A Stronger Benefit for High-Risk, Union Workers

RxBenefits empowered a Midwest firefighters' trust to control costs, improve member outcomes, and strengthen long-term sustainability allowing the trust to focus on protecting those who protect us.

A firefighter's trust in the Midwest had escalating pharmacy costs fueled by high-priced specialty medications and complex member needs common among first responders, such as exposure to hazardous materials, higher rates of diabetes, and respiratory conditions. Members also faced frustrating administrative barriers, including delays in prescription fulfillment, confusion about coverage, and limited help navigating their pharmacy benefits.

As costs climbed and satisfaction dropped, the trust needed a specialized partner who understood the challenges of unionized, high-risk professions and could deliver both cost control and an exceptional member experience.

The Trust partnered with RxBenefits to design a more sustainable pharmacy strategy focused on clinical management, cost transparency, and personalized care.

• Independent Clinical Management: Advanced clinical management ensured every prescription was both medically necessary and cost-effective. This included review of GLP-1 therapies and High-Touch Therapeutic Interchange, which saved a member $800 in out-of-pocket costs on a specialty respiratory medication.
• Tailored Plan Design: The plan was customized around the treatments for health risks and chronic conditions most prevalent among firefighters, balancing short-term relief with long-term wellness.
• Exceptional Member Support: RxBenefits’ dedicated service team provided one-on-one assistance, resolving issues quickly and compassionately, resulting in faster access to needed medications.
• Risk Mitigation: By proactively managing high-cost claims, RxBenefits helped protect both the trust and its members from financial surprises.

Through strategic plan design and proactive clinical management, RxBenefits delivered tangible financial relief and measurable improvements in member satisfaction.

• 18% reduction in first year pharmacy spend through clinical interventions and benefit optimization.
• Faster member resolutions and clearer communication.
• Engaged long-term partnership to continue fiscal stewardship.

RxBenefits empowered a Midwest firefighters trust to control costs, improve member outcomes, and strengthen long-term sustainability allowing the trust to focus on protecting those who protect us.