The cost of insurance, prescription drugs and specialty visits can add up fast, causing a lot of financial stress for working people and their families. And without quality health insurance, the financial burden of a single diagnosis or injury can be debilitating. That’s why at the Laborers’ Health and Safety Fund of North America (LHSFNA), our staff work hand-in-hand with LIUNA’s health and welfare funds (HWFs) to help offer the best health coverage possible at the lowest cost for members and their families.
Since its inception, the Fund has employed a comprehensive and multifaceted approach to promote better health and decrease healthcare costs for Laborers. We’re attacking the healthcare issue from multiple directions:
“No medical visit, procedure or prescription should be able to financially devastate a full-time worker,” said LIUNA General Secretary-Treasurer and LHSFNA Trustee Michael F. Sabitoni. “The LHSFNA works with health and welfare funds to ensure LIUNA members and their families receive the highest-quality care at an affordable price.”
Over 20 years ago, the Fund began partnering with Express Scripts to provide optional pharmacy benefit services to LIUNA HWFs through the LaboreRx coalition. Express Scripts is a pharmacy benefit manager (PBM), a company that negotiates with manufacturers and pharmacies to determine drug prices, formularies (lists of covered medications) and in-network pharmacies. PBMs offer a valuable, highly specialized skillset that makes it easier for many HWFs to provide Laborers with competitive benefits. When negotiating with third parties like PBMs, we also tend to have strength in numbers. You can think of it like collective bargaining in unions: the more funds that participate, the bigger our purchasing power, and the better chance we get what we’re asking for.
How does this translate to less money out of your pockets? The Fund negotiates the LaboreRx contract, leveraging the large number of LIUNA members to get bigger rebates and discounts on prescription drugs from manufacturers. We also go out to bid these contracts as early as possible, which ensures we get the best rates. These savings then go to health plans to offset or supplement membership contributions. We also work with Express Scripts to educate funds about the availability and effectiveness of cheaper medications—like generics or biosimilars. All of these help keep your drug prices down.
In addition, the Fund advises HWF administrators on benefit plan review, data analysis, insurance industry trends and the impact of legislative initiatives. Part of this support includes introducing funds to vendors that could help reduce costs. For instance, we work with Ullico (The Union Labor Life Insurance Company)—a labor-owned insurance and investment company—to negotiate better rates on optional medical stop loss insurance policies for individual HWFs. So if a member receives a diagnosis that costs more to treat than the health and welfare fund budgeted for, stop loss insurance would cover the additional cost.
Managing multi-fund contracts is only one piece of the puzzle. The LHSFNA also recognizes the benefit of investing in prevention. When people live healthier lives, they tend to need less expensive healthcare down the line. The Health Promotion Division works to equip LIUNA members and their families with the tools needed to stay healthy and manage conditions. The Fund organizes health fairs that offer free checks for blood pressure, glucose and cholesterol so problems can be found early. We also create educational materials on topics like quitting smoking, eating well, staying fit and avoiding substance abuse to help people make healthier choices.
By strategically partnering with third-party organizations and implementing a robust health promotion program, the LHSFNA demonstrates a comprehensive and proactive commitment to making healthcare affordable and a healthy life achievable for Laborers and their families. Need assistance navigating your healthcare benefits? Reach out to your local health and welfare fund.
[Hannah Sabitoni]
