BUSINESS INSURANCE DIRECTORY OF PRESCRIPTION BENEFIT MANAGERS: Y

York Prescription Benefits

1 Church St., Fifth Floor, New Haven, Conn. 06510; 203-781-3411; fax: 203-946-3591

www.yorkpbm.com

1997 revenues

Total gross revenues$21,000,000

PBM gross revenues$9,000,000

PBM unbundled revenues$7,500,000

PBM clients

Total53

Employer/group plans with direct service51

Lives covered

Group Health:

Total77,039

Active enrollees51,028

Through employers64%

Through third-party vendors16%

Through Medicare/Medicaid20%

Workers Compensation:

Active enrollees2,359

Retail network

Pharmacy locations40,392

Mail-order services

Percent of prescription volume10.3%

Generic usage

Percent of prescription volume41.3%

Staff

Total75

Professionals23

Includes: 4 registered pharmacists

PBM services since: 1995.

Parent: Yale New Haven Health.

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, daily drug utilization review.

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, pharmacy utilization, therapeutic utilization.

Service area: Nationwide.

Billing methods: Capitated rate, fee per claim, per member per month. Volume discounts to employers.

Officers: Lily Khodadoost-Kamvar, director-clinical services; James Bigl, general manager, York; Michael Hajdun, director-operations, York.

Contact: Karen Bradbury, business development manager, 203-781-4875.