Customized Group Benefits That Work

Negotiating rates to keep premiums affordable.

Creating fully customizable benefit plans.

Access to over 30 different insurers

Drug Diversion

How Drug Diversion Works

• The drug diversion team is contacted when a high cost prescription is submitted at the pharmacy
  Specialty and high-cost drug claims are flagged when they enter the plan.

• The member is contacted and supported
  A clinical team explains the program, manages consent, and provides one-on-one support.

• Clinical appropriateness is confirmed
  The medication, dosage, and diagnosis are reviewed to ensure therapy is appropriate and uninterrupted.

• Alternate funding options are pursued
  Eligible costs are redirected to manufacturer assistance, patient support programs, or other available funding sources.

• Administration is handled on the member’s behalf
  Applications, paperwork, pharmacy coordination, and prescriber follow-ups are managed by the program.

• Medication delivery continues without disruption
  Prescriptions are fulfilled through the most appropriate channel while maintaining continuity of care.

• Plan drug costs are reduced
  Eligible claims are partially or fully removed from the group benefit plan.

• Ongoing monitoring and renewals
  Funding is maintained over time to prevent claims from re-entering the plan.

• Clear, employer-friendly reporting
  Employers receive aggregated savings and utilization reports—no private medical information.