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Anchor 3(16) Fiduciary Solutions
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Regional Vice President, Sales MAP Retirement USA LLC
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July Business Services
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Relationship Manager for Defined Benefit/Cash Balance Plans Daybright Financial
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Retirement Plan Administration Consultant Blue Ridge Associates
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Managing Director - Operations, Benefits Daybright Financial
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-- An attorney subscriber
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Search the News Archive
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36 Matching News Items |
| 1. |
Chelko Center for Benefits Management
July 17, 2023
"Even in a high-inflation, post-pandemic market, the group as a whole saw overall benefit costs similar to the prior year.... Modest stop loss premium increases did not rise to meet historically high claims, resulting in heightened loss ratios for insurers and sweet (but likely temporary) relief for employers.... Despite a 24% increase in rebates, gross Rx spend (i.e., before rebates) for the group soared 30% from one year to the next."
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| 2. |
Chelko Center for Benefits Management
Jan. 20, 2022
"[M]ost benefit programs are 'benchmarked' to be close to (above or below) average. Almost no companies seek to be best-in-class, and rarely do any seek to be world class.... [M]any more employers can sponsor high-performing benefit programs -- programs with excellent and affordable coverage, exceptional service, and at a low cost. The process begins with good data but shouldn't end with the status quo."
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| 3. |
Archimedes via Chelko Center for Benefits Management
May 24, 2017
"The overarching 'best practice' management approach for specialty drugs in the medical benefit is to: [1] pay only reasonable costs for drugs, administration, and related fees; and [2] pay only for drugs that are clinically appropriate for the patient.... [T]hese 'simple' objectives aren't easy to carry out for specialty drugs administered in medical sites of care for two reasons.... First, medical claims may be billed with limited information.... Second, drug pricing in the medical benefit is highly, and inappropriately, variable."
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| 4. |
Chelko Center for Benefits Management
Mar. 4, 2018
"The survey asked participants to rate 30 plan management strategies based on market acceptance and effectiveness.... Responding employers generally considered highly accepted strategies as highly effective, and there was a strong correlation between almost all acceptance levels and the corresponding effectiveness levels. The notable exception was voluntary products, which were viewed as significantly less effective than accepted. Private exchanges stood out as the least effective and least accepted strategy."
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| 5. |
Chelko Center for Benefits Management
Nov. 18, 2025
"[One large client] set up about 200 direct agreements with health systems and regional PPOs. It quickly became too much for them to manage ... [T]his became unwieldy for the providers too. They didn't want to deal with one-off contracts either. Ultimately, the client decided it was just a lot easier and more practical to tap into a national network (easier in the short-term, albeit more expensive in the long term)."
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| 6. |
Chelko Center for Benefits Management
July 31, 2018
"[R]ebates are not only driving higher list prices -- they are driving higher net prices and overall drug benefit costs.... We need to adopt a system that is focused on getting the right patient, the right drug, in the right dose and amount, at the right time, in the right location, and at the best price (considering what it truly costs to do everything else). This is a system that is driven by the value to the patient and not to the PBM."
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| 7. |
Chelko Center for Benefits Management
Oct. 2, 2022
"All too often, plan sponsors assume they have little opportunity to control or reduce their healthcare spend. They accept the status quo and do not challenge brokers who are receiving financial incentives to keep them in poorly managed arrangements with specific insurers. Dave Chase's book, Relocalizing Health ... outlines a 5-step process called LOCAL that a plan sponsor can implement to better manage the health of their workforce and their healthcare spend[.]"
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| 8. |
Chelko Center for Benefits Management
Aug. 25, 2022
"Generally speaking, employers have allowed pharmacy benefits managers and health networks to agree to any price on their behalf for years. And most of these intermediaries will agree to any price ... Will employers rise up and change their own purchasing models? Or will they continue to reinforce the opaque, rebate- and markup-driven systems prevalent in the market today? Also, will they cover any drug approved by the FDA regardless of cost?"
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| 9. |
Chelko Center for Benefits Management
Aug. 25, 2020
"Virtual enrollment has been trending for several years, and the COVID-19 pandemic is helping to solidify its prominence. A virtual enrollment process typically includes an online enrollment platform for selecting benefits, remote meetings between employees and HR, and downloadable benefits resources.... Preparation will be the key factor for a successful open enrollment this year.... Employers should review [listed] strategies and consider how similar initiatives might improve their own open enrollment efforts."
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| 10. |
Chelko Center for Benefits Management
Jan. 30, 2025
"[M]uch like rebates, broker offers of lower (sometimes even zero) fees are really just a subterfuge for hidden fees and higher plan costs. They are not in the best interest of the benefit plan or its members. One could even argue that receiving these incentives is counter to the obligations of a fiduciary."
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