Navigating Legal Strategies for Covering GLP-1s in Self-Insured Medical Plans

Troutman Pepper Locke

In this episode of Troutman Pepper Locke’s Employee Benefits and Executive Compensation podcast, hosts Lydia Parker and Lynne Wakefield explore the complex legal landscape surrounding the coverage of GLP-1s prescribed for weight loss purposes within self-insured medical plans. As these medications gain popularity, plan sponsors face the challenge of controlling costs while meeting participant demand and maintaining legal compliance. The discussion covers various design alternatives, including cost-sharing strategies, waiting periods, and wellness program rewards, while addressing potential legal risks under HIPAA, the Affordable Care Act, and the Americans with Disabilities Act. Tune in to explore how plan sponsors can navigate these issues effectively as a means to attract and retain employees, while mitigating financial exposure.

Transcript also available.

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