HealthLinX (HLX) starts by gathering comprehensive plan information from your Pharmacy Benefit Manager (PBM). This includes data files, implementation documents, contracts, emails, and plan change forms.

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Our team reviews this information to identify key details about your plan's structure, services, and pricing. We then benchmark these elements against the marketplace, comparing them to plans of similar size and type. Key areas of comparison include copays, covered drugs, AWP discounts, dispensing fees, disease state management programs, and other provided services.

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We also analyze your contract for accuracy against the implementation documents and to identify common pitfalls. For example, does your contract language terminate rebates when the contract ends? Is there a net effective rate that guarantees overall savings? HLX will define these areas and provide recommendations to improve your program management.