Hi Guys, Here is the disruption report. Obviously, it is recommended to move to the lowest net cost formulary. The rebates will be less, but the original cost to the plan will also be less. Win Win. Also... forgot to mention we will plan to continue to move forward with the no-cost Over the Counter scripts previously included. So we need to move forward with a motion, second, and vote. 🙂 Thanks!! Tara Tara Johnson This email may contain confidential and privileged information for the sole use of the intended recipient. Any review or distribution by others is strictly prohibited. If you are not the intended recipient please contact the sender and delete all copies. ________________________________ From: Sarah Thielen AH <sthielen@Apta-health.com> Sent: Thursday, November 7, 2024 5:00 PM To: Tara Johnson <tjohnson@netroopers.org> Cc: Tim Longwell <tlongwell@theolsongroup.net>; Howard Shandell <hshandell@theolsongroup.net>; Ryan Thiess <rthiess@novoconnection.com> Subject: RE: 2025 Renewal - Signature Requested Stop Loss Quote Hi Tara, Thank you for your patience as I am catching up from travel yesterday! With ServeYou, we would recommend the Lowest Net Cost formulary. However, I have also included the disruption detail for ServeYou’s standard formulary. Lowest Net Cost – Novo Formulary: The lowest net cost formulary is more expansive which allows for greater substitution opportunity to affect the greatest clinical outcome for the member, with the lowest financial output for the Plan. Traditional PBM based formularies are typically subject to manufacturer negotiations that steer members towards drugs with larger rebates and larger discounts off of wholesale price. ServeYou Standard Formulary: ServeYou has a longstanding history of being able to minimize cost using their own formulary strategy. There is more disruption for the ServeYou formulary, as it is built using different principals than the Novo Lowest Net Cost formulary. This is not to say it is a worse option, rather an explanation for the variance. I would be more than happy to set up a call to review the formulary options! Please let me know if you have any questions. Thank you, Sarah Sarah Thielen Lead Client Experience Executive Apta Health | Novo Connection 628 N 108th Court | Omaha, NE 68154 402.999.4478 direct | 402.707.9786 mobile [cid:image001.png@01DB3132.B8B05010] The information contained in this message and any accompanying attachments may contain privileged, private and/or confidential information protected by state and federal law. Penalties may be assessed for unauthorized use and/or disclosure. This message and any attachments are intended for the designated recipient only. If you have received this information in error, please notify the sender immediately and return or destroy the information. This e-mail transmission and any attachments are believed to have been sent free of any virus or other defect that might affect any computer system into which it is received and opened. It is, however, the recipient's responsibility to ensure that the e-mail transmission and any attachments are virus free, and the sender accepts no responsibility for any damage that may in any way arise from their use. From: Tara Johnson <tjohnson@netroopers.org> Sent: Wednesday, November 6, 2024 12:48 PM To: Sarah Thielen AH <sthielen@Apta-health.com> Cc: Tim Longwell <tlongwell@theolsongroup.net>; Howard Shandell <hshandell@theolsongroup.net> Subject: Re: 2025 Renewal - Signature Requested Stop Loss Quote Hi Sarah, Have you seen the report for ServeYouRX's formulary disruption report yet? I think this is the only item we are really waiting on to finalize things on our end. Once this is ready, do you know when the benefit guide, OE slide show, etc. will be ready so that I can begin OE? Thank you!! Tara Tara Johnson This email may contain confidential and privileged information for the sole use of the intended recipient. Any review or distribution by others is strictly prohibited. If you are not the intended recipient please contact the sender and delete all copies. ________________________________ From: Sarah Thielen AH <sthielen@Apta-health.com<mailto:sthielen@Apta-health.com>> Sent: Wednesday, October 23, 2024 3:32 PM To: Tara Johnson <tjohnson@netroopers.org<mailto:tjohnson@netroopers.org>> Cc: Tim Longwell <tlongwell@theolsongroup.net<mailto:tlongwell@theolsongroup.net>>; Howard Shandell <hshandell@theolsongroup.net<mailto:hshandell@theolsongroup.net>> Subject: 2025 Renewal - Signature Requested Stop Loss Quote Hi Tara, Thank you for joining us for lunch today! For the 2025 renewal we are looking at a 4.1% increase on admin costs and 8.9% overall with Stop Loss premiums and aggregate factors. As discussed, we are working with Granular to see if we can get some relief on the aggregate factors. While we are pending their final review, I do recommend that you sign the current quote to ensure it is locked in as-is. In the event of a reduction, a new quote will be generated. * Granular Firm Quote – Signature requested on page 10 * Meritain PHI Form – Signature requested at the bottom of page 1 We are running the formulary disruption to see the impact of using our custom Lowest Net Cost formulary with ServeYouRx as the PBM. Plan changes discussed are as follows: * OON Hearing Aid benefit to mirror INN benefit of 85% AD, $2500/ear * Obesity exclusions will be updated to allow nutritional counseling with a licensed dietician or nutritionist. OON benefits will mirror INN benefit level 85% AD. * Addition of GLP-1 Compounding Pharmacy program – employee paid Thank you, Sarah Sarah Thielen Lead Client Experience Executive Apta Health | Novo Connection 628 N 108th Court | Omaha, NE 68154 402.999.4478 direct | 402.707.9786 mobile [cid:image001.png@01DB3132.B8B05010] The information contained in this message and any accompanying attachments may contain privileged, private and/or confidential information protected by state and federal law. Penalties may be assessed for unauthorized use and/or disclosure. This message and any attachments are intended for the designated recipient only. If you have received this information in error, please notify the sender immediately and return or destroy the information. This e-mail transmission and any attachments are believed to have been sent free of any virus or other defect that might affect any computer system into which it is received and opened. It is, however, the recipient's responsibility to ensure that the e-mail transmission and any attachments are virus free, and the sender accepts no responsibility for any damage that may in any way arise from their use.
