A handful of usual suspects: a PBM with spread pricing that’s never been audited, a TPA that’s slow or unresponsive, a specialty pharmacy carve-out that was never implemented correctly, or stop-loss terms that don’t line up with the current plan design.
What’s most often the actual problem when a self-funded plan underperforms?
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About the Author: Ohio Health Benefits Team
Ohio Health Benefits is a locally-owned independent insurance broker serving Ohio from offices in Tallmadge, Canton, and Hiram. We have a reputation for personal attention, flexibility, dependability, and integrity. As a broker, we carefully select both national and Ohio-based insurance companies to provide you with the insurance policies that are the best fit for your unique situation and budget.
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