How it works
SaveOnSP is committed to supporting plan sponsors working to make expensive specialty medications more affordable for their participants and their families. For plans that have modified their specialty pharmacy benefit to reduce costs for plan sponsors and their participants through a copay assistance benefit, SaveOnSP provides administrative services and a quality experience: educating plan participants on their new benefit, helping them enroll in manufacturer copay assistance, and obtaining their consent to monitor their pharmacy account on behalf of their plans on an ongoing basis. Through these plan-implemented benefit design changes, plan sponsors are able to control premium increases, maintain existing benefits, and keep room in their budgets for new medications in the ever-evolving specialty market.
Helps plan participants save money on their specialty medications by supporting their enrollment in manufacturer copay assistance
Supports plan participants on more than 300 medications in approximately 20 therapy classes through education of the plan benefit and monitoring their pharmacy account to ensure a seamless experience for participants
Helps plans achieve $4.50-$6.50 PMPM net savings through the implementation of a copay assistance benefit
Frequently asked questions
Copay assistance and specialty medications can be confusing. To help plan sponsors make the best decision for themselves and their participants, below is a list of frequently asked questions.
What is SaveOnSP?
SaveOnSP is a company comprised of healthcare and pharmaceutical industry experts with a mission to help plan sponsors and their participants reduce the high cost of certain specialty medications. SaveOnSP offers consultative and administrative services to employee benefit plan sponsors and commercial health insurers to support and implement a change to their existing plan benefit design. The plan’s new copay assistance benefit is consistent with Affordable Care Act (ACA) regulatory requirements and focuses on delivering optimized health outcomes.
The copay assistance benefit creates a unique savings opportunity for plan sponsors and their participants through the use of available manufacturer copay assistance. The goal of the copay assistance benefit is to ensure plan participants can overcome financial barriers while driving improved adherence on their treatment.
Why do plan sponsors work with SaveOnSP?
Through partnerships with the prescription benefit manager and plan sponsor, SaveOnSP administers the plan’s copay assistance benefit and assists plan participants with their enrollment in available manufacturer copay assistance, which could otherwise be confusing and difficult for them to navigate. With consent from the plan participant, SaveOnSP then monitors their pharmacy account on behalf of the plan to ensure assistance is applied correctly. Enrollment in copay assistance helps both plan sponsors and their participants reduce costs while keeping the plan participant on therapy. With a growing specialty pipeline and continually increasing specialty medication costs, it is critical that plan sponsors, brokers, and consultants evaluate specialty management methods that won’t sacrifice clinical outcomes or regulatory compliance for cost containment.
How will plan sponsors see savings generated?
The plan sponsor will experience savings by leveraging the Affordable Care Act state benchmark requirements to classify certain specialty medications under the category of non-essential health benefits. These medications will not accumulate toward the plan participant’s deductible or out-of-pocket maximums. This allows higher cost-sharing to apply to the medications and a lower overall cost paid by the plan.
What service does SaveOnSP provide?
SaveOnSP partners with the plan’s in-network specialty pharmacy to administer the plan’s copay assistance benefit, facilitating the plan participant’s enrollment in the applicable manufacturer’s copay assistance program. Prior to filling an eligible specialty medication prescription, qualified plan participants will be directed to SaveOnSP. SaveOnSP representatives will educate them on their plan benefit design and the new copay assistance benefit, help with enrollment in the available copay assistance to lower the cost of their specialty medication, and obtain consent to monitor the plan participant’s pharmacy account on behalf of the plan on an ongoing basis. SaveOnSP provides the filling pharmacy with the necessary information to ensure the plan participant’s final responsibility for their specialty medication is reduced in accordance with the applicable plan benefit.
Which specialty medications are included in the copay assistance benefit and supported by SaveOnSP?
Only certain specialty medications are included in a plan’s copay assistance benefit. The list is proprietary and varies based on the plan’s formulary and benchmark state.
What if a plan participant doesn’t agree to participate in the plan’s copay assistance benefit and receive SaveOnSP’s support?
Eligible plan participants who do not agree to participate in the plan’s copay assistance benefit, specifically, they do not agree to enroll in the available manufacturer assistance program and do not consent to SaveOnSP monitoring their pharmacy account on behalf of their plan, will miss out on an opportunity to lower the cost of their specialty medication. Additionally, they may experience a higher cost-share than they previously had based on the plan’s benefit design, which now includes the copay assistance benefit. It is strongly recommended that all eligible plan participants utilize the plan’s copay assistance benefit. SaveOnSP will then be able to help ensure the plan participant’s out-of-pocket cost continues to be reduced for eligible specialty medications.
Does this new cost-share under the plan’s copay assistance benefit accumulate to the plan participant’s out-of-pocket or deductible?
No, it will not apply to any deductibles or out-of-pocket limitations. By preventing manufacturer dollars from subsidizing the shared medical and pharmacy deductible or out-of-pocket obligation, plan sponsors create an equal pharmaceutical benefit across their population.
What is the impact to plan participants?
Plan participants will be required to enroll in their applicable copay assistance program and consent to SaveOnSP monitoring their pharmacy account on behalf of their plan. If a plan participant is not already enrolled in the available manufacturer copay assistance, SaveOnSP will assist them with such enrollment. Plan participants who utilize the plan’s copay assistance benefit can expect a lower cost for all eligible specialty medications included in the benefit.
Will my members have visibility to the new cost-share?
Yes; however, SaveOnSP will educate the plan participant on the plan’s benefit change and the new copay assistance benefit.
Does a plan need to implement the design change at the beginning of the plan year?
No, the copay assistance benefit can be implemented as soon as the plan documentation (Summary Plan Description [SPD], SMM, SBC) and plan design changes are made, consistent with applicable law. Each plan sponsor should consult with its legal counsel and advisors to decide whether mid-year benefit changes can be made and determine the process needed to make such changes.
Who do I contact about SaveOnSP's services?
Contact your benefits consultant or pharmacy benefit management account team for further information.
Where are you located?
SaveOnSP has offices in Buffalo, NY, Vero Beach, FL and Denver, CO.