Third Party Administrative Services

The Health Insurance Solutions strategy for RX benefits has a proven track record of delivering aggressive financial performance for members for more than thirteen years. HISI holds strongly the position as a proven leader in the employer-led Prescription Drug landscape with:

  • 45 + individual plan sponsors
  • 50,000 covered lives
  • Representation of members in all multiple states

The realized savings is greater than any plan could achieve individually, and members range from a few hundred covered lives to more than 5,000 lives.

In addition to exceptional customer service and account management services, participating members and Broker Partners tell us they value:

  • Clinical Oversight: Members benefit from one on one interaction on topics such as new drugs, generic launches, plan design strategies and overall trends based on actual plan data. At no additional cost members benefit from first-hand knowledge and support having their best interest represented.
  • 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 to managing more complex scenarios.
  • Contract Oversight/Audit: With our audit approach, Broker’s 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 an independent third party audit are passed back to the appropriate plan sponsor.
  • Market check – Market check renegotiations in each year of the contract – 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 ad hoc reports to help interpret plan performance metrics.