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INSIGHTS & RESOURCES

What your pharmacy benefits aren't showing you.

One PBM mechanism decoded every week, plus evergreen reference libraries. Read here, on Substack, or on LinkedIn.

Latest from Benefit Blind Spots Updated Weekly

ROUND UP · WEEKLY

What Crossed My Desk This Week
 

Four or five stories from the week, each with the read on what it means for your plan
 

Read on Substack →

DEEP DIVE · NOV 2

Your PBM Can File Your Gag Clause Attestation. It Can't Be Responsible for It.

Every self-funded plan attests by December 31 that no contract keeps it from its own cost and claims information. A TPA or PBM can submit it, but t...

Read on Substack →

FIELD NOTE · OCT 29

Is Your Pass-Through Price the Price the Pharmacy Got?

Verify pass-through by confirming the contract defines it per claim, getting the pharmacy's actual reimbursement on a sample of your claims and com...

Read on Substack →

Evergreen Reference Libraries Always free

PBM Contract Language Library

Side-by-side weak vs. protective language for every major PBM contract provision.  Updated regularly

Open the library →

"What I'd Ask"

Scenario-based question sets: exactly what to ask a PBM in specific situations. On Substack.

Browse the series →

What We're Seeing

Aggregated patterns from the hundreds of PBM contracts Prescription Benefit Solutions reviewed in 2025, with the real numbers

Read the 2025 review →

Plan Sponsor Toolkit Library

Printable audit frameworks and decision tools, sent to your inbox

Browse the toolkits →

Guides & Answers Plain-English explainers

What is a PBM contract audit?

What the engagement covers, what it produces, and what it costs you to skip.

Read the guide →

What is spread pricing?

The margin between what your plan pays and what the pharmacy is paid.
 

Read the guide →

How do you run a PBM RFP?

The timeline, the questions, the scoring, and when to negotiate.
 

Read the guide →

How do you read a rebate report?

The money is usually in the definition, not the total

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Read the guide →

How do you choose a PBM consultant?

The five criteria to put to any firm you interview, including us.
 

Read the guide →

PBM audit vs. broker review

Two different jobs, most need both.
 

Read the guide →

Get it weekly

SUBSTACK

Benefit Blind Spots

Deep dives, field notes, and the Wednesday roundup. The full analysis, with the integrated tools

LINKEDIN

The Pharmacy Benefits Briefing

The executive briefing version, every Monday.  1,200+ plan sponsors and brokers read it.

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