How the Plan Works:

We've kept your drug plan simple

The HealthWATCH® drug plan is an employee-first approach. Our goal is to find the right balance between drug plan affordability and helping to keep employees healthy and at work.

We've kept your drug plan simple

We began with a ton of research

The HealthWATCH® drug plan team, which includes some of our pharmacists, leads the decision-making process, guided by the advice of a Clinical Advisory Board.

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Pharmacists

physician

Physicians

epidemiology

Epidemiologists

(people who study diseases
in specific populations)
hand supporting a coin

Health
Economists

human resources

Human
Resources
Professionals

They base their coverage decisions on:

Clinical
Evidence

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An Economic and Cost Comparison

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Impact on
Employees

human resources

The Result?

A plan member-first plan that is focused on traditional* prescription medications, with a policy that supports biosimilars, into two levels of coverage or reimbursement, called “tiers”.
The amount of coverage you get depends on the tier your prescription drug falls under:

Tier 1
Higher coverage

tier 1
  • Includes most generics and some brand name drugs that are more cost-effective

Tier 2
Lower coverage

tier 2
  • Includes some generics and brands (with or without generics) which the HealthWATCH® drug plan team has determined do not demonstrate additional clinical benefit relative to their cost, when compared to Tier 1 drug options that treat the same condition

Together, these two tiers cover the majority of traditional prescription drugs that are used to treat common conditions.

Together, these two tiers cover the majority of traditional prescription drugs that are used to treat common conditions.

Not listed
No coverage

not listed

Not listed
No coverage

  • Drugs that have more cost-effective alternatives on the drug plan that treat the same condition
  • Therapies that are available over-the-counter

* Most prescription drugs are “traditional.” They treat a wide range of common illnesses or conditions like diabetes, high blood pressure and high cholesterol.