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Prime Therapeutics Offers Enhanced Consumer-Directed Products

Posted on: Tuesday, 4 October 2005, 12:00 CDT

Prime Therapeutics LLC (Prime), announced today that it is implementing a business system called IPS that will allow its clients to offer more sophisticated consumer-directed products. The full technology will be available January 1, 2006.

The IPS system will enhance Prime's consumer-directed product offering by providing greater flexibility in the integration of pharmacy and medical benefits and provide real-time benefit accumulation at the point of sale.

"The IPS system allows Prime to offer a unique and valuable service to our customers and their employees," said Tim Dickman, President and CEO of Prime. "The ability to integrate a number of pharmacy and medical benefits at the pharmacy, and still provide the flexibility to have unique protocols for the use of savings account dollars, will accelerate consumer-directed products into mainstream benefit offerings for health plans, employers, and consumers."

Prime's IPS system will support savings accounts in varying tiers. For example, benefit designs may require funds to be used from one type of savings account, such as a Health Savings Account (HSA), before Flexible Savings Account (FSA) funds may be utilized, or vice versa. The system will support all standard accounts including: HSA, FSA, medical savings account (MSA) and health reimbursement account (HRA).

In addition, the IPS system will support complex benefit requirements and payment rules, such as:

-- Savings accounts that pay before or after a benefit has been met (e.g., deductible, out of pocket, etc.)

-- Integrated condition-specific parameters (e.g., fertility treatment, smoking cessation)

-- Integrated lifetime maximums

-- Multiple benefit periods for one accumulator type (e.g., yearly benefit maximum and lifetime maximum are both applied to a specific condition)

-- Out-of-pocket sequence order (e.g., deductible is waived if out-of-pocket maximum is met)

Administration of integrated medical and pharmacy benefit design accumulators is necessary for consumer-directed programs to be fully adopted in the marketplace. The U.S. Department of Revenue has established a guideline regarding full integration of pharmacy benefits into any high deductible health plan (HDHP) offered as part of an HSA as of January 1, 2006. Prime's IPS system enables users to meet these requirements.

Prime is implementing its new IPS system in support of consumer-directed programs for two of its nine Blue Cross and Blue Shield plan customers, with some IPS components being implemented as early as the beginning of 2006.

Prime Therapeutics LLC is a thought leader in the pharmacy benefit management industry, transforming pharmacy through a customer-aligned and flexible business model that allows for unmatched collaboration with clients. Providing services nationwide to approximately 7.5 million covered lives, its client base includes several Blue Cross and Blue Shield plans, employer and union groups, and third party administrators. Headquartered in St. Paul, Prime Therapeutics is collectively owned by various Blue Cross and Blue Shield plans, subsidiaries or affiliates of those plans. Learn more at www.primetherapeutics.com.

Source: Business Wire

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