Just got the notice Cigna will not cover Zepbound for its employees for weightloss effective 7-1. Feels like the ultimate bait and switch: “join our program, use Omada, we cover your medication cost for this lifetime
Med!!” 2 years and 100lbs later “just kidding- you can pay $500 per month cash pay, it’s accessible now!”. Between layoffs, benefit downgrades, verint, stagnant wages I feel like I’m actually losing money working for this company not making money lol. Anyone else feel like they are paying for the “luxury” of working here? Maybe they’re just hoping we regain the weight and unalive so they can save money without additional layoffs
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I am not in a department that deals with ASO clients or laws around self-funded plans, but a quick google asking the notice period for an ERISA plan to change a benefit like this stated that they have to cover for 60 days, not the 30 days they provided.
Does anyone know if that’s accurate? I will happily file a complaint against them. The greed of this company is mind blowing, truly. Call it non preferred, raise the OOP co-insurance, but no they go to the extreme. It doesn’t take a data scientist to predict the long term increase in costs due to a less healthy population not to mention actual loss of life.
It's an absolute nightmare of a rug pull to get us on these dr-gs that change our lives for two years then see-saw so quick.
Even if it costs them 20 million yearly, thats .25% of their 8 billion net profits. Wrecking quality of life for thousands lf employees by a huge measures for fractions of a percent on the bottom line
@qd
“ Well a lot of them are super narcissistic about their appearances especially if Band 4 and above so makes since this health insurance company would subsidize glp over cancer treatment.”
That’s quite the straw man you built there.
@OP I don't think $280 a share is "surging" considering Drive to 25 had a much higher target - but here is what they think of you:
"Cigna shares are climbing as investors cheer the company’s latest cost-cutting push, including a move to stop covering pricey GLP-1 obesity dr-gs for its own employees in an effort to rein in pharmacy benefit expenses. The rally is gaining extra strength from a fresh analyst call at Piper Sandler, which lifted its price target to $346, highlighting further upside even with the stock trading ex-dividend today."
https://www.tipranks.com/news/catalyst/why-cigna-stock-is-suddenly-surging-higher-today#google_vignette
@qa Well a lot of them are super narcissistic about their appearances especially if Band 4 and above so makes since this health insurance company would subsidize glp over cancer treatment.
Tells me far more coworkers went on GLP-1s than expected.
@a5 how would one go about finding a place with insurance that would cover this med?
Absolutely wild that they’re taking away this benefit mid-year (but if I want to make changes on my end, there’s only a limited scope of reasons I can make changes). Is the company really hurting for money that badly?
And what does this tell our clients and broker partners? Hey, we’ve got these excellent, shiny new programs that will help you manage GLP-1 utilization and keep costs lower - but we have to remove the benefit from our own employees’ health plan because we can’t manage our own GLP-1 utilization. Yes, access has increased and there are new, alternate methods of obtaining GLP-1s, but they still unreasonably expensive.
@d9
“ I can be down with that but I request consistency so that any claim where any culpability falls on the patient is handled the same way. Deal?”
Your terms are acceptable.
This is why health insurance should cover only the most catastrophic situations and should have never entered the wellness arena.
No. This post is about the removal of an EMPLOYEE benefit. Nothing at all to do with the subscriber base as a whole.
As such, any discourse about the broader impact (if the benefit were to be applied beyond the employee base) is irrelevant and serves as a bad-faith distraction from the matter at hand.
But ok, let's accept your stance at face value. You have carved out one narrow item that you want excluded because the condition is self-inflicted.
Cool. I can be down with that but I request consistency so that any claim where any culpability falls on the patient is handled the same way. Deal?
@d0 What if we reminded you that all employees get one specific window per year to choose (increasingly limited) options... but employers get to subject changes to the plan at any time during the year?
@cw
What if I told you that Cigna insures more than just its employees, and that Cigna commercial doesn’t give Cigna corporate special treatment?
All employers have the ability to opt out of coverage for GLP-1s. Many choose not to cover as a way to control costs.
@cr
"Do you realize that a 25% membership utilization of GLP meds would wipe out all insurer profits? Are you willing to pay another $250+ per month because of people who largely eat too much processed and calorie-heavy food?"
Wait, wait. Let's strive to keep the goalposts in place here. The op was about employee coverage. Employee.
In a feeble attempt to bolster your stance, you've switched to the entire enrolled base. Intellectual dishonesty.
User AS, kindly shut the f__k up about "diligent with our weight control" and "chronic overeaters." You think those of us on a GLP1 haven't gone to the ends of the earth to diligently try to lose the weight? Endless dieting and exercising. Consider yourself very lucky to be set up metabolically and hormonally the way you are. The rest of us live with constant hunger and teeny tiny weight loss after a tremendous amount of effort that other people don't have to contend with. This dr-g is not a quick fix for fatties who choose to pig out while you shoulder the load. This dr-g fixes the entire problem and allows us to eat clean and exercise and do the things we need to be healthy without feeling tortured. How do I know this? I am one of them. Happy to show you the long list and many years of efforts I have contributed towards weight loss. Pulling reasonable access away from us is no different than saying your blood pressure medicine is now going to cost you $500 per month. Now if you just quit putting salt on your food and meditated more, maybe the rest of us wouldn't be stuck with your lack of effort and poor choices.
Abused the program? Yeah, I'm sure thousands of people are getting on GLP1 dr-gs unnecessarily and/or taking more than needed. You know, for recreational reasons...such a buzz.
100%! The only problem is that you are too narrow in singling out overeating/obesity.
What about
- The smoker who got lung cancer?
- The woman who had pregnancy-related complications?
- The driver who was partially at fault for a car accident?
- The person who ignored symptoms until a condition needed expensive treatment?
- The person injured from rowdy behavior at a pool?
All of these and many more were to some extent self-inflicted and thus can all be self-covered.
No insurance at all unless the recipient can prove that they didn't contribute to their situation. Right?
Come on now! How much can we expect from a company that's struggling to keep the doors open, with quarterly profits not even clearing 2 billion?
A bit of belt-tightening is in order and, as usual, the employee base is targeted.
Good thing comorbities don't cost health insurers a lot of money which was being minimized with significant weight loss as well (said sarcastically). Health care is an absolute joke. This country deserves to fail with the stupidity in most industries right now. But at least the healthcare shareholders are happy - until the house of cards inevitably, and so predictably, fall.
@b4 don’t waste your time arguing. They probably still believe the earth is flat, covid was Fake and the moon landing was made up. Why would they follow the science now
@as -to your point, only a few small medical organizations, including the American Medical Association and the World Health Organization, officially classify obesity as a complex, chronic disease…no longer blaming it on overeating or a lack of self-control. So glad my people like you working at my insurance company know better than the AMA, doctors, and many other medically trained professionals. I just hope Cigna can soon diagnose my cervical health without that silly little exam my doctor recommends each year! Maybe stop covering erectile meds too…ED is just a “disorder” and really, people don’t “need” to have s-x. They can just abstain and practice self control :)
Why is @as being downvoted?
Maybe the Peleton comment was a bit much, but there is a fair conversation to be had about the economic viability certain dr-gs.
And while there are some people that this is medically necessary, there is a fair argument to be made that a sizeable percentage of pepoe on GLP1's are on it due to a lack of will power.
Complaints may be best lodged against those who have abused the program rather than a person that points out the abuse.
This was the only benefit that gave me heartburn about taking competing offers. I guess this is goodbye…
The wholesale cost of Zepbound to insurers is $1086.37/month.
It is estimated that 46% of Cigna’s 11M commercial membership is at or near obesity. That’s around 5M obese members.
Now imagine if 1/2 of those members got Zepbound. That’s $2.7B per month. Potentially forever.
Insurers cannot absorb such a huge expense without substantial rate increases, and employers (even our own) have zero appetite for this.
I hate to sound heartless as I know many people are obese due to metabolic issues, but it’s not really fair to those of us who are diligent with our weight control to shoulder much of the cost of obesity meds for people who are largely just chronic overeaters. Obesity is definitely an epidemic, but it’s also something that the overwhelming majority of people can positively impact through diet and exercise.
Perhaps some of you would benefit from the Peloton offerings.
You nailed it. I’m honestly wondering what the purpose of working is for because the benefits are becoming less and less. Even with the spousal surcharge I’m losing more. Granted I’m a level entry employee, after all is said and done I take home less than $1,000 every 2 weeks working in claims. I’m unsure where to go from here but the company keeps changing and it’s not for the good. Glad I’m not the only one who feels like this but it’s sad for us that have no where else to go right now.
This was so disheartening and stupid to hear. At a time when employee morale is truly at it's lowest this was just the final kick in the teeth. I was feeling some relief not getting laid off just for them to effectively destroy my health instead. I will absolutely be looking elsewhere now because this medication literally has saved my life.