Very few plan sponsors are equipped to handle the cost, exposure and administrative functions that accompany a transition to an Employer Group Waiver Plan (EGWP). For clients seeking skilled outside assistance, AmWINS is a logical choice. AmWINS EGWP portfolio dates back to 2006 when the program was first introduced, and also offers more than 25 years of retiree administration experience. With an AmWINS partnership, we can help your client achieve these six key outcomes:

1. Reduced costs—AmWINS will shoulder the annual compliance expenses. Plus, our qualifications, including our long-term relationship (we have been in Medicare Part D since 1/1/2006) with the Center for Medicare Services (CMS) ensures procedures will be done efficiently and correctly.
2. Satisfied commitments—Our ability to customize plan offerings to match current benefits minimizes disruption and ensures organizations continue their benefits promise to retirees.
3. Increased efficiency—AmWINS will remove the administrative burden from your organization, freeing up valuable time. Our experience will also ensure that your government contribution is maximized.
4. Improved cash flow—Our model of transparency shows that 100 percent of rebates are passed on to the client. Additionally, there is no waiting time for the reimbursement, aiding cash flow.
5. Reduced CAT exposure—AmWINS’ model allows most advantageous use of CMS’ catastrophic coverage, which is allowed at 80% of the CMS Covered Claim Cost.
6. Increased client and member savings—AmWINS clients receive a 70% discount on brand name drugs in the donut hole. Members receive a low income subsidy that reduces premiums and copays. (Eligibility required.)

MEMBER SERVICE

AmWINS’ customer care and advocacy center provides retirees with a necessary resource 24 hours a day, 365 days a year, with no lengthy phone menus. Representatives can help retirees choose the right plan, as well as answer questions about coverage, billing and claims. Our licensed representatives receive extensive training on products, programs and senior sensitivity training.

WHY WE ARE DIFFERENT

AmWINS Rx differentiates itself from other PBMs through:

• Case management and utilization reviews for total management of the patient’s health care
• An integrated pharmacy data repository to better manage member needs
• A member services administration for improved member, provider and PBM communication
• Independently owned status - resulting in broader solutions not driven by rebates
• Focus on customized solutions through plan design flexibility and reporting
• Programs and reports designed around the customer’s needs
• Case management (with your provider) and utilization reviews for total management of the patient’s health care
• A relationship-driven approach that results in high year-over-year client retention

Many of our self-funded groups converted from a Retiree Drug Subsidy program and experienced significant cost savings and minimal disruption. Our streamlined implementation process is the key component to a successful retiree transition.

Every EGWP installation is effectively communicated through a mutually agreed upon timeline and frequent interaction with subject matter experts.

Following implementation, our internal procedures allow us to quickly identify program changes and communicate them to retirees via mail and our customizable member website and mobile application.

AmWINS is an independent organization and will not steer your clients to any pharmacy