4 Annual Benefit Review and Open Enrollment Mistakes to Avoid

Open enrollment time brings a number of challenges for employers as focus shifts to a full review of employee benefits. Picking the right prescription drug plan to meet employee needs while saving money can be complex. But that doesn't mean you should just leave this very important benefit plan status quo and call it quits. What you don’t know CAN hurt you, and by doing nothing you could be costing yourself more money in the long run. So this week, we're sharing 4 annual benefit review and open enrollment mistakes that are seen all too often by hurried and confused employers in hopes that you'll avoid making the same mistakes.


Mistake #1: Automatic Renewals
Studies have shown that 9 out of 10 employers stick to the same plan each year without even doing an actuarial savings analysis.  This alone can cause a major spike in drug costs for both you and the employee, as pricing is continuously changing, prescriptions drugs are added and removed from the approved drug lists (formularies) quarterly and semi-annually, new high cost drugs become available, and employees’ chronic conditions need to be managed.  Getting a professional second opinion about your prescription drug plan may lower drug costs significantly for the employer, and reduce out-of-pocket expenses for your employees.

Mistake #2: Not Communicating with Employees
This goes hand in hand with the first mistake. If you're not providing helpful information to your employees about their prescription drug coverage, they're likely not going to read your open enrollment materials, so you're leaving the door open for failure. Communication and education about the prescription drug benefits offered will ensure that your employees understand the benefits being offered and how to best use them to meet their needs. Even after open enrollment, you should continue to communicate with your employees about their benefits utilization and alternate medications to reduce theirs and your drug costs. Frequent communication will keep benefits at the top of your employees’ minds even after open enrollment, which in turn will keep employees engaged with their benefits all year round.

Mistake #3: Not Hiring a Pharmacist
You can’t choose the most cost-effective prescription drug coverage without knowing how much you’re likely to spend on healthcare in the coming year. Having a Pharmacist continually reviewing your drug claims is imperative to ensure the right drugs are being used, and that when there are clinical programs or options to better manage utilization, you know about them.  Only after auditing your current prescription drug claims and receiving clinical recommendations on options will you be able to make an informed decision for the upcoming year.  With ongoing clinical oversight and claims auditing, you can ensure that the pharmacy benefit is being managed proactively. This will also help you to determine if there are any areas of your plan that are being misused or abused and will allow you to adjust copays accordingly to further help cut costs for your business.

Mistake #4:Not Having an Rx Benefit Strategy
The prescription drug benefits landscape is constantly changing, and it is up to each employer to create a strategy to adapt to the ever increasing cost of medications. This means that each year, employers have a responsibility to go over the current plans they offer to their employees and review what pharmacy plan designs (both copay and clinical) are driving the lowest costs and healthier employees. By hiring a professional consultant to conduct ongoing pharmacy claims audits, employers can protect their prescription drug program from purposeful fraud or accidental waste. Synergy Pharmacy Benefit Consultants can help you review your current PBM contract and determine the best options, including proactive clinical programs and services for the upcoming year.

Prescription drug spending growth is at historically high levels – which makes it tough to contain costs and maintain or improve the quality of care for your employees. So employers, avoid these 4 common open enrollment mistakes and take control of your prescription drug spending. Give Synergy Pharmacy Benefit Consultants a call today and let us provide a FREE no-obligation claims analysis to see if we can help lower your prescription drug costs!

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Lake Ozark, MO 65049


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