Compare RDS vs EGWP Plans

RDS vs. EGWP Retiree Drug Subsidy Employer Group Waiver Plan Medicare Part D History 2006 Medicare Part D, created in 2003, takes effect. Part D established two ways of receiving subsidy for Medicare-eligible drug costs: The RDS subsidy and the EGWP. 2010 The Affordable Care Act removed the tax free status of RDS payments effective Jan. 1, 2013. 2011 The Medicare Coverage Gap Discount requires pharmaceutical manufac- turers to provide a 50% discount on brand name drugs for Rx plan members in the coverage gap. 2013 EGWP + Wrap programs maximize savings by combining and EGWP without gap coverage for brand name drugs PLUS a commecial insurance wrap product to provide the missing coverage which greatly increases the discount impact for plan sponsors. RDS vs EGWP + wrap PAYOUT LEVELS $45 $100 National monthly average subsidy National monthly average of subsidies and discounts an EGWP +wrap provides payout by CMS per retiree. per retiree. CASHFLOW 31 Reimbursement JAN Annual Reimbursement Monthly ACCOUNTING UNFAVORABLE accounting treatment for public sector entities. HIGHLY FAVORABLE accounting treatment for public sector entities. (ADMINISTRATION HIGH LEVEL of administrative burden MNIMAL LEVEL of administrative for Plan Sponsor. burden for Plan Sponsor. ACTUARIAL TESTS MUST PASS NO TESTS Plan Sponsor MUST PASS two actuarial equivalence tests annually. Plan Sponsor has NO TESTS for actuarial equivalence. CATASTROPHIC COVERAGE NOT PROVIDED PROVIDED RDS Plans D0 NOT PROVIDE EGWP's provide reimbursement federal subsidy reimbursement coverage for retirees who exceed subsidies for 80% OF ELIGIBLE DRUG COSTS that exceed maximum TROOP levels. maximum TROOP levels. CMS INTERACTION DIRECT CMS NONE CENTERLHE NEKARIA DEAD VICE Plan Sponsor must Interact directly with Plan Sponsor DOES NOT interact with CMS to receive monthly reimbursement CMS to recelve annual relmbursement based on ELIGIBLE GROSS DRUG SPEND. based on PER ELIGIBLE MEMBER drug TrOOP. Egg Whips (EGWP's) The Employee Group Waiver Plan (EGWP, commonly pronounced egg-whip) is amajormove forward in Medicare eligible retiree pres cription drug benefits. Our EGWP provider contracts with CMS directly to manage the plan and compliance, making it easy for the plansponsorto realize enomous savings. Subsidy amounts are used to reduce the plan premium. There is no paperwork filing to do and no delay to receive CMS reimbursements. Thesubsidized and fully insured premium allows the employer to budget for pres cription drug costs effectively and affordably without affecting plan enrollee's benefits. If you are a plan sponsor or a broker you can leam more about how to implement an EGWP by visiting www.EGWPInfo.com today. To speak with a qualified EGWP provider and get answers to your Medicare Part D benefit questlons, please visit the site and fill out our contact fom to schedule a no obligation assessment. Information provided by www.EGWPInfo.com.