The pharmacy benefit management industry in Illinois is filled with key players who offer diverse services. They operate in a thriving sector that centers around making prescription medications more affordable and accessible. Companies in the domain offer tailor-made solutions such as specialty drug management, cost-effective prescription benefit plans, and advanced technology optimization for a better healthcare experience. The future of this industry looks promising, with evolving healthcare technologies and a focus on personalized care, shifting the traditional role of Pharmacy Benefit Managers towards an era of agile pharma services.


Top 23 pharmacy benefit management companies in Illinois

1. CastiaRx

  • Website: castiarx.com
  • Headquarters: Bannockburn, Illinois, United States
  • Founded: 2018
  • Headcount: 501-1000
  • LinkedIn

CastiaRx is a specialty benefit manager that aims to simplify the management of specialty drug spend for small and midsize payers. With expertise in clinical intervention, patient care, compliance programs, and analytics, CastiaRx helps patients maximize the benefits from their treatment. It is now part of the Optum family, delivering enhanced pharmacy care services and a better healthcare experience.


2. Citizens Rx

  • Website: citizensrx.com
  • Headquarters: Oak Park, Illinois, United States
  • Founded: 2009
  • Headcount: 51-200
  • Latest funding type: Private Equity
  • LinkedIn

Citizens Rx is a company that offers innovative pharmacy benefit management solutions. They focus on providing cost-effective and customizable prescription benefit plans to their clients. Through their expertise and technology, they help clients optimize their pharmacy benefits and improve healthcare outcomes.


3. Professional Benefit Administrators, Inc.

  • Website: pbaclaims.com
  • Headquarters: Oak Brook, Illinois, United States
  • Founded: 1985
  • Headcount: 51-200
  • LinkedIn

PBA Claims is a machine-readable files (MRFs) solutions provider offering savings service solutions for self-funded plans. With more than 35 years of experience, they specialize in streamlining processes and delivering meaningful savings for plan members.


4. Meridian of Illinois

Meridian is a healthcare company that offers Medicaid, Medicare-Medicaid and Managed Long Term Services & Supports plans. They provide benefits and services including care coordination, disease management and healthy rewards.


5. The Horton Group

The Horton Group is an insurance advisory services company based in Edina, MN. They offer a comprehensive insurance portfolio to protect businesses and individuals, including employee benefits, liability coverage, and personal asset protection.


6. CMR Benefits Group, Inc.

CMR Benefits Group is a consultative broker providing strategic benefit consulting, core benefits, voluntary worksite benefits, group disability & life benefits, and other employee benefits services for businesses in various industries.


7. Shortlister

MyShortlister.com is a platform that helps employers connect with HR vendors and streamline the vendor selection process. It offers a comprehensive database of vendor profiles and allows users to research, request proposals, and manage the RFP process. The platform empowers HR professionals to make informed decisions and improve efficiency in selecting the right vendors for their specific needs.


8. Teachers Coalition on Health

  • Website: tcohealth.com
  • Headquarters: Rockford, Illinois, United States
  • Founded: 2014
  • Headcount: 11-50
  • LinkedIn

TCO Health is a company that offers programs to help reduce healthcare costs for schools and businesses, through Prescription Benefit Managers and HRA/FSA Administration.


9. AIM Specialty Health

AIM Specialty Health is the leading specialty benefits management partner for healthcare organizations. They promote appropriate, safe, and affordable healthcare by improving the quality of care and reducing costs for complex tests and treatments.


10. bswift

  • Website: bswift.com
  • Headquarters: Chicago, Illinois, United States
  • Founded: 2000
  • Headcount: 501-1000
  • Latest funding type: Acquired
  • LinkedIn

bswift is a benefits administration partner that helps companies and their employees optimize their health and welfare benefits through technology and a caring approach.


11. BAS (a HealthComp Division)

  • Website: bashealth.com
  • Headquarters: Homewood, Illinois, United States
  • Founded: 1983
  • Headcount: 501-1000
  • LinkedIn

BAS Health is a benefit administrative systems company that offers comprehensive health care plans.


12. Maestro Health

  • Website: maestrohealth.com
  • Headquarters: Chicago, Illinois, United States
  • Founded: 2013
  • Headcount: 201-500
  • Latest funding type: Acquired
  • LinkedIn

Maestro Health is an end-to-end health plan solution provider, offering self-funded benefits that prioritize employee health and simplify benefits. They offer personalized healthcare, cost management, clinical care management, and administrative services. Their mission is to improve health outcomes and overall well-being for members by optimizing benefit plans at a lower cost.


13. Evive | goevive.com

  • Website: goevive.com
  • Headquarters: Chicago, Illinois, United States
  • Founded: 2007
  • Headcount: 201-500
  • LinkedIn

Evive is an industry-leading engagement solution that improves the financial, physical, and emotional well-being of workers. Their platform replaces sweat with software, streamlining strategies and delivering measurable results to employers. Evive's personalized approach utilizes curated communication and deep data analytics to create meaningful messaging and optimize workplace well-being.


14. Prairie States Enterprises, Inc.

Prairieontheweb.com is a health benefits administrator that provides personalized and compassionate service to create customized health benefits plans for unique individual and company needs.


15. AIM Inform

AIM Inform is a platform that integrates with EMR systems and simplifies the prior authorization and CMS program workflow, reducing the need for multiple administrative staff. It enables completion of health plan prior authorizations for outpatient advanced imaging and compliance with the CMS Appropriate Use Criteria Program from a single source, resulting in real-time payment clarity and clinical determination.


16. EPAY Systems

  • Website: epaysystems.com
  • Headquarters: Rolling Meadows, Illinois, United States
  • Founded: 2001
  • Headcount: 51-200
  • Latest funding type: Acquired
  • LinkedIn

EPAY Systems is a workforce management company that offers solutions for time tracking, applicant tracking, performance management, HR management, payroll, and benefits administration. Their tools and analytics help businesses streamline processes, cut labor costs, and make informed decisions. They provide cloud-based software, hardware, and services to support efficient workforce operations.


17. Tandem HR

  • Website: tandemhr.com
  • Headquarters: Westchester, Illinois, United States
  • Founded: 1997
  • Headcount: 51-200
  • Latest funding type: Private Equity
  • LinkedIn

Tandem HR provides high-touch and cost-effective human resource solutions for businesses. They offer comprehensive HR services, including payroll administration, HR technology, benefits administration, risk management, and HR consulting. Their team of experts provides guidance and support in navigating HR challenges and maintaining a productive workplace. Partnering with Tandem HR allows businesses to outsource HR management and focus on business growth.


18. Point C

Point C Health is a health benefits partner that simplifies benefit management for clients by providing seamless partnerships with healthcare providers and vendor organizations. They believe in meeting real health needs by ensuring access to skilled clinicians and delivering meaningful solutions for brokers and self-funded clients.


19. Group Administrators, Ltd.

Group Administrators is a leading TPA service provider that has been offering its services for over thirty years. With a focus on the latest technological advances in the industry, Group Administrators is a trusted choice for TPAs.


20. Unland Companies

  • Website: unland.com
  • Headquarters: Pekin, Illinois, United States
  • Founded: 1941
  • Headcount: 51-200
  • LinkedIn

Unland is an insurance agency that offers a wide range of life and health insurance products, including life insurance, health insurance, disability insurance, and long-term care insurance. They also provide business insurance, such as business auto insurance and workers' compensation insurance. With a focus on personalized protection plans, Unland aims to keep homes, vehicles, businesses, employees, and other assets protected.


21. Benefit Planning Consultants, Inc.

  • Website: bpcinc.com
  • Headquarters: Champaign, Illinois, United States
  • Founded: 1979
  • Headcount: 51-200
  • Latest funding type: Acquired
  • LinkedIn

BPC is a company that provides a participant portal to optimize BPC Benefits. The portal offers improved efficiency, comprehensive account information, and useful tools and resources.


22. Unite Here Health

  • Website: uhh.org
  • Headquarters: Aurora, Illinois, United States
  • Headcount: 201-500
  • LinkedIn

UHH (UNITE HERE HEALTH) is a national health fund that works with local unions and employers to provide health benefits and resources to approximately 200,000 children and adults across the nation. They offer insurance coverage and support for improving health and healthcare.


23. HealthStrategy, LLC

Health Strategy is a pharmacy benefit consulting firm that helps clients reduce costs and provide independent clinical insights. They offer expertise in managing pharmacy benefits contracts, negotiating with pharmacy benefit managers, and maximizing pharmacy benefit performance.


Want to find more pharmacy benefit management companies?


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