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Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2]
In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans.
The logo of Anthem Blue Cross Blue Shield. Elevance Health, Inc. is an American for-profit health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. [2]
A formulary is a list of pharmaceutical drugs, often decided upon by a group of people, for various reasons such as insurance coverage or use at a medical facility. [1] Traditionally, a formulary contained a collection of formulas for the compounding and testing of medication (a resource closer to what would be referred to as a pharmacopoeia ...
In 1982, Blue Shield merged with The Blue Cross Association to form the Blue Cross and Blue Shield Association (BCBS). [11] Prior to 1986, organizations administering BCBS were tax exempt under 501(c)(4) as social welfare plans. The Tax Reform Act of 1986 revoked the exemption, however, because the plans sold commercial-type insurance.
The Anthem medical data breach was a medical data breach of information held by Elevance Health, known at that time as Anthem Inc. . On February 4, 2015, Anthem, Inc. disclosed that criminal hackers had broken into its servers and had potentially stolen over 37.5 million records that contain personally identifiable information from its servers. [1]
In January 2016, Horizon BCBS announced their newest endeavor to improve care quality and lower costs through their Omnia Health Alliance. [citation needed] The new Omnia health insurance plans provide access to all of Horizon's network hospitals with some of them being designated as Tier 1 with greater cost savings for consumers.
Empire Healthchoice Assurance, Inc. was a health insurance company that sued the estate of a deceased federal employee who received $157,000 in insurance benefits as the result of an injury. The wife of this federal employee had won $3.2 million in a separate lawsuit from those who she claimed had caused her husband's injuries.