Specialty drugs now exceed 50% of employer pharmacy spend. With oncology, GLP-1s, and $3 million gene therapies in the 2027 pipeline, here's what self-funded employers need to do before it hits.
Your stop-loss carrier raises your specific deductible and calls it a deal. Here's how to model the breakeven, spot laser risk, and decide whether to accept, push back, or shop the market.
Healthcare costs are jumping 10% in 2026. A disengaged broker isn't neutral, they're a cost. Here's how to fire them, what to gather first, and how a Broker of Record change actually works.
GLP-1 usage doubled in less than two years. Before you finalize your 2027 formulary, here's how to build structured coverage that doesn't blow your pharmacy budget.
The Transparency in Coverage rules require your health plan to post three machine-readable files every month. Most employers have no idea whether their vendor is actually doing it.
Your broker's carrier shortlist isn't built around your best premium. It's built around their easiest workflow. Here's what's actually driving those repeat recommendations.
Most PBM rebate guarantees protect the PBM, not your plan. Here's the specific contract language, audit rights, and reconciliation clauses that actually ensure rebates flow back to you.
Self-funded employers owe a PCORI fee by July 31 each year, filed on IRS Form 720. The 2026 rate is $3.84 per covered life for calendar-year plans, and first-timers rarely see it coming.
Illinois SB3114, the Transparency in Downcoding Act, passed 59-0 and 111-0 and awaits the Governor's signature. Self-funded ERISA plans are exempt, but the law exposes a claims practice every employer should be auditing.
The CAA requires brokers to disclose all compensation before your renewal is signed. Most employers never ask for it, and that creates real fiduciary exposure.
