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.

Apart from providing exceptional customer service, account management services, and contractual guarantees — participating employers and broker partners tell us they value:

  • Plan Oversight: Our dedicated Member Services team is readily available to assist brokers, manage complex scenarios, and act as an extension of the benefits team; working closely with brokers to ensure their clients’ needs are met.
  • Contract Oversight/Audit: With our audit approach covers all contractual obligations and legal aspects of the Pharmacy Benefit Manager (PBM). This providers peace of mind to brokers and their clients, knowing that they are fully represented and covered. Any recoveries resulting from independent third-party audits are passed back to the appropriate plan sponsor.
  • Market check: We conduct market check renegotiations during the contract term, ensuring savings each year of the relationship and flattening cost trends over time.
  • Data Analytics/Reporting: In addition to the reports from the Pharmacy Benefit Manager (PBM), brokers and members benefit from objective ADHOC reports that help interpret plan performance metrics. Our data analytics and reporting capabilities provide valuable insights to help brokers make informed decisions and optimize their client’s benefit plans.