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BUSINESS INSURANCE DIRECTORY OF PRESCRIPTION BENEFIT MANAGERS: C

Posted On: Aug. 2, 1998 12:00 AM CST

Caremark Inc.

2211 Sanders Road, Northbrook, Ill. 60062; 847-559-4700

www.caremark.com/pharmacy

1997 revenues

Total gross revenues$1,400,000,000

PBM gross revenues$1,000,000,000

PBM clients

Total973

Employer/group plans with direct service973

Lives covered

Group Health:

Total8,441,000

Active enrollees6,330,000

Through employers97.3%

Through Medicare/Medicaid2.7%

Retail network

Pharmacy locations51,000

Mail-order services

Percent of prescription volume96.3%

PBM services since: 1985.

Parent: MedPartners; primary business: physician practice manager.

Services: Retail pharmacy network, mail-order distribution, claims processing, online claims processing, concurrent utilization review, disease management, retrospective utilization review, benefit design consulting, formulary management/review, monitoring of physician prescribing practices, patient education.

Formularies offered: Open, closed, based on incentives.

Pharmacies contracted: Independently owned; retail chains.

Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization.

Service area: Nationwide.

Billing methods: Client-specific.

Officers: John Arlotta, president; Sara J. Finley, vp/secretary; Peter J. Clemens, vp/treasurer.

CLAIMSPRO Health Claims Services Inc.

24370 Northwestern Highway, Suite 200, Southfield, Mich. 48075; 248-352-2852; fax: 248-352-3714

www.claimspro.com

1997 revenues

Total gross revenues$7,383,412

PBM gross revenues$7,014,241

PBM unbundled revenues$5,962,105

PBM clients

Total960

Lives covered

Through employers70%

Through third-party vendors27%

Through Medicare/Medicaid3%

Retail network

Pharmacy locations43,000

Mail-order services

Percent of prescription volume6%

Generic usage

Percent of prescription volume40.5%

Staff

Total46

Professionals27

Includes: 1 registered pharmacist

PBM services since: 1989.

Services: Retail pharmacy network, mail-order distribution*, claims processing, online claims processing, concurrent utilization review, disease management, retrospective utilization review, benefit design consulting, formulary management/review*, monitoring of physician prescribing practices, patient education*, high potential medical claimants.

Formularies offered: Open, closed, restricted/customized.

Pharmacies contracted: Independently owned; retail chains.

Reports provided: Physician prescribing patterns, generic vs. name brands dispensed analysis, employee utilization, high potential medical claim trigger.

Service area: Nationwide, Puerto Rico, Virgin Islands.

Billing methods: Capitated rate, fee per claim.

Officers: Ron Klein, executive vp; Bruce Liebowitz, president.

Contact: Ron Klein.

* Subcontracted.