DISPENSING FEE FREQUENCY LIMIT: A GREAT WAY TO SAVE ON DRUG PLAN COSTS

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Sun Life is continuously searching for opportunities to help plan sponsors lower their drug plan costs at the same time as encouraging plan members to make informed decisions when shopping for their prescription drugs. Our Dispensing Fee Frequency Limit (DFFL) is a new plan option that is available to all Pay Direct Drug (PDD) plans. This feature allows you to limit the number of dispensing fees per maintenance drug that will be reimbursed by your drug plan.

Dispensing Fee Frequency Limit: Facts at a Glance

  • Optional plan design feature available at renewal for all PDD plans.
  • Only maintenance** drugs will be targeted, as these drugs can typically be dispensed
    in 3-month supplies. Categories include, but are not limited to: Antiasthmatics, Female Hormone Replacement Therapy, Antiparkinsons, Oral/transdermal contraceptives, Cardiac drugs, Antihypertensives, Cholesterol lowering drugs, Diabetes drugs and Thyroid agents.                                               
  • Certain maintenance drugs will be excluded for specific reasons such as: cost, storage, compliance, or patient monitoring. These include, but are not limited to: Antibiotics for infections, Anti-anxiety drugs/sedatives, sleeping pills, and Narcotic Pain medications.  Also excluded are extremely expensive therapies where a monthly supply is reasonable
    to decrease wastage, such as genetic replacement therapies.
  • Sun Life recommends a limit of five dispensing fees per maintenance drug per benefit period.
  • Currently not available in Québec. Other options, different than DFFL, can be put in place in this important market to help control drug costs.
  • An exception process based on medical criteria is available for those plan members who require their maintenance drugs to be dispensed more frequently.

As we expect you will have questions in regard to how the DFFL works, we have prepared a DFFL Brochure and a Frequently Asked Questions (FAQ) document to help you with any questions you might have.

Plan Member Communication

To educate plan members about the DFFL, we have developed a Frequently Asked Questions (FAQ) document which we encourage you to share with your plan members.

Integration With Other Drug Plan Management Solutions

The DFFL works in combination with our other BrightChoices drug cost management solutions such as Dispensing Fee Cap, Generic Substitution, Prior Authorization, and Evidence-Based Drug Plan.

Questions?

Please contact your Client Service Administrator at 1-877-786-7227.