2026 Highlights: Through June 1, 2026, we have identified and initiated resolutions with PBMs for the following problems amounting to more than $7.6M in savings and/or restitution expected, initiated investigations with the PBMs, and recaptured lost funds:

1. An employer received their Q1 Rebate Check from their PBM. It was the highest quarterly rebate check they had ever received and their finance team was very pleased because it exceeded budgeted rebate amounts for Q1. However, we identified almost $2M more in hidden "clawbacks"from previously paid quarterly rebates. Investigation initiated

2. An employer who covered Wegovy and Zepbound received a large Q1 rebate because rebates per claim had been increased by the manufacturers in 2026. However, we discovered that their PBM had inadvertently left those drugs on Tier 3 instead of moving them to Tier 2 as agreed to in order to maximize rebates. Investigation initiated and restitution currently being calculated

3. During a routine request by the employers nationally recognized health benefits consultant, a file containing was provided by the PBM indicating that, in 2025, the employer had 36,000 GLP-1 rebate-eligible claims and what the total rebate amount was. However, we researched paid claims using the PBMs claim reporting system and found over 39,000 paid GLP-1 Claims. A 3,000 claim difference in claims subject to rebates could mean a difference of $1.5 to $2M in "lost" rebates. Investigation initiated, pending results

4. An employer contracted for a PBM Plan Maximizer program that included a unique, expanded list of drugs in their program. Because it differed slightly from the PBM usual list, an error was made by the PBM during the transition to the employers 2026 contract and dozens of savings opportunities were not available due to the PBM internal programming error. We discovered the miss working with the clients in-house pharmacy team and through our own investigations. Restitution Agreed almost $100,000

5. In March 2026, an employer was found to have been billed for PA services in February at both a per claim fee AND a PMPM fee. Investigation concluded, issue resolved, employer refunded overcharges for February. Annualized savings from removing duplicate billing $658,500

6. An employer opted for a new, lower cost Prior Authorization fee with their PBM for 2026. Prior PA services were billed on a per claim basis. The new alternative selected for 1/1/26 was a PMPM fee for PA's. On audit of monthly invoices for January, we found the PBM incorrectly continued billing the employer at the much higher per claim basis Investigation concluded, issue resolved, employer refunded overcharges for January. Annualized savings for moving to PMPM fees $622,500