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