A True Story
A new hire came to work this summer. She was on COBRA for good reasons. The employer had no idea she was a walking risk management disaster that could bankrupt the firm’s self-funded health plan.
The company thought they were hiring a $50,000 employee. Little did they know there were really hiring a $500,000 employee.
The new hire is taking four specialty drugs. Her previous employer was paying for it through COBRA to the tune of over $400,000 per year. The most expensive drug was trikafta.
As luck would have it, the employer excluded specialty drugs effective June 1. The new hire was not going to get her medication through the plan. So she didn’t…………………but she did.
With the employer’s assistance she was able to get three of her drugs free through manufacturer assistance programs. Savings realized exceed $360,000 that would otherwise have been a risk assumed by the employer’s self-funded health plan.
This is an example of hiring a $50,000 employee with a $500,000 price tag.
NOTE: This is a true story. The employer eliminated specialty drugs effective June 1, 2022. In 90 days the savings have exceeded $1,000,000. Not one plan member has been unable to obtain the drugs they need.