Creating a Stronger Future with The New York Labor Health Care Alliance

NYLHCA Pharmacy Coalition Offering

Understanding the needs of labor unions is at the core of what we do. With 50+ years of experience we know and understand the evolving needs of your members. We push further for labor Funds – actively listening and rigorously interrogating our extensive data to pinpoint opportunities to unlock new value.

• Funds are able to retain their autonomy while receiving the combined pricing strength from two national coalitions that cover 48 Funds and 95,000 lives.
• Annual Market Checks to keep pricing current and aligned with what the market dictates.
• Annual claims audit on your Fund’s behalf to assure that your Fund’s claims were processed in accordance to the contract guarantees.
• Pharmacy Management Funds (PMF), are contracted financial resources allocated to each Fund, to help Funds offset the cost of implementing and maintaining Express Scripts programs and services.
• NYLHCA recognizes the rising costs of health care and the desire of Funds to offer comprehensive health insurance for members at a manageable cost. To provide some financial relief, the coalition provides a credit of $0.05 per member per month (PMPM) to each Fund that is enrolled in an Express Scripts cost add-on clinical program.
• Segal’s Health Analysis of Plan Experience (SHAPE) program provides insights into the drivers of healthcare costs and the quality of care members are receiving. If Funds choose to participate, at no cost to them, it allows plan sponsors to understand what programs are working, how their network is performing and how members will be affected by plan changes.
• Dedicated Therapeutic Resource Centers (our pharmacy practices that specialize in caring for patients with the most complex and costly conditions) are available 24/7 by calling 1-800-803-2523.

Unlocking Value While Looking Ahead

We understand that innovation moves the needle towards improving health care. To solve your unique challenges, Express Scripts digs deep into your data, conducts research, and exposes new opportunities. Check out the videos below, or go to our website, to learn more about our solutions and ways we help Labor clients achieve better outcomes and lower their drug spend.