RxDC Reporting Made Easy for MedBen Clients
As you may recall, the Consolidated Appropriations Act of 2021 (CAA) requires group health plans to submit to the Centers for Medicare & Medicaid Services information about prescription drugs and health care spending. This data submission is called RxDC (for...
A New Warning on Women’s Heart Health
Heart disease risk among women is rising — and younger women are no longer considered low risk. A new scientific statement from the American Heart Association warns that women ages 20–44 and women of color face disproportionate risk, and by 2050, 6 in 10 U.S. women...
The High Cost of Avoidable ER Visits
For MedBen clients in 2025, 14% of emergency room visits were identified as potentially avoidable — often for conditions that could have been treated safely and effectively in a more appropriate setting. When care is delivered at an urgent care facility or physician’s...
Fair Market Pricing Delivers 59% Average Discount for MedBen Clients
In 2025, MedBen clients who used fair market pricing achieved an average discount of 59.3% with an appeals rate of just 0.2%. Fair market pricing combines the strengths of traditional PPO networks and reference-based pricing by reviewing every claim to determine the...
Biosimilars Takes Aim at Rising Specialty Drug Costs
Specialty medications continue to dominate pharmacy spend, now accounting for 52% of all U.S. pharmaceutical sales, according to a recent report from the Healthcare Distribution Alliance. With costs often reaching tens — or even hundreds — of thousands of dollars per...
The MedBen Access App Is Smarter Than Ever – Help Your Members Take Advantage!
The MedBen Access mobile app has been updated to help your plan members manage their health care and costs even easier. What’s New: Fresh Look & Easy Navigation: Clean design and intuitive menus make it simple for members to find what they need. At-a-Glance...
Stay on Track with the Compliance Deadlines List
MedBen’s Compliance team reminds you that our “Self-Funded Plan Sponsors Annual Compliance Deadlines” list is available to help clients stay current with mandatory health plan regulatory requirements. MedBen clients can acquire this valuable reference document MedBen...
March 15 FSA Grace Period Deadline Is Fast Approaching
If your health plan offers a flexible spending account (FSA) grace period, now is the time to encourage employees to review their remaining balances. Participants have until March 15, 2026 to incur eligible expenses using their 2025 FSA funds. After that deadline,...
MedBen Benefits Advisory Conference Highlights Key Industry Trends
Consultants and advisors from 10 different states attended the MedBen 2026 Benefits Advisory Conference on January 28. The event featured insights from some of the industry’s most respected voices and gave brokers a clearer view of today’s benefits landscape, what...
Where TrumpRx Can Add Value for Self-Funded Pharmacy Plans
The February 5th launch of the TrumpRx.gov online portal has generated attention for its lower prescription drug pricing… and may offer value for self-funded pharmacy plans in cases where medications are excluded from coverage or members face high upfront costs. While...
Cancer Survival Reaches Historic Milestone
The fight against cancer has reached a major turning point. According to the American Cancer Society (ACS), seven in 10 people diagnosed with cancer in the U.S. now survive at least five years — a milestone that reflects decades of progress in prevention, detection,...
Federal Actions Put PBMs Under the Microscope
Pharmacy benefit managers continue to draw scrutiny in Washington, and two recent federal actions signal that greater transparency and oversight may be on the horizon. One is a newly enacted funding law that includes PBM reforms, and the other is a proposed Department...