While the treatment of plan members who have a chronic health condition can certainly increase plan costs, proper coverage is a small price to pay to have healthy, productive employees at work, rather than on disability or sick leave because of poorly managed conditions.
In addition, offering a benefits package that includes coverage for chronic illness medications without a drug cap could be a key competitive advantage. Employers who offer such coverage could be drawing from a wider pool of talent, compared to those organizations that are tempted to introduce lower drug caps as a measure to control drug plan costs.
A notable finding from our survey, Fresh Perspective on Group Benefits, is the startling difference between those who have a benefits plan and those who do not, as it relates to taking medication for chronic health conditions.
The results can mean two things, assuming the incidence of chronic conditions is equal across the population:
1. People who don’t have a benefits plan are less likely to take medication to treat their illness (affordability concerns)
2. People with a chronic illness specifically choose employers who offer group benefits, so they can be reimbursed for the medication expenses they incur and can afford treatment
If the latter is true, employers with less restrictive prescription drug coverage for chronic conditions will be more attractive to prospective employees, and could enjoy a competitive advantage in the acquisition of talent.