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Self-Insured Employers

Similar to large employers who were leaders in implementing self-insured plans, small and medium-sized employers are increasingly opting for self-insured models to manage prescription medication benefits, driven by the need for greater control over escalating drug costs and benefit design. 

This is where Aphora Health comes in – we provide pharmaceutical cost containment for self-insured employers.

In other words, we save you a ton of money on prescription medications.   
We work with self-insured employers of all sizes, as well as with brokers, consultants, and even PBMs, to deliver significant cost savings on prescription medications – Specialty, Brand, and Generic. We combine this with dedicated, personal Care Navigation solutions that help employees and HR departments with adherence and utilization reporting.

Different size employers typically have different pain points when it comes to employee medication benefits:

  • Large employers are concerned with escalating specialty medication costs, extremely complex vendor oversight, and fiduciary risk.
  • Medium-sized employers are concerned with unpredictable pharmacy costs, limited internal resources, and often mistrust of PBMs.
  • Small employer concerns center on limited budgets, lack of leverage, and the potential administrative burden of self-insured plans.

We solve these issues and more.

Aphora health provides customer and partner solutions that provide:

  • Massive Savings and Full Transparency – We help self-insured employers cut pharmacy benefit costs up to 70%, without sacrificing member satisfaction or outcomes.
  • Total Control and Visibility – Real time reporting, full claims transparency, and no opaque PBM rebates.  With Aphora Health, you know exactly where every dollar goes.
  • Simple Setup and Seamless Experience – Launch in weeks, not months.  No disruption to your employee experience with a fully supported integration.

A more detailed view of how we help self-insured employers includes

Claims Processing

Handles claims with full cost transparency, avoiding hidden markups or spread pricing

Formulary Management

Provides customizable, clinically-driven formularies focused on cost-effectiveness and patient outcomes

Specialty Pharmacy Service

Delivers transparent specialty drug pricing with personal guidance and support to minimize specialty spend

Reporting & Analytics

Offers real-time, actionable insights into drug utilization, cost drivers, and savings opportunities

Clinical Programs

Ensures lowest net cost therapy through prior authorization, adherence programs, and utilization management

Care Navigation & Support

Provides high-touch support to guide employees to lowest-cost, most effective pharmacy solutions

Arrange for a free analysis of your current program and a clear, tangible report on the savings you will get with Aphora Health.  It’s free with no obligations.  

Schedule a Savings Analysis

Brokers & Consultants

Brokers and consultants play an important role for many self-insured companies.   

Unlike fully insured plans (where the carrier assumes the risk), brokers and consultants in self-insured arrangements take on a much more strategic, financial advisory role, as the employer is the one at risk and must be more actively involved in managing their healthcare costs.   

Aphora Health works with Brokers and Consultants to give their clients an edge – guaranteed pharmacy savings with NO disruption and FULL transparency.

Whether we provide a Specialty carve out or services that cover all medications, Aphora Health works closely with brokers and consultants to deliver self-insured employers with the same high degree of service and support.   

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Ready to start saving?

It all starts by analyzing your previous claims data. Schedule your call today to uncover your potential savings