Do you understand what part of your benefit program are being impacted by Biologic Drugs?
What is a biological product?
Biological products include a wide range of products such as vaccines, blood and blood components, allergenics, somatic cells, gene therapy, tissues, and recombinant therapeutic proteins. Biologics can be composed of sugars, proteins, or nucleic acids or complex combinations of these substances, or may be living entities such as cells and tissues. Biologics are isolated from a variety of natural sources – human, animal, or microorganism – and may be produced by biotechnology methods and other cutting-edge technologies. Gene-based and cellular biologics, for example, often are at the forefront of biomedical research, and may be used to treat a variety of medical conditions for which no other treatments are available.
Under the Extended Health portion of your Employee Benefits there is a component called Pooling. This is an area of the contract that until recently we did not worry about because claims for one person very rarely reached the pooling level. Now with the introduction of Biologic Drugs the pooling portion of your benefit plan are being effected. Empire Life is only one of the Insurance Carriers that are changing their rates and benefit minimums due to these drugs.
The Insurance Companies have created a pool called EP3 which is suppose to assist in keeping the costs for employers affordable while still providing full benefits to the employees. I believe the jury is still out on whether the EP3 is working the way they initially hoped.
If you would like to get a better understanding of your Employee Benefit Program and how you are or can be impacted by these Biologic drugs, please contact me.