Post by Lynx

Healthcare benefits are moving from defined benefit to defined contribution. ICHRA has made this shift visible in health insurance, but the same transformation is beginning to reshape alternative plan design, pharmacy benefits, and healthcare payments more broadly. Instead of absorbing unlimited and unpredictable costs, employers and health plans can define exactly how much they will contribute, where those funds can be used, and which products or services are eligible. In pharmacy, that could mean moving GLP-1s off the traditional benefit and funding them through a defined-contribution model. It could also apply to fertility medications, specialty drugs, an entire drug class, or a full formulary. The funding structure can be tailored to the underlying plan design, including: • An ERISA-compliant HRA • A post-deductible HRA coordinated with an HSA-eligible plan • A post-tax employer-funded account With real-time adjudication down to the NDC code, the contribution can be applied directly at the pharmacy counter. This is more than a new way to cover GLP-1s. It is a new model for designing, funding, and administering high-cost healthcare benefits. 👉 Read more in Lynx's latest blog: https://lnkd.in/ennWkRSr #PharmacyBenefits #DefinedContribution #AlternativePlanDesign #HealthcarePayments #EmployeeBenefits #GLP1