Association Benefit Plan Health America Patient Safety Initiatives
Pharmacy Benefit Management Arrangements—Association Benefit Plan
The Association Benefit Plan along with Mutual of Omaha is extremely concerned and aware of the rising cost of prescription drugs and make every attempt to provide means of assisting in controlling these costs.
Mutual of Omaha has a contractual arrangement with Express Scripts, Inc. as our pharmacy benefit manager. Through a contractual arrangement with Express Scripts, we have strengthened our oversite through the following:
- Annual onsite audit by Deloitte and Touche
- internal audits to review claim adjudication accuracy
- Performance guarantees surrounding the following
- Timeframe for rebate payments
- Participant satisfaction survey
- Speed of answering customer service calls
- Customer service response time
- Prescription accuracy
- Turn-around time for mail service
- Generic substitution rates
- System downtime
- Timely production of management reports
- ID card production
- Drug file change accuracy
- Pharmacy auditing
In addition to the above, Express Scripts has monthly conference calls with the pharmacy team to discuss operational issues and strategic planning. Express Scripts also meets with the pharmacy team on a quarterly review basis to discuss the different measuring reports and goals that are in place.