Third Party Administrative Services

Specialty drugs continue to be the fastest growing costs within the healthcare industry today. While there’s a very small subset of patients on specialty therapy, typically only 1-2% of the population, specialty therapy is the main driver of overall pharmacy trend.

Our Health Insurance Solutions strategy for RX benefits has a proven track record of meaningful change of delivering aggressive financial performance for more than 20 years. HISI has been a proven leader in the employer-led Prescription Drug landscape with:

68 + individual plan sponsors

138,000+ members

Representation of members in all multiple states, the realized savings is greater than any plan could achieve individually, and members range from 100 to over 20,000 lives.

In addition to exceptional customer service, account management services, and contractual guarantees — participating employers and broker partners tell us they value:

Plan Oversight: A dedicated Member Services team is readily available, and acts as an extension of the benefits team working with Brokers to assist with acute issues and manage more complex scenarios.

Contract Oversight/Audit: With our audit approach, brokers and their clients can rest assured that all contractual obligations and legal aspects of the PBM are represented and covered. All recoveries as a result of independent third party audits are passed back to the appropriate plan sponsor.

Market check: Market check renegotiations during the contract term – ensuring savings during each year of the relationship over time, to flatten cost trends.

Data Analytics/Reporting: In addition to reports from the PBM’s, brokers and members benefit from objective ADHOC reports to help interpret plan performance metrics.

Third Party Administrative Services

68 + individual plan sponsors

138,000+ members

Representation of members in all multiple states, the realized savings is greater than any plan could achieve individually, and members range from 100 to over 20,000 lives.

Plan Oversight: A dedicated Member Services team is readily available, and acts as an extension of the benefits team working with Brokers to assist with acute issues and manage more complex scenarios.

Contract Oversight/Audit: With our audit approach, brokers and their clients can rest assured that all contractual obligations and legal aspects of the PBM are represented and covered. All recoveries as a result of independent third party audits are passed back to the appropriate plan sponsor.

Market check: Market check renegotiations during the contract term – ensuring savings during each year of the relationship over time, to flatten cost trends.

Data Analytics/Reporting: In addition to reports from the PBM’s, brokers and members benefit from objective ADHOC reports to help interpret plan performance metrics.