New program designed to help policyholders gain insight into their PBM strategy

November 4, 2024 – Hamilton, New Jersey – With prescription drug costs continuing to rise, Pharmacy Benefit Managers (PBMs) are a key component to an employer’s strategy to manage health plan costs.  However, it can be difficult for employers and their benefit consultants to navigate the complex and evolving PBM landscape. To help employers gain insight and transparency into their PBM strategy, Berkley Accident and Health, a Berkley Company, has launched PBM Checkup, an innovative program for employers with self-funded health plans.

“Prescription drug costs are a major cost driver for U.S. employers, accounting for 27% of all health plan spending,¹ and PBMs are an important tool that employers use to manage their costs. Business leaders need to make sure their PBM strategy is working for them,” said Brad Nieland, President and CEO of Berkley Accident and Health. “With PBM Checkup, we’re supporting our policyholders to make more informed, data-driven decisions about their PBM strategy.

PBM Checkup is designed to empower companies through an independent evaluation of their PBM strategy. Policyholders who complete a PBM Checkup can qualify for a Stop Loss renewal credit. The PBM Checkup credit is available to Berkley Accident and Health’s Stop Loss policyholders, including members of its EmCap Group Captive programs.

“What is the outcome of a PBM Checkup for our policyholders? It could be the knowledge that their current PBM is delivering great value. Or it could be that another PBM could offer better benefits to their health plan,” explained Jim Hoitt, Sr. Vice President and Chief Growth Officer. “Either way, the employer wins because they gain insight into their PBM strategy and receive a Stop Loss renewal credit.”

PBM Checkup Highlights:

• To qualify, a policyholder selects an approved independent PBM consultant to perform a comprehensive evaluation and repricing analysis.

• Then the policyholder submits the completed analysis to Berkley Accident and Health before their initial renewal review. Policyholders receive up to a 2% renewal credit simply for completing a PBM Checkup – whether or not they switch PBMs.

• PBM Checkup is best started four to six months before a policyholder’s Stop Loss renewal effective date.

PBM Checkup is the latest in a series of innovations from Berkley Accident and Health to make self‑funding more accessible and predictable. For more details about PBM Checkup, please contact your Berkley Accident and Health representative.

About Berkley Accident and Health

Berkley Accident and Health is committed to protecting the financial well-being of people and organizations. We are an industry leader offering an innovative portfolio of accident and health solutions and the personal support that our clients need. Berkley Accident and Health is a member of W. R. Berkley Corporation, a Fortune 500 company, and provides Employer Stop Loss, Group Captive, Specialty Accident, and Managed Care solutions nationwide. Coverage is underwritten by Berkley Life and Health Insurance Company and/or StarNet Insurance Company, both rated A+ (Superior) by A.M. Best. For more information, please visit www.BerkleyAH.com.

¹Median percentage of health care dollars spent on pharmaceuticals in 2023. Business Group on Health. 2025 Employer Health Care Strategy Survey. August 2024. Available at: https://www.businessgrouphealth.org/resources/2025-Employer-Health-Care-Strategy-Survey-Intro.

Stop Loss is underwritten by Berkley Life and Health Insurance Company and/or StarNet Insurance Company, both member companies  of W. R. Berkley Corporation and rated A+ (Superior) by A.M. Best, and involves the formation of a group captive insurance program that involves other employers and requires other legal entities. Berkley and its affiliates do not provide tax, legal, or regulatory advice concerning EmCap. You should seek appropriate tax, legal, regulatory, or other counsel regarding the EmCap program, including, but not limited to, counsel in the areas of ERISA, multiple employer welfare arrangements (MEWAs), taxation, and captives. EmCap is not available to all employers or in all states. Payment of claims under any insurance policy issued shall only be made in full compliance with all United States economic or trade and sanction laws or regulation, including, but not limited to, sanctions, laws and regulations administered and enforced by the U.S. Treasury Department’s Office of Foreign Assets Control (“OFAC”).

BAH AD 2024-233     © Berkley Accident and Health   10/24