish you the best in your exploration of how to save money and continue offering coverage to your employees. I hope this has been helpful and please reach out if I can help more.
Thank you Alan … you know, the term “win-win” is an overused cliché, so I’ll just say that our new program for independent pharmacist in small- and mid-sized communities is “win-win-win-win.”
- Pharmacist win. This program creates more business.
- Business owners win. Our unique plan is able to save business owners hundreds if not thousands with a managed-care plan that cuts out the middlemen and gives him or her more control of their costs.
- The employees. Personal is better – the local pharmacist is experienced and a friend, offer personal service, and the discounts we’re able to work out is appreciated.
- The community. Supporting the local independent businesses keeps the town strong. Let’s bring the money back to main street.
This is what we at ECCHIC do every day, and we can do it for you in in your community. In Alan’s words, “Go for it.”
