September 2020 Newsletter

32 bj health fundamentals newsletter

Standing With 32BJ Members and Their Families in the Fight Against COVID-19

Since the coronavirus hit the United States, 32BJ members have been on the front lines of the COVID-19 pandemic. Union members work in essential jobs that are impossible to do from home—cleaning, maintaining and securing residential, office, school, public and government buildings up and down the East Coast.

Frankie Echevarria, a doorman at the Lafayette on East 9th Street in the Village told the New York Times what work during the coronavirus outbreak is like: “‘It’s scary and I’m nervous… I keep my distance, but I try to stay positive,’… [Mr. Echevarria] routinely dons latex gloves and lavishly deploys the building’s stock of Clorox to deter cross-contamination. Yet exposure to the coronavirus continues to hold added terror for him, he said, since his wife suffers from a serious immune disorder. ‘At the end of the day, though, we’re here to help.’”

Union members and their families have been highly exposed to COVID-19. From March through July 2020, 9,000 plan participants had diagnostic tests for COVID-19 and more than 800 were hospitalized with the virus. More than 150 32BJ members have passed away from COVID-19.

The outbreak has also had financial consequences throughout the real estate industry as many office workers are now working from home and some New York City residents have moved out of the city. In continued partnership and commitment to 32BJ members, the Health Fund’s Employer Trustees and Union Trustees have worked together to reduce the strain that COVID-19 has placed on union members by extending health coverage for participants to 150 days after layoff, up from the standard 30 days of coverage after layoff that the Health Fund provided before COVID-19 hit.

“It is not by any stretch of the imagination a typical employer employee relationship,” Howard Rothschild, president of the Realty Advisory Board on Labor Relations, told the Los Angeles Times.

32BJ members wear masks while on the front lines of the COVID-19 pandemic.

In an op-ed in Crain’s, 32BJ President Kyle Bragg talked about the union and employer relationship that can be a model for other industries. “We have shown how collaboration between labor and management creates the conditions for an industry to not only survive the tough times but to thrive afterward… Today we are again working hand-in-hand to mitigate this crisis. We meet daily and have come to new agreements, extending health benefits and allowing for more flexible rules that enable people to continue working during the pandemic while also being able to deal with personal and family issues. These agreements build on the already existing best-in-class wages, benefits and protections for workers.”

You can read more about 32BJ members on the front lines of COVID-19 in New York Magazine, The New York Post, and New York CBS 2.

The 32BJ Health Fund Launches the 32BJ Maternity Program

We are proud to announce the launch of the 32BJ Maternity Program on July 1. The first-of-its-kind program is designed to lower the rates of complications, including unnecessary C-sections, for new mothers and make maternity care even more affordable for the working class union members who participate in the plan. When complications are lower, members are healthier and happier, and costs are lower.

The NYC hospital partners are: NYC Health + Hospitals/Elmhurst, NYC Health + Hospitals/Jacobi, NYC Health + Hospitals/Metropolitan, Mount Sinai West and Maimonides Medical Center in Brooklyn.

The NJ hospital partners are: Atlantic Health System’s Morristown and Overlook Medical Centers and Hackensack University Medical Center (Hackensack Meridian Health). 32BJ SEIU union members and their eligible dependents covered by the 32BJ Health Fund get help choosing a provider for prenatal care and a high-quality hospital for labor and delivery. The program also brings transparency to hard-to-find quality data that expectant parents want to see when choosing a provider and hospital, and educates plan participants about key questions to ask their providers about the care they need.

The key goal of the 32BJ Maternity Program is to reduce the rates of harm to pregnant women, particularly women of color—a majority of the Health Fund’s plan participants—who are at increased risk for complications.

The 32BJ Maternity Program will also lower plan participants’ out-of-pocket costs to as low as $40 for all prenatal care and labor and delivery costs. As childbirth has become more expensive for many families, the Health Fund is focused on ensuring a healthy pregnancy and a safe delivery that is affordable for plan participants.

“We’re excited to see the results of the new program,” 32BJ Health Fund Director Sara Rothstein said. “Our partner hospitals have made a commitment to practices that lower the risk of harm for women. We believe this will transform maternal care and improve outcomes for 32BJ families.”

32BJ Health Fund Issues PBM RFP

The 32BJ Health Fund, which currently contracts with CVS Caremark for pharmacy benefits, issued a Request for Proposals to identify the most appropriate vendor for the next contract period, starting in January 2021.

As a self-insured health plan, the Health Fund provides pharmacy benefits through a Pharmacy Benefit Manager (PBM) that offers discounts on prescription drugs, builds networks of pharmacies, maintains formularies, and provides clinical and utilization management services.

The RFP enabled the Health Fund to compare multiple PBMs across several areas including:

Contract terms, drug discounts and rebates.

Although many PBM formularies have prioritized maximizing rebates over the lowest net cost, the Health Fund sought out formularies that were clinically appropriate and prioritized lowest net cost over rebates. The Health Fund also carefully reviewed contract terms, which define which categories of drugs are rebate eligible and which discounts apply to each category of drugs. These contractual terms can have a meaningful impact on the overall cost for prescription drugs.

Formulary management and clinical programs for specialty and nonspecialty drugs.

The Health Fund wants to ensure that its plan participants have access to prescription drugs that are medically necessary. At the same time, the Health Fund wants to ensure that its formularies don’t include drugs that have little or no clinical value. These kinds of drugs can drive up costs for the Health Fund and its plan participants and have little or no clinical value above other drugs that are on the formulary or available over the counter.

A retail pharmacy network that offers both savings to the Health Fund and geographic access to pharmacies for plan participants.

The Health Fund needs to ensure that plan participants can access prescription drugs. At the same time, the Health Fund explored limited retail pharmacy networks to see if they provided lower drug costs.

Account support and a commitment to implement innovative programs that provide access to clinically necessary medication at the lowest cost to the Health Fund and its plan participants.

The Health Fund sought an organization that is committed to being a true partner to the Health Fund and its plan participants. Off-the-shelf solutions do not always meet the Health Fund’s needs and the Health Fund sought out partners that are willing to experiment with custom solutions that maintain high-quality benefits at the lowest cost.

The Health Fund will soon announce the outcome of the RFP.

To learn more about the Health Fund, visit 32bjhealthfundinsights.org.