Employee Benefits

Rx Carve-Out: If you haven't already crunched the numbers, you could be in for a pleasant surprise.

More employers are choosing to "carve-out" the pharmacy benefit of their health plans. Prescription drug coverage is the most utilized healthcare benefit, trending annually at 15% to 25%. Pharmacy costs represent nearly 30% of total healthcare dollars. As these costs continue to rise, it is becoming increasingly important to proactively manage the pharmacy benefit.

Why carve-out your prescription drug benefit to a pharmacy benefit manager? Cost containment. To better control pharmacy benefit costs, many employers separate or carve-out their prescription drug benefit from their major medical plan and contract directly with a pharmacy benefit manager, who is able to focus only on managing prescription drug costs.

Resource Group and Pharmacy Benefit Intermediary - A partnership committed to bridging solutions in pharmacy benefits.

We at Resource Group believe that PBIRx, an independent management company with 30 years experience in the pharmacy benefit industry, has the in-depth knowledge, tools, staff, and partners to help our clients unravel the complexities of pharmacy benefit management. PBIRx goal is to reduce the trend of escalating drug costs and put the profit back in the client's pockets.

PBIRx is the expert in Rx Carve out plans. They provide complete evaluation of present pharmacy benefit, plan design, and associated costs; development of Pharmacy Benefit Management RFP, evaluation criteria and negotiation strategies; quotes from various vendors; implementation liaison; analysis of data and recommendations for optimum renewal rates and/or pharmacy trend.

Our goal is to provide a comprehensive multi-year trend strategy for each client's specific needs and manage pharmacy benefit costs one client at a time.

  • Fully Insured (Guaranteed Rate)
  • Self Insured with Stop Loss
  • Self Insured
  • Fully Insured Generic with Discount on Brand
  • Discount Card

Support to manage trend and the pharmacy benefit manager include:
  • Retiree Drug Subsidy Services
  • Audit of Current PBM
  • Plan Design Modeling & Analysis
  • Allocation Rates & Budgeting

 

 

 

 

 

 

Important Note - The information on this site is general in nature. Any description of coverage is necessarily simplified. Whether a particular loss is covered depends on the specific facts and the provisions, exclusions and limits of the actual policy. Nothing on this site alters the terms or conditions of any policies. You should read the policy for a complete description of coverage. Coverage options, limits, discounts and deductibles are subject to availability and to individuals meeting underwriting criteria. Not all features available in all areas.