Chair Talk
January 2005
SERA representatives (Alvin Whitfield, Leland Hall, David Schwab and myself) met with Dr. David Fink (OSE), Peggy Moczul (Emp. Ben.) and Tom Hall (OSE) on January 12, 2005. Among the items we discussed were the third-tier co-pays ($30) for non-formulary drugs. At this meeting we were presented with breakdowns (retirees only) by State Health Plans (Aetna/Blue Cross) of prescriptions that were brand formulary, generic and non-formulary and subsequent costs for the month of November. In both the Aetna and Blue Cross members, the non-formulary drugs ($30 co-pay) made up less than 10% of all prescriptions filled. It is the State’s position that this is a minimum impact on retirees based on the numbers. We believe that it may be a minimum impact in total prescriptions filled, but it may be a major impact on retirees based on retirement dates/pension amounts. Especially hard hit are those retired prior to 1987. We were informed that we were only into the third month of this plan change and that the State would not at this time reverse the third-tier co-pays. What Mr. Fink did offer was that if we could provide information to them that if several third-tier drugs were prescribed for the same disease, they would look at the individual case and make a determination about what may be done to accommodate those prescriptions.
Based upon the type of information discussed at the meeting — we have to decide individually if we want that information to be gathered by SERA and then turned over to Employee Benefits or should that be done by the individual? I do not think that that individuals calls to Employee Benefits or the Office of the State Employer regarding third-tier drugs is advisable. I have been gathering some information from SERA members who have called me based on articles written previously. From those phone calls, I have member names, phone numbers and prescriptions that are third-tier drugs — but don’t have the disease listed that the drugs were prescribed for. The issue of third-tier drugs is not going to be resolved instantly and probably not to our total satisfaction. I would propose that information (names, phone numbers, drugs and disease name) be funneled through the SERA Chapters and passed on to me — I have developed a list of retiree and third-tier drugs and can utilize that list in its present form. I can then pass this list on to Employee Benefits for further investigation.
The cost of health care is rising daily. The third-tier co-pay is just one way of many that Employers are exploring to reduce health care costs. More and more costs are being passed on to retirees/employees. Health care costs are problems shared by all of us. According to Express Scripts breakdown for November, there were a total of 138,943 prescriptions for retirees at a total cost (Employer and Retiree) of $11,500,808.16. These figures are only for prescriptions — not other health care needs. The costs of health care are mind-boggling. As retirees we need to be looking at ways to reduce health costs — it is in our best interest to have our views known. Many of us (myself included) at times take for granted the amounts spent to keep us alive and somewhat healthy. We need to be more involved and be pro-active not reactive.
It has been brought to my attention that members who have diabetes and use monitors daily — there is a co-pay at Express Scripts for test strips and various monitors. However, you may check with the Durable Medical Equipment (DME) provider (Wright & Filippis) and there may be no co-pay for test strips. If you are using test strips, you may want to call the DME provider at 1-800-321-8074 and get your test strips from them rather than Express Scripts.
As we start a new year in our organization, I would request that all members who were serving as committee chairs and/or committee members please continue in those roles. If you are unable to continue in that role, please let me know. If someone would volunteer to provide the Washington Panorama report, I would appreciate it. I seem to have more on my plate as chair to be able to fulfill the Washington duties.
I have asked Peggy Moczul (Director of Employee Benefits) to be our speaker at the next Coordinating Council meeting February 4th. There has been a new contact person named by Aetna for retirees — Peggy will ask that person to attend the CC meeting also.
Editor’s note: Bob Kopasz is Chair of the Michigan SERA Council. He may be reached at P.O. Box 692, Mt. Morris, MI 48458; phone 810/240-8380
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