Prescription Drug Benefit Actuarial and Financial Consulting

  • On prescription drug plans, we believe that we have innovative experience that challenges even the larger actuarial firms. Our experience allows our clients to understand the different formulary, benefit design, rebate structures and administrative fees which exist in the marketplace and to compare alternative solutions.
  • Our actuaries have experience in developing virtually all drug benefit structures currently offered by health care organizations.
  • We have worked with numerous major Prescription Benefit Managers serving our clients by providing an independent assessment of their claims experience and providing an alternative voice in the discussions.
  • Our actuaries have developed independent formularies, which maximize the effectiveness of the health care dollar for our clients. These formularies have been developed in collaboration with medical and pharmaceutical opinions on medical necessity and balanced with financial concerns.
  • Our actuaries have extensive experience in performing Retiree Drug Subsidy (RDS) Actuarial Attestations that are required for drug subsidy payments from CMS.  CCA performs the Gross and Net Value Tests to determine if the drug plan passes the actuarial equivalency requirement.  CCA can also perform the administrative functions required by CMS, such as application process, filing claims and performing payment reconciliation at the end of the plan year.

Contact us today for prescription drug benefit actuarial and financial assistance.