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State Fund is California's largest provider of workers' compensation insurance and a vital asset to California businesses. State Fund supports California's entrepreneurial spirit and plays a stabilizing role in the economy by providing fairly priced workers' compensation insurance making California workplaces safe, and restoring injured workers.



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Express Scripts, Inc.

Pharmacy Benefits Management Program

In November 1999 State Fund began a Pharmacy Benefit Management (PBM) program with Express Scripts, Inc. (ESI). Through our relationship with ESI, experts in the field of Pharmacy Benefits Management assist State Fund with the management of our workers’ compensation pharmaceutical benefit. The program is fully operational for Policy claims that are adjusted in all State Fund Regional Offices.

With the ExpressComp program, State Fund provides unique benefits to the injured employees, which offers acute, short-term medication therapy and mail order pharmaceutical service for long-term therapy.

The program simplifies the prescription process for our eligible injured employees. Network pharmacies electronically submit their requests for authorization to fill prescriptions to ESI. These requests are processed at the point of service when the injured employee submits the prescription. Within seconds of electronically transmitting the prescription requests, pharmacies receive authorization instructions from ESI. In many instances, this provides injured employees the opportunity to have their prescriptions filled by one of the many participating pharmacies that offer longer hours of operation, at times when State Fund Claims Examiners are not available.

The PBM program has a vast network of retail pharmacies that are used by injured employees. Eligible injured employees receive a list that contains the names, addresses and phone numbers of participating pharmacies.

For a statewide listing of ESI network pharmacies, go to MEDfinder MPN Search.

 

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