HR Benecast

Our host, Mike Stull, talks with Employers Health's Senior Vice President, Regulatory Compliance and External Affairs Madison Connor as she covers the latest state and federal employee benefits and PBM legislation under the new presidential administration. Together, they'll cover proposed bills affecting anti-steering legislation including mail vs. retail, preferred pharmacy networks and more. They'll discuss how Rutledge vs. PCMA affects state pharmacy reimbursement laws, ERISA preemption and more. Finally, hear how the rule-making process under a new president could affect your benefit plans.

Cell and gene therapies (CGT) are widely considered a triumph of scientific innovation, focusing on providing cures for diseases rather than treatments. By 2030, it's predicted that over 100,000 U.S. patients will utilize some form of CGT. While CGTs are revolutionary, these therapies come with a giant price tag, leaving many employers wondering how they'll afford potential CGT use for their population.

In this episode, Employers Health's Mike Stull is joined by Drew Wilkins, managing director at Deloitte Consulting to discuss the major costs associated with CGTs, how companies can manage this costly class and how employers can prepare for its surge in the future.

In this episode of HR Benecast, Mike Stull and Eric Dublikar cover your pharmacy and employee benefits questions including:

• What's new in federal and state pharmacy benefit legislation.
• How Employers Health is working to help clients manage changes to their PBM plans.
• What the switch to biosimilars for Humira and Stelara means for plan sponsors.
• What impact GLP-1s are having on employer drug spend?
• Trends in GLP-1 coverage for weight loss.

This episode features Employers Health Chief Operating Officer, Zach Hostetler. He joins our Chief Sales Officer, Mike Stull to discuss pharmacy benefit rebate credits and why they exist. They'll cover how rebate credits are calculated, how long we can expect rebate credits to be around, how Employers Health is working to validate the value of the rebate credits and more.

In this episode, we're joined by Madison Connor, senior vice president of regulatory compliance and external affairs at Employers Health. She will share the latest in state and federal PBM legislation. Hear who's behind many of the recent PBM legislative initiatives, how PBMs like CVS and Optum Rx plan to handle these newly-proposed state laws and discover how employers can prepare for these new requirements.

Hear from employee benefits and compensation lawyer Jeff Zimon as he covers why fiduciary obligations are making headlines and what the Johnson & Johnson lawsuit means for plan sponsors. He discusses steps employers can take to ensure they are fulfilling their fiduciary duties, the importance of summary plan descriptions (SPDs) and the need for proper pharmacy benefit documentation.

The first 2024 episode of HR Benecast features Courtney Keefe, Employers Health's resident GLP-1 expert. She'll share utilization, discontinuation and coverage trends for GLP-1s and anti-obesity drugs. Listeners will hear the latest on anti-obesity drug coverage under the pharmacy benefit, new drugs in the pipeline and how the big PBM's are managing drugs like Wegovy, Mounjaro and Zepbound.

On our last episode of 2023, we sit down with Ryan Siemers, founder and principal at Aegis Risk to cover all the intricacies of stop loss. As the costs of catastrophic claims continue to grow, reinsurance protection and medical stop loss are more important than ever. Listen to hear how costly gene therapies are impacting deductibles, potential health care industry changes could drive prices even higher and more.

To learn more about the Aegis Risk Medical Stop Loss Premium Survey visit https://www.aegisrisk.com/copy-of-stop-loss-premium-survey-header and to register to hear Ryan Siemers presentation on Medical Stop Loss & Risk Strategies for Catastrophic Claimants please visit https://www.employershealthco.com/resource-center/events/abf24/.

In this episode of HR Benecast, we're joined by Travis Baughn, vice president of clinical solutions at Optum Rx. Listen to hear how pharmacogenetics works and its importance for employers. He'll share what plan participants need to know, and how it can be used to reduce medical waste and long and complex medication journeys. For additional resources on pharmacogenomics, please visit cpicpgx.org and pharmgkb.org.