How can USI help our organization better manage the cost and efficiency of our pharmacy benefit plan?
USI’s proprietary Clear Options Rx strategy provides a “Managed Carve-In” solution, offering greater transparency, improved contract terms, and reduced profits for carriers, distributors, and pharmacy benefit managers.
A well-negotiated and accountable "managed carve-in" contract offers employers the convenience of a carrier-based program with the estimated 10% to 20% pharmacy benefits savings typically associated with a carve-out plan.
We’ve estimated the financial impact for you. Feel free to update the assumptions.
- Low level of service disruption for plan participants
- Validation of contractual terms that are unavailable under a carrier-based Pharmacy Benefit Management (PBM) program
- USI Clear Guard provides performance monitoring ensuring compliance with contract terms and conditions
Clear Options RX is a “Managed Carve-In" strategy that improves contractual terms with little disruption for plan members.
The price paid by employers for prescription benefits is determined by the PBM contract and includes revenue sources for the PBM in the form of rebates, spread pricing, and administrative fees. PBM contracts vary these fees per client to achieve profit targets, regardless of billed administrative fees or rebate credits.
Carrier-based “bundled” PBM solutions generate significant undisclosed revenue to carriers, but remain the most common arrangement for self-funded employer-sponsored health plans.
USI has more than 2,500 self-funded accounts, giving us significant market leverage to negotiate favorable terms and conditions with carrier-based PBMs and third-party "carve-out" solutions.
I’d like to explore further how USI can help our organization ensure better health outcomes and efficiency within our pharmacy benefit plan.
We will need just a few pieces of information from your organization, including a completed Clear Options Rx data request form. Let's set up time for us to fill out the form together. We will prefill in as much as possible based on what we know to make the process as easy as possible for you.