Colin Barry, MBA, P.Eng, CFP
CERTIFIED FINANCIAL PLANNER® Professional
CERTIFIED FINANCIAL PLANNER® Professional
Article Licenses: CA, DL, unknown
Advisor Licenses:
Compliant content provided by Adviceon® Media for educational purposes only.
Drug Plan Management Solutions: There is a wide range of drug plan options that can be fine-tuned to suit your organization’s needs, while allowing you to better manage the rising cost of prescription drugs. Yet you can still provide your plan members with the coverage they need. We can help you keep your drug plan affordable for both you and your plan members, by implementing drug plan cost management solutions.
Two-tiered plans: A two-tiered drug plan design allows you to cover two formularies at two different levels of reimbursement. A tier-one managed formulary with a higher coinsurance can be supplemented by a more comprehensive formulary at a lower coinsurance level. This allows your plan to maintain broad drug coverage, while still lowering overall costs.
Managing your drug plan with formularies: A formulary is a list of drugs the benefits plan will cover, out of the thousands of prescription and non-prescription drugs on the market today. There are many types of formularies, but the overall goal of each one is to control the eligibility of drugs, and therefore help manage drug costs by either: adding new drugs only after their therapeutic value and cost effectiveness have been proven, or allowing only generic drugs, or following the guidelines set by provincial governments.
Formularies may be designed such as:
Managing your drug plan with cost-containment options
We offer a number of plan design options to help you manage your healthcare plan costs. Let us help you determine which of these solutions fit your needs.
Using Generic Substitution
Cost reimbursement is established to the value of the generic equivalent of a drug, regardless of what has been prescribed, unless the physician indicates ‘no substitution’ on the prescription
Per-prescription deductibles: This is the amount the plan member must pay for each prescription drug claimed. It can be set to a specific amount, or equal to the dispensing fee portion of the drug.
Coinsurance: Coinsurance is the determined percentage amount that the plan will pay for eligible prescriptions after any deductibles have been met.
Dispensing fee limits: This is the plan’s coverage up to the maximum amount of the fee pharmacies charge to cover their business expenses.
Drug maximums: This is the maximum amount the plan will reimburse for prescription drug coverage per person, per calendar year; maximums can be set at a specified amount per year, or can be unlimited.
Note: Plan Sponsors in Quebec: The Quebec government has a public drug plan that covers anyone who is not eligible for coverage under a private plan. This plan is administered by the Régie de l’Assurance Maladie du Québec (RAMQ). The law in Quebec also requires private drug plans to provide equivalent or better coverage than the public plan. Plan sponsors in Quebec are limited in how much they can alter their drug coverage, since they must ensure it conforms to RAMQ.
Note: Plans and coverage vary depending on the carrier used.
All articles are a legal copyright of Adviceon®Media and are for educational purposes only. The particulars contained herein were obtained from sources which we believe are reliable, but are not guaranteed by us and may be incomplete. This website is not deemed to be used as a solicitation in a jurisdiction where this representative is not registered. This content is not intended to provide specific personalized advice, including, without limitation, investment, insurance, financial, legal, accounting or tax advice; and any reference to facts and data provided are from various sources believed to be reliable, but we cannot guarantee they are complete or accurate; and it is intended primarily for Canadian residents only, and the information contained herein is subject to change without notice. References in this website to third party goods or services should not be regarded as an endorsement, offer or solicitation of these or any goods or services. Always consult an appropriate professional regarding your particular circumstances before making any financial decision. The information provided is general in nature and should not be relied upon as a substitute for advice in any specific situation. The publisher does not guarantee the accuracy and will not be held liable in any way for any error, or omission, or any financial decision.
Commissions, trailing commissions, management fees and expenses all may be associated with mutual fund investment funds, including segregated fund investments. Please read the fund summary information folder prospectus before investing. Mutual Funds and/or Segregated Funds may not be guaranteed, their market value changes daily and past performance is not indicative of future results. The publisher does not guarantee the accuracy and will not be held liable in any way for any error, or omission, or any financial decision. Talk to your advisor before making any financial decision. A description of the key features of the applicable individual variable annuity contract or segregated fund is contained in the Information Folder. Any amount that is allocated to a segregated fund is invested at the risk of the contract holder and may increase or decrease in value. Product features are subject to change.
Life Insurance policies vary according to contract terms. Please read any Life Insurance policy contract provided, or the segregated fund summary information folder prospectus before the time of purchase. Full details of coverage, including limitations and exclusions that apply, are set out in the policy of insurance. Commissions, trailing commissions, management fees and expenses may be associated with segregated fund investments which may not be guaranteed and their market value changes daily and past performance is not indicative of future results. A description of the key features of a life insurance policy, a segregated fund; and any applicable individual variable annuity contract is contained in information provided by the company from which it is purchased. Talk to your advisor before making any financial decision. For specific situations, advice should be obtained from the appropriate legal, accounting, tax or other professional advisors. The information provided is accurate to the best of our knowledge as of the date of publication and is general in nature, intended for educational purposes only, and should not be relied upon as a substitute for advice in any specific situation. For specific situations, advice should be obtained from the appropriate legal, accounting, tax or other professional advisors. Rules and their interpretation may change, affecting the accuracy of the information.