Is Your Health Plan Killing the Corner Pharmacy?
Is Your Health Plan Killing the Corner Pharmacy? How employer decisions fuel pharmacy closures—and what you can do about it Executive Brief Independent pharmacies are disappearing—hurting…
Category: PBM
Pharmacy benefit manager practices, contracting, economics, transparency, and strategies for improving pharmacy benefits.
What Health Plan Lawsuits Reveal
What Health Plan Lawsuits Reveal And How to Stay Out of Them You may never find yourself in court over your company’s health plan. But that…
Boardroom Risk Alert
Boardroom Risk Alert Fiduciary Failure Leads to Personal Liability Inflation, wage pressure, rising drug costs, and tariffs on products and supplies are squeezing health plan budgets.…
Compensation Disclosure
Compensation Disclosure Time for Brokers to Come Clean The world of employee benefits is changing—and so is the expectation around who works for whom. For decades,…
Why Employees Pay More for Prescription Drugs
Why Employees Pay More for Prescription Drugs What Can Employers Do About It? It’s a question every health plan sponsor should be asking: Why are employees…
Smarter Approach to PBM Management
Smarter Approach to PBM Management The PBM Landscape The Big 6 PBMs—CVS Health, Express Scripts, OptumRx, Humana Pharmacy Solutions, MedImpact, and Prime Therapeutics—control 94% of the…
Rising Risk of Pharmacy Benefits
Rising Risk of Pharmacy Benefits Board Directors Are Now Named Defendants Recent lawsuits against major corporations highlight a growing risk: PBM mismanagement is leading to overspending,…
Controlling Medical Benefit Drug Spending
Employers target PBMs to curb drug costs but often miss a big issue—specialty J-code drugs billed under medical benefits
Stop-Loss Insurance
Stop-Loss Insurance A Shield with Compliance Cracks Stop-Loss insurance protects self-funded health plans from catastrophic claims, but it comes with hidden risks. Employers must navigate these…
Managing PBM Costs and Risks
Managing PBM Costs and Risks Key Issues for Plan Sponsors Pharmacy Benefit Managers (PBMs) claim to lower drug costs but often raise them with hidden pricing…