Retaining Talent through Specialty Advocacy
The Challenge
A high-performing long-term employee was diagnosed with a rare condition requiring an extremely expensive specialty drug. The standard insurance plan had a restrictive formulary that would have forced the employee to pay tens of thousands of dollars out of pocket.
The IMPACT
The organization faced the possibility of losing a key employee due to the financial strain of their medical care. Leadership felt that their benefits plan was failing a loyal member of the team when they needed support the most, creating an ethical rub for the firm.
The Strategy
JA introduced a Specialty Medication Advocacy program that sourced the drug through alternative funding channels at no cost to the employee or the plan. We provided a dedicated advocate to handle the logistics, ensuring the employee could focus entirely on their recovery.
THE OUtcome
The advocacy program successfully secured the medication, allowing the employee to stay with the firm and continue their meaningful work. This outcome reinforced the company’s culture of care and sent a powerful message to the rest of the workforce about the firm’s commitment to its people.
Things Employers Should Consider
Specialty pharmacy claims are often the moments where your benefits plan’s true value is tested. Traditional providers often prioritize cost-containment over member support in these catastrophic situations. Employers must seek out objective advocacy that prioritizes the member’s health and the plan’s sustainability to ensure long-term talent retention.