CerpassRx

CerpassRx offers pharmacy discount cards, workers' compensation, clinical, analytic, pharmacy benefit, and specialty management services.

CerpassRx is a pharmacy benefit management (PBM) company based in Dallas-Fort Worth, Texas, that provides pharmacy management services. The company's primary offering is its Proactive Prior Authorization Process, which reviews prior authorizations in less than 24 hours, significantly faster than the industry standard of three to five business days. As of 2022, the company maintained approval rates of 66.7% for prior authorizations. CerpassRx's Prescription Optimization Program (POP) helps manage high-cost medications through patient assistance programs, manufacturer copay cards, and alternative sourcing options. The program demonstrated significant growth, expanding from 29,555 lives in 2020 to 250,000 lives in 2022, while achieving over USD 8.8 million in savings during the first two quarters of 2022. In January 2024, the company launched an AI-powered platform called Intelligent Specialty Engine in collaboration with Waltz Health to manage specialty drug spending by routing prescriptions to cost-effective pharmacies.

Managing employee health-related benefits

Health Benefits Platforms

CerpassRx, Waltz Health team up to bring down specialty pharmacy costs

CerpassRx is a pharmacy benefit management (PBM) company based in Dallas-Fort Worth, Texas, that provides pharmacy management services. The company's primary offering is its Proactive Prior Authorization Process, which reviews prior authorizations in less than 24 hours, significantly faster than the industry standard of three to five business days. As of 2022, the company maintained approval rates of 66.7% for prior authorizations. CerpassRx's Prescription Optimization Program (POP) helps manage high-cost medications through patient assistance programs, manufacturer copay cards, and alternative sourcing options. The program demonstrated significant growth, expanding from 29,555 lives in 2020 to 250,000 lives in 2022, while achieving over USD 8.8 million in savings during the first two quarters of 2022. In January 2024, the company launched an AI-powered platform called Intelligent Specialty Engine in collaboration with Waltz Health to manage specialty drug spending by routing prescriptions to cost-effective pharmacies.
Key customers and partnerships
CerpassRx partners with Teachers Health Trust, providing prescription drug benefits management services for their members. The company's network includes both national and regional pharmacies. In November 2024, CerpassRx formed a strategic partnership with Waltz Health to integrate their Waltz Connect platform for specialty drug management services.

CerpassRx Launches AI-Powered Specialty Drug Management Platform

CerpassRx Announces Growth of POP

CerpassRx Announces Proactive Prior Authorization Process

Teachers Health Trust

Medhealth Outlook

Prescription Drug Benefits

Corestream provides voluntary benefits administration through a cloud-based, proprietary HR technology platform. The platform creates a single integration point for carriers, brokers, employers and employees to streamline the selection and administration of insurance benefits and other employee perks. The platform handles insurance benefits like critical illness, long term care, pet insurance, auto and home insurance, as well as financial assistance programs and health/wellness offerings. A Duke University study found that enrollment through Corestream's platform contributes to employee retention, with enrolled employees staying an average of six years versus three years for non-enrolled employees. The platform removes complexity by demystifying benefit features and preventing employees from enrolling in unsuitable benefits, as these offerings are not one-size-fits-all.
Key customers and partnerships
In January 2022, Corestream entered into a strategic partnership with Standard Insurance Company (The Standard) to streamline benefits management and provide insurance products through its platform. Corestream's platform was delivering benefits to more than two million employees as of March 2022. The company has also partnered with Enhesa to provide content supporting risk management and compliance requirements, and with SafePaaS to support identity security and access governance solutions. Additionally, Corestream maintains a partnership with Data Privacy Simplified to offer consultancy services including information audits, gap analysis, and requirements identification.

CoreStream

BeneBay is a cloud-based claims processing and management technology platform for healthcare services. The platform processes claims at the point of service and provides real-time data responses to help manage healthcare costs effectively. Initially developed and implemented in Northern Europe, where it processed over 90% of private health insurance transactions covering 400,000 members, the platform expanded to the US market starting in Florida in mid-2015. BeneBay functions as an online self-insurance platform specifically designed for smaller employers, addressing the underserved market of health benefits for smaller groups through self-funded health insurance products and simplified product design. The platform's technology stack includes secure cloud delivery, built-in intelligence, and automation features for claims adjudication. In 2016, BeneBay reported annual recurring revenues of USD 0.5 million.
Key customers and partnerships
BeneBay served customers in Florida following its US market entry. In Northern Europe, the platform managed transactions for a member base of 400,000 individuals in the private health insurance sector.

Benebay

Benecaid Health Benefit Solutions Inc. is a provider of group health benefits solutions for Canadian small and medium-sized businesses. The company's core offering includes health spending accounts (HSAs) and the Honeybee digital benefits platform. Through HSAs, employers can provide tax-free accounts for employees to pay for healthcare services not covered by government insurance plans. In July 2022, Benecaid, as part of the Green Shield Canada (GSC) group of companies, launched Honeybee Select, a digital benefits solution specifically designed for small businesses with 25 or fewer employees. Honeybee Select offers standardized health, dental, and travel benefits plans powered by GSC, with additional mental health coverage through Inkblot Therapy. The platform features streamlined user experience, add-on allowance accounts, and electronic claims processing through GSC's adjudication platform, enabling instant eligibility assessment at healthcare providers.
Key customers and partnerships
Benecaid operates as a third-party administrator for several Canadian insurance companies and serves clients through a network of independent licensed insurance advisors. Benecaid integrated GSC's adjudication system for processing health and dental claims for Honeybee Select plan members. The company also partnered with Inkblot Therapy to provide mental health coverage as part of its Honeybee Select offering.

Benecaid

Marsh McLennan Agency (MMA) is a provider of business insurance, employee health and benefits, retirement, and private client insurance solutions in North America. The company offers services including commercial property and casualty insurance, employee benefits, management liability, cyber insurance, captives, alternative risk transfer programs, small business solutions, and personal lines insurance. As of January 2024, MMA operates through 170 offices across the US and Canada with over 9,900 employees. The company generated more than USD 2 billion in annualized revenue, making it one of the largest brokerage operations in North America. MMA leverages data analytics capabilities, maintaining one of the industry's largest data repositories to help clients make objective decisions about insurance products and risk exposure. In November 2024, MMA completed the acquisition of McGriff Insurance Services, integrating over 3,500 employees and expanding its capabilities in specialty and middle-market segments. McGriff, which reported revenue of USD 1.3 billion for the 12 months ended June 2024, brought expertise in areas such as commercial property and casualty, corporate bonding and surety, cyber insurance, and management liability.
Key customers and partnerships
MMA works with organizations across various industries including healthcare, senior living, physician practices, construction, transportation, education, agriculture, hospitality, public entities, and banking. The company serves as the official business insurance partner for NCHA (North Carolina healthcare Association) and works with more hospitals and health systems in North Carolina than any other brokerage or consultant.

Marsh McLennan Agency

SAG-AFTRA Health Plan provides health insurance coverage to eligible members of the Screen Actors Guild-American Federation of Television and Radio Artists (SAG-AFTRA). The plan offers comprehensive medical services including medical, surgical, mental health, life and AD&D insurance, maternity care, hearing aids, therapy, and dental and vision services. As of January 2024, only 12.7% of SAG-AFTRA's 170,000 members qualify for the union's health plan. Monthly premiums for members range from USD 125 to USD 250, with costs increasing to USD 2,501 following unemployment. The plan requires members to meet specific earnings-based or days-based eligibility criteria, which varies depending on occupation and work performed under specific contracts.
Key customers and partnerships
The SAG-AFTRA Health Plan partnered with Carrot Fertility in 2024 to provide infertility treatment coverage starting January 2025, offering services including IVF, IUI, and prescription drug therapy with a family lifetime maximum of USD 30,000. In December 2022, the organization partnered with AFL-CIO to offer new SAG-AFTRA Senior Benefit Plans for Medicare-eligible members and their Medicare-eligible spouses/partners.

SAG-AFTRA Health Plan

Enterprise platforms that help employees and their dependents receive primary or specialist care services as part of their health benefits. These platforms also provide access to Telehealth services, behavioral care services, and remote patient monitoring

Enterprise platforms that help employees better navigate their healthcare journey by identifying which healthcare services are covered under their benefits plan and how to best maximize their use (e.g. identifying a wider pool of suitable regional physicians for consultation)

Enterprise platforms that specialize in helping employees manage their pharmacy- and prescription-related benefits to refill prescriptions or dispense medication for in-store pickup or home delivery

Enterprise platforms that allow employers to directly manage and customize employee benefit plans. These platforms enable enterprises to present employees with multiple health benefits options across health plans and negotiate terms with third-party health administrator services and insurance providers

Platforms are offered using a B2B SaaS business model, enabling digital health

Platforms are offered on a B2B basis to help manage employee benefits across an enterprise

CerpassRx

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