Third Party Administrators (TPA)

Solid Benefit Guidance (SBG) understands the TPA market first-hand!

We can work with your organization to provide a unique service model that will help you grow and maintain the clients you represent with an integrated prescription and medical drug program.

Today SBG serves the needs of over 300,000 TPA lives across the country.

As your PBM partner, SBG will:

  • Develop a robust value proposition to support an integrated medical and pharmacy offering with your TPA
  • Help your TPA grow membership (Medical and Pharmacy Services) while improving your profitability
  • Offer flexible and competitive PBM pricing and a service model that is more intimate and flexible so that we can meet the demands of the TPA market and your clients
  • Ensure that the PBM relationship generates adequate service fees to compensate your organization for the added value you provide in terms of an integrated benefit offering
Other reasons why TPAs choose Solid Benefit Guidance:

Our Unique Approach to RFP Management/Contract Negotiations

For TPAs, this is what separates us from our competition. By having the insiders’ edge, our RFP process removes any gamesmanship and guarantees the best possible deal with fair, flexible and auditable contractual terms. Our best in class RFP process provides our TPA partners with the flexibility to provide various pricing strategies.

Our Invaluable TPA Rx Tool Kit will Help You Manage Costs:

Flexible Pricing Provisions

SBG can assist with setting up multiple pricing structures to help drive value to the TPA while providing a strong financial outcome for you. This will help you win prospects and retain existing clients.

  • Sales and Key Client Support: We will act as an extension of the TPA sales and account management team to help win new and retain existing business.
  • Customized Reporting Package: The bottom line is that our reporting is deeper and more intuitive than what a PBM can offer.  We develop a customized reporting package that is easy for your team to demonstrate the value you are providing to your clients. This will help them manage their drug costs.
  • Savings Model: This modeling tool will be customized with the specific terms of your PBM deal(s).  It will allow you to provide turnkey savings analysis for your potential or existing clients. Solid Benefit Guidance will be the PBM expert “inside” your organization.

We Have a Business Plan PBM Strategy and Value-Added Services

Through regular contact with our team – driven from a PBM strategy document we develop together – our approach ensures that your team is staying on top of trends. You will be able to make recommendations to your clients to implement designs and clinical programs that drive real value to your Pharmacy program.

Value added services include:

  • Access to a team of professionals
  • Marketing/business development support
  • Unique PBM offering focused on TPA market needs

Our Thought Leaders in Clinical Program Consulting and Oversight will Guarantee Savings for your Clients

Our industry experts will partner with your team and clients to ensure that the right clinical programs are being implemented. This process assists members in getting the right drug, at the right time, for the right price. Our experts will proactively monitor your clients’ data and proactively bring trends to you so you can stay ahead of the curve. This includes managing the pharmacy benefit and the explosive and emerging specialty drug arena.

High Quality Vendor Management, Audit and Oversight

We conduct quarterly reviews of the performance of your block of business and provide detailed-customizable reports to your team to demonstrate how the PBM is meeting its contractual commitments. At SBG we help manage the vendor relationship to ensure that your needs and issues are being met and that the vendor is working towards meeting and exceeding your expectations.

Top Notch Financial, Clinical and Service Benchmarking

We have the power and the proven experience to guarantee that you are getting a fair deal when doing a market check or renewing an existing contract. With our extensive database of PBM financial, clinical and service contracts, we know what a competitive PBM contract entails and how to secure it for your company and your clients.

Plan Design Modeling & Recommendations that Achieve the Lowest Net Cost

We will help your TPA achieve the lowest net cost through clinical support and an in-depth analysis of many complex variables such as:

  • Formulary management
  • Step therapy and other clinical programs
  • Optimizing member cost share and generic utilization
  • Specialty drug management and much more

We Will Manage, Monitor and Negotiate your Specialty Pharmacy Benefit

With specialty pharmacy projected to become 50% of total pharmacy costs over the next 5 years, it is imperative that TPAs have a consultant partner at the helm that has a laser focus on these medications and proactively brings solutions to you. Our unparalleled experience and insider’s edge will provide your TPA the added protection they need when it comes to managing the complex world of Specialty Pharmacy…for both the Pharmacy and Medical Specialty components of the benefit offering.

Our Compliance Department Helps Keep your Pharmacy Plan in Check

Under the new landscape of Healthcare Reform, SBG recognizes the importance of maintaining a compliant program. We engage a world class Compliance Service that provides bulletins, timely updates and guidance to our clients to ensure their programs are compliant with the latest HCR requirements…we will leverage our assets for your firm!

Our Medicare Part D/Employer Group Waiver Program (EGWP) Expertise is Unrivaled in the Industry

With the increasing cost burden of providing retiree coverage, coupled with the constant movement of regulations under Healthcare Reform, relying on experts for guidance in the decision making process is a must. Let Solid Benefit Guidance help your organization make the right decision for your clients’ retirees.

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