Broken Arrow City Council
Meeting of: 01-21-2020
Title:
title
Approval of and authorization to execute Copay Max Addendum with Navitus Health Solutions, LLC to manage costs related to specialty drugs paid for by the employee health plan
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Background:
The City has provided employee health benefits through self-insurance since 1989. On October 7, 2014, the Council approved an agreement with Navitus Health Solutions, LLC (Navitus) to be the pharmacy benefit manager for the City’s employee health plan. This direct contract with Navitus enables the City to negotiate the rebate and fee structures of the prescription plan and allows greater control of the plan design.
The Copay Max Addendum will be effective as of February 1, 2020 and will allow the plan to maximize the specialty copay assistance for both the plan and the member. With this addendum, Navitus will assist plan participants in enrolling in applicable specialty drug manufacturer copay assistance programs when available for applicable prescriptions. The savings will apply to the member’s copay and any remaining savings will be absorbed by the plan. There is a $75 per claim fee for this service; however, the savings to the plan is estimated to be greater than the fee.
Staff recommends approval of and authorization to execute Copay Max Addendum.
Cost: As estimated in the Group Health and Life Fund in the FY2020 Budget
Funding Source: Group Health and Life Fund
Requested By: Jannette McCormick, Human Resources Director
Approved By: City Manager’s Office
Attachments: Navitus Agreement, Copay Max Addendum
Recommendation:
recommend
Approve and authorize execution of Copay Max Addendum with Navitus Health Solutions, LLC.
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