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|Self-Funded Supporting Entities|
Self-Funded Supporting Entities
The following are self-funded supporting entities:
Carriers.The term "Carrier" refers to insurance companies that are regulated by the states in which they do business. A carrier employs actuarial and underwriting practices to evaluate and assume risk for insurance policy coverage.
Pharmacy Benefit Manager (PBM)is a third party administrator of prescription drug programs. They are primarily responsible for processing and paying prescription drug claims. They also are responsible for developing and maintaining the formulary, contracting with pharmacies, and negotiating discounts and rebates with drug manufacturers.
Preferred Provider Organization (PPO)is an entity that provides health care services with utilization review through providers that are otherwise independent on a discounted fee-for-service basis, typically in return for expedited payment of claims and an increased volume of patients.