AH079 - Capital Equilibrium, a New Level-Funded Pharmacy Plan, with Mike Miele, FSA, MAAA
Description
In this episode of the Astonishing Healthcare podcast, Mike Miele, FSA, MAAA (SVP of Insured Services), joins us again for a lively discussion about a new product and the growth of level-funded pharmacy plans. What are level-funded plans? How does Capital Rx's "Capital Equilibrium" work? Listen in to hear how these plans, positioned between self-funded and fully insured models, offer employers budget certainty while maintaining flexibility and transparency. Mike highlights the scenarios where a level-funded plan can truly help - e.g., a municipality with a fixed budget and the role stop-loss plays (building on Episode 55), and he also notes that not all level-funded plans are equal, and plan sponsors should look for transparency around rebates and whether any savings - if a plan's performance is better than the guarantee - ultimately benefit the plan.
Related Content
- AH071 - A Look at What's Really Driving Drug Spend, and How it Impacts Us, with IQVIA's Michael Kleinrock
- Pharmacy Benefits 101: Pharmaceutical Rebates
- AH067 - Aligned Health Benefits and the Freedom to Unbundle, with Kristin Begley, PharmD
- How to Manage Pharmacy Benefit Spend in a GLP-1 World
For more information about Capital Rx and this episode, please visit Capital Rx Insights.
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