4 FAQs (and answers) employers may have about COVID vaccinations
Employers should be prepared to communicate their organization’s point of view on any vaccine requirements, says Brent Eberle.
Many states have now opened up COVID vaccination eligibility to the general public, and more will follow suit in the coming weeks. As such, employers will likely be faced with myriad questions from their employee population in regards to how, where and whether they need to get vaccinated. But employers have their own questions, too–how involved do they need to be in driving compliance and awareness? How much will employee vaccines end up costing them?
Related: Addressing vaccine hesitancy among employees
Brent Eberle, senior vice president and chief pharmacy officer at Navitus Health Solutions, recently shared some guidance for employers on common questions they might have. At Navitus, Brent oversees the Health Strategies Division, which is responsible for clinical and population health initiatives; drug utilization review programs, formulary and drug rebate management; and outcomes management initiatives.
Why is it important for plan sponsors to communicate with their members frequently as the COVID-19 vaccine rolls out? What information should they share?
The scale and speed of the COVID-19 vaccine rollout in the U.S. is unlike anything we’ve experienced before. There are now three vaccines available under an emergency use authorization (EUA), including Moderna and Pfizer, both a two-dose shot series, and the recently approved single-dose vaccine from Johnson & Johnson. With updates evolving daily, members have many questions about receiving the vaccine and how their pharmacy benefit plans will play a part. It’s beneficial that plan sponsors be prepared to address these questions and communicate new updates and information to their employees throughout the vaccine rollout. Doing so can help ease some of the stress brought on as a result of this pandemic.
One thing plan sponsors should absolutely be prepared to communicate is their organization’s point of view on any vaccine requirements—for example, will your company require a certain number of employees to be vaccinated before they can return to the office? Will the company reward employees for getting vaccinated? Because the vaccines are available under EUA right now, most organizations are not mandating that employees receive the vaccine at this time, but many are strongly encouraging it. Some organizations in the grocery and retail sectors, for example, are providing incentives to their employees for getting the vaccine, such as a one-time payment or extra vacation time.
Regardless of what your organization decides when it comes to requiring or encouraging employees to get the vaccine, make sure any formal policies or recommendations are clear to your members and communicated whenever new updates are made.
What role do employer-sponsored pharmacy benefit plans play in the vaccine process?
When plan members become eligible for the vaccine, one option is to receive their vaccine through a retail pharmacy, which can sometimes provide more convenience if it’s closer to home or requires less wait time than other locations. Eligible members who choose to receive the vaccine through a retail pharmacy will be able to use their employer-sponsored pharmacy benefit coverage for the vaccination. While the cost of the vaccine is covered by the federal government and is 100% free for the member receiving it, plan sponsors are required to cover the administration fee for the vaccine.
What costs or fees should plan sponsors expect when it comes to the COVID-19 vaccine and their pharmacy benefit plans?
The pharmacy or administrator of the vaccine receives payment for administering it. When an eligible plan member receives the vaccine at a retail pharmacy, plan sponsors will see an administration or dispensing fee on their claims data. But because some of the available vaccines require two doses, plan sponsors may see variations in this dispensing fee. For the two-dose vaccine series, the second dose administration fee is generally slightly higher than the first dose fee. This is because it covers the time and resources the pharmacy is spending encouraging patients to make an appointment for their second dose.
Plan sponsors should also keep in mind that although the federal government is currently covering the cost of the vaccine, this would likely only be the case for the duration of the current public health emergency. Coverage beyond this point, such as a booster series vaccine that may be required later, has not yet been determined. Once the public health emergency ends, there is a chance vaccine costs could shift back onto the plan sponsor in a similar fashion as how other vaccines are covered today.
How can employers help with second-dose compliance? What resources are available?
First and foremost, plan sponsors should direct members to their local public health departments for more information on who is eligible to get the vaccine and when. All eligible members should opt to get the vaccine wherever they can, but the CDC does recommend that patients try to get the second dose from the same location they received the first one.
Once a member meets state or local vaccine eligibility requirements, if they elect to use a pharmacy it’s their responsibility to contact the pharmacy to set up an appointment. As soon as they become eligible and the first dose is received, employers should encourage their plan members to make an appointment for their second dose before leaving the vaccination site. Having the appointment prescheduled can help increase the likelihood that they will return for their next dose.
Pharmacies and other administration sites also do a great job of coordinating with members and encouraging them to get their second doses. Retail pharmacy chains already utilize dose reminder cards, email and text reminders, as well as mobile app notifications to maximize second-dose compliance. The CDC has also developed VaxText, a free text-messaging-based reminder for the second dose, and V-Safe, an after-vaccination smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after patients receive the COVID-19 vaccine.
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