Jan 192005

Well here is the message (edited to remove my employer’s name – per corporate policy) I sent to the Executive Vice President over Human Resources, and CC’d my boss and my boss’s boss. While I have about zero expectation anything will change, this was my very best effort. I will post the reply – and I’m sure I will get a reply. 😉

And while I am not “extremely” disabled, I do score a 1.5-2.0 on the EDSS and I think that should count.

I wanted to make you aware of, and petition you to change, some of the modifications implemented in the health plan for 2005, specifically changes to prescription benefits. As someone suffering from Multiple Sclerosis, with continuing disability, these changes significantly punish me; especially in regards to my primary medication, Rebif.

Last week I called the mail order pharmacy to schedule my first refill for the new year, to be delivered this week. I got a call from them on Monday to make me aware of the new co-pay of $281.88. In disbelief, I called Walgreens Health Initiatives (WHI) to see about resolving this problem. The lady I spoke to, after looking at our plan for this year, said that XXXXXXXX had modified the plan so that “specialty medications” through mail order would now be paid at 20%, and that Rebif is specifically listed in the plan as being a specialty drug. This is up from last year’s co-pay of $25.00 per month. From a financial perspective this is very upsetting because this devastating change in the plan was kept secret and hidden. No where, in any documentation, is there a “specialty drugs” designation; furthermore, there was nothing stating that the plan would be radically changing for that group of medications. With the information I was provided by XXXXXXXX, and what I assumed the cost would be, I setup my health care account incorrectly. Keeping this intentional change to the plan secret, especially with such a radical and negative effect, seems to me, exceptionally unethical.

On a personal level, and as one already suffering disability, I am severely disappointed by XXXXXXXX changing the insurance plan so negatively. The changes to the plan seem targeted to save money at the expense of those of us with disabilities and chronic illnesses, the small subset of XXXXXXXX employees who use these specialty drugs. It would seem that, regardless of the talk, XXXXXXXX is not interested in their disabled employees; and is actively making changes to drive the disabled away.

Now I am caught in a dilemma. I can either find some way to pay for the medication that unexpectedly had over an eleven fold increase in price; or face a rapid worsening of disease progression, and thus increased disability. As I look at the XXXXXXXX plaque, and screen saver, on my desk about “Principals That Endure” I really question how well those are being fulfilled; in particular the “Commitment to the Well-Being of our People” and “Unquestioned Integrity.” In the minimum, XXXXXXXX does not seem to be interested in diversifying the workplace with the disabled when they make such penalizing changes to the insurance plan, as happened this year. I beg you, as one who has the authority to make this change happen, reverse out these modifications in the 2005 insurance plan.


Erik Smith

  6 Responses to “Concerns over 2005 Health Insurance Changes:”

  1. Well written Erik. I sure hope this goes somewhere for you and look forward to hearing about the reply you get. Crossing my fingers for you!

  2. I agree with you 100%! I was told by my pharmacy that I would have to meet my deductible for the new year ($500) when I called for my first refill of the year. I immediately called my insurance company and they assured me that I did not have a deductible and that the usual copay of $35 was all I needed to pay. However, I wonder if what you encountered is the beginning of how insurance companies and employers are going to deal with those of us who they may consider a “drain on their resources”. I have been very open and up front with my employer about my MS and they have so far been very supportive. Of course I realize that their bottom line is prefaced with dollar signs and our medicine is very expensive. However, those of us who continue to help them increase those dollar signs (through every increasing premiums and ever dwindling pay raises) should not be punished because we have a disability. I make an effort to come to work every day (even on those days when I feel like I’ve been hit by a train) while others stay at home because they have a headache! And guess who takes up their slack! I will step down from my little soap box now. Keep up the good work, Erik!

  3. Anon,

    You sound a lot like Erik with his work. He does such a good job for his company. He has three customer service awards, and they don’t just give those away there either. He works so hard, and has been there for almost 8 years now. When he had his worst exacerbation, he never complained, and only missed work on the days he was inpatient at the hospital. He could barely use his hands, and he just worked twice as hard.

    I am really proud of him for writing this letter, and at least trying to make a change. An increase this large is going to have an impact on us financially, and potentially change our way of life. This is bigger than what we can absorb.

    I guess what gets my goose the most is that this company just had a record earnings year. Each year of the decline in the economy they did great, but there were no raises. They laid people off, and expected other people to pick up the slack, but not even any acknowledgment. They have grown accustomed to “screwing” people, and I don’t think they are going to change. I hope that I am wrong.

    Thanks for writing in supportively Kim too!

  4. This is eactly why I dropped my insurance through my company and picked it up through the wife’s. In a small consulting firm of 14 people, I was the lone cripple and the rates from Blue Cross were starting to become oppressive. For the good of the company, I dropped my insurance. I did not discuss this with the CEO because I knew how conflicted he would be and how he would stick up for me and swallow the costs. I couldn’t allow this.

  5. mdmhvonpa,

    Must be nice to have a work enviroment where you know that the powers that be have your back. Erik’s company hires about 7,000 people, and we don’t belive they pick up any of the insurance cost. Each year the prices rise, and we pay thousands per year for the honor of having the policy. We spent years doing this, and not using the insurance at all. We do understand how it works. And the kids and I use it very infrequently as a whole… unless I am pregnant, then we make up for it.

    I would love it if Erik worked somewhere that they gave a flying flip about him period. He works with some WONDERFUL folks, but they are the regular joes like us.

    I did not think there were companies that cared anymore.

  6. On a side note I don’t usually make an emotional appeal in my persuasive papers. On the other hand I didn’t think speaking logically would help me much.

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