Expert PBM Negotiations
Driving Cost Savings and Mitigating Risk Through Strategic PBM Negotiations
Driving Cost Savings and Mitigating Risk Through Strategic PBM Negotiations
At Hall Benefits Law, we are dedicated to empowering plan sponsors by leveraging legislative frameworks such as the Consolidated Appropriations Act (CAA) and the No Surprises Act (NSA) to ensure transparent, equitable Pharmacy Benefit Manager (PBM) agreements. Our expert team collaborates with plan sponsors to negotiate and renegotiate PBM contracts, achieving substantial savings and maximizing enterprise value. We are advocates for your fiduciary responsibilities, aligning PBM services with the best interests of your plan participants.
Our collective experience delivers consistent results.
Relevant matters and negotiations, prepared for all the possibilities.
Our services are designed to ensure your PBM provides fairness and transparency in respect of the law.
We mitigate fiduciary risk at the same time, creating a win-win for your legal and benefits teams.
We scrutinize current PBM agreements to identify opportunities for improved terms and cost efficiencies.
Our team ensures your PBM agreements adhere to the latest CAA and NSA provisions, promoting transparency and accountability.
We negotiate directly with PBMs to secure favorable terms that align with fiduciary duties and maximize plan value.
Ongoing evaluation of PBM performance to ensure compliance and the continuous optimization of plan sponsor interests.
At Hall Benefits Law, our work has led to significant financial gains for plan sponsors through strategic PBM negotiations. Our clients have saved millions by realigning their PBM contracts with legislative expectations and organizational goals.
In-depth Understanding of Plan Sponsor Needs
We begin by meeting with plan sponsors to understand their specific goals and challenges related to PBM agreements. This consultation sets the foundation for a comprehensive review of current contracts and objectives, ensuring that our team is aligned with your strategic priorities.
Detailed Analysis of Current PBM Contracts
Our team meticulously examines existing PBM contracts to identify any clauses that may not comply with CAA and NSA provisions. We focus on pinpointing areas where changes can be made to enhance transparency, align with fiduciary standards, and generate cost savings or credits for the plan sponsor.
Applying Legislative Insights to Plan Sponsor Advantage
Leveraging our in-depth understanding of the CAA and NSA, we develop a tailored legal strategy aimed at maximizing benefits for the plan sponsor. This involves crafting targeted amendments and negotiation points that ensure your contracts are not only compliant but also advantageous in terms of cost and service value.
Advocating for Optimal PBM Terms
Our team leads the negotiation process with PBMs, advocating for revised terms that favor the plan sponsor. We apply our comprehensive knowledge of current legislative mandates to push for credits, improved transparency, and better terms, securing millions of dollars in potential savings for our clients. We also provide continuous representation to address any questions or challenges that arise during or after the negotiation process.
PBM Negotiator works relentlessly for your corporate and your employee best interests.
PBM negotiations involve revisiting the terms of agreements with Pharmacy Benefit Managers to secure more favorable conditions and improve cost management. Under the CAA and NSA, it is critical for plan sponsors to ensure these agreements align with fiduciary responsibilities and provide value to participants.
The CAA emphasizes transparency and fairness, mandating that fiduciaries act in the best interest of plan participants. This has significant implications for PBM agreements, as plan sponsors must ensure that their contracts reflect these legislative standards.
Negotiations lead to cost savings, increased transparency, and better service terms, ultimately benefiting both the organization and the plan participants.
Explore our latest case studies highlighting PBM negotiation strategies, legislative updates related to the CAA and NSA, and best practices for maximizing value from PBM partnerships.
