Top 24 Pharmacy Benefit Firms in North Carolina
Top 24 Pharmacy Benefit Firms in North Carolina
The Pharmacy Benefit Management (PBM) sector in North Carolina comprises varied companies offering distinctive services within the healthcare industry. These firms play a critical role in managing prescription drug programs for health insurers, self-insured employers, and government entities, among others. They help in negotiating with pharmacies and pharmaceutical manufacturers to maximize cost savings. A focus on integrated services, transparent pricing, comprehensive healthcare solutions, and innovative products characterizes these companies. With an increasing focus on cost containment and quality healthcare, the industry is seeing a growing demand for specialized services and tailored solutions.
Top 24 pharmacy benefit management companies in North Carolina
1. ProRx Solutions
- Website: prorxsolutions.com
- Headquarters: High Point, North Carolina, United States
- Headcount: 11-50
ProRx Solutions is a pharmacy benefit management company that offers fully integrated services through partnerships with mail, specialty, and compounding pharmacies, claims processing platforms, and core programs. They provide customized formulary management, cost containment programs, and transparent pricing structures for clients and members.
2. MedCost
- Website: medcost.com
- Headquarters: Winston-Salem, North Carolina, United States
- Founded: 1983
- Headcount: 201-500
MedCost is a company that offers comprehensive healthcare and benefits solutions. With a focus on providing access to high-quality care, they help employers navigate the complexities of healthcare and manage costs. Their services include eligibility and benefits management, claims processing, provider network management, and member support.
3. ACS Benefit Services, LLC
- Website: acsbenefitservices.com
- Headquarters: Winston-Salem, North Carolina, United States
- Founded: 1982
- Headcount: 51-200
ACS Benefit Services is a leading third-party administrator (TPA) that offers innovative health benefits solutions and exceptional customer support. With over four decades of experience, we create tailored health plans to meet the unique needs and goals of employers, members, brokers, and providers. Our comprehensive data management and reporting, proactive wellness education, and largest network of dentists ensure improved outcomes. We specialize in reference based pricing and offer national and regional networks, MEC and consumer-directed options, infusion care, and specialty programs.
4. AvaCare, Inc.
- Website: avacare.biz
- Headquarters: Greensboro, North Carolina, United States
- Founded: 2008
- Headcount: 11-50
Avacare is a pharmacy benefits management company that specializes in providing clinical and financial solutions for hospices. They offer top-notch clinical pharmacists, symptom management and pain control assistance, and partner with local pharmacies to reduce medication expenses. Their superior customer service sets them apart in the market.
5. Sona Benefits
- Website: sonapharmacybenefits.com
- Headquarters: Asheville, North Carolina, United States
- Founded: 2005
- Headcount: 51-200
Sona Pharmacy Benefits is a pharmacy benefit management company providing a custom program that significantly reduces the costs of specialty medications for clients through pass-through pricing and 100% pass-through rebates.
6. RxLogic
- Website: rxlogic.com
- Headquarters: Asheville, North Carolina, United States
- Founded: 2020
- Headcount: 11-50
RxLogic offers a powerful SaaS claims platform for pharmacy benefit management organizations and care providers to manage benefit solutions for simple to complex design.
7. Crescent Health Solutions, INC.
- Website: crescenths.com
- Headquarters: Asheville, North Carolina, United States
- Headcount: 11-50
Crescent Health Solutions provides cost-effective and quality-centric health management solutions while fostering collaboration and customer-driven programs for employers, employees, and providers.
8. Exemplar Health Benefits Administrator
- Website: exemplarhba.com
- Headquarters: High Point, North Carolina, United States
- Founded: 2019
- Headcount: 11-50
Exemplar Health Benefits Administrator provides benefits solutions for businesses. Their specialists in the healthcare industry offer COBRA administration, case management, compliance management, and other services to control healthcare costs.
9. Pharmacists United for Truth & Transparency
- Website: truthrx.org
- Headquarters: Winston Salem, North Carolina, United States
- Founded: 2007
- Headcount: 1-10
Pharmacists United for Truth and Transparency (PUTT) is a 501(c)(3) non-profit organization advocating for greater transparency in the pharmacy benefit management (PBM) industry.
10. InMedRx
- Website: inmedrx.com
- Headquarters: Raleigh, North Carolina, United States
- Headcount: 51-200
InMedRx delivers pharmacy services for institutional pharmacies, healthcare providers, state departments of corrections, juvenile detention centers, and behavioral health departments, providing around-the-clock support to make sure patients receive medicines they need in a timely manner.
11. Exemplar Healthcare Partnership Organization
- Website: exemplarhpo.com
- Headquarters: High Point, North Carolina, United States
- Founded: 2019
- Headcount: 201-500
By joining Exemplar, you will become a strategic partner in the largest collective of independent primary care physicians and pharmacies focused on bringing more lives and better reimbursement to the network.
12. Nbfsa LLC
- Website: nbfsa.com
- Headquarters: Winston Salem, North Carolina, United States
- Founded: 2004
- Headcount: 11-50
NBFSA is a solutions company specializing in delivering customized benefit administration solutions that support our clients’ product distribution and servicing needs with control, integrity and security.
13. Blue Cross NC
- Website: bluecrossnc.com
- Headquarters: Durham, North Carolina, United States
- Founded: 1933
- Headcount: 1001-5000
Blue Cross NC provides medical insurance services in North Carolina, offering a variety of plans and benefits for individuals and families. They also offer dental and vision plans, and are committed to improving the health and well-being of their customers and communities.
14. Tucker Administrators, Inc.
- Website: tuckeradministrators.com
- Headquarters: Charlotte, North Carolina, United States
- Founded: 1958
- Headcount: 11-50
Tucker Administrators is a third party administrator providing tools for employers, brokers, and consultants to reduce group health plan costs and promote employee health.
15. Healthgram
- Website: healthgram.com
- Headquarters: Charlotte, North Carolina, United States
- Founded: 1977
- Headcount: 201-500
Healthgram is a diversified healthcare company that supports midsize and large businesses through a unique design, flexibility, and a focus on providing a customized healthcare experience. They partner with forward-thinking companies to deliver high-value healthcare that minimizes costs. With solutions for health plan administration, member advocacy, clinics, and EHR software, Healthgram helps employers achieve more ownership and control over their healthcare benefits.
16. iBenefit Communication, Inc
- Website: ibenefitcommunication.com
- Headquarters: Charlotte, North Carolina, United States
- Founded: 2015
- Headcount: 51-200
- Latest funding type: Private Equity
iBenefit Communication is a benefits enrollment company with over 20+ years of experience helping brokers and their clients execute successful employee enrollments. They offer customized education and communication plans to engage employees in understanding and utilizing their benefits.
17. Vintage Hill Consulting
- Website: vintagehillconsulting.com
- Headquarters: Raleigh, North Carolina, United States
- Founded: 2016
- Headcount: 11-50
Vintage Hill Consulting is an HCM consulting firm that partners with organizations across multiple industries to help them maximize their HCM solution investment and optimize their most important resource, their people.
18. JRW Associates
- Website: jrwassoc.com
- Headquarters: Raleigh, North Carolina, United States
- Founded: 1991
- Headcount: 11-50
JRW Associates is a full-service employee benefits advisory firm specializing in compliance, cost management, education, and administration. We provide peace of mind by managing compliance responsibilities and distributing required notices to employees. Our focus on effective communication ensures success in diverse employee populations. With extensive resources and tools, we simplify benefit administration for our clients. Upholding integrity and leveraging our affiliation with United Benefit Advisors, we deliver customized programs at competitive rates. Our vision is to provide exceptional service that empowers employers and enhances employee satisfaction.
19. Benefit Advocates, Inc.
- Website: benefitadvocates.net
- Headquarters: Winston-Salem, North Carolina, United States
- Founded: 2001
- Headcount: 11-50
Benefit Advocates is a company that helps HR professionals and brokers navigate the challenges of healthcare benefits. They advocate for individuals dealing with complex healthcare claims, denial, or billing errors. Their services help clients avoid insurance traps and frustrations related to health benefits, including Medicare.
20. Advisor HR, Inc.
- Website: advisorhr.net
- Headquarters: Huntersville, North Carolina, United States
- Founded: 2016
- Headcount: 11-50
AdvisorHR.net offers time and labor management services, delivering easy and pain-free transitions for businesses. They provide payroll, HR, benefits, and compliance solutions, helping businesses consolidate and simplify their administrative tasks. With personalized services and a focus on compliance, AdvisorHR.net allows businesses to concentrate on their core operations.
21. CEC (Community Eye Care)
- Website: cecvision.com
- Headquarters: Charlotte, North Carolina, United States
- Founded: 1998
- Headcount: 11-50
- Latest funding type: Acquired
Community Eye Care (cecvision.com) is a vision benefits company that offers easy-to-use, 12-month plans with no frame restrictions. They provide flexible eyewear allowances, allowing members to get exactly what they want, including frames, lenses, contact lenses, sunglasses, and special lens options. They have a strong focus on customer service and strive to simplify eye care for their members.
22. Capstone Health Alliance
- Website: capstonehealthalliance.com
- Headquarters: Fletcher, North Carolina, United States
- Headcount: 11-50
Capstone Health Alliance is a regional group purchasing organization that offers savings and value to its members. Through strategic partnerships with industry-leading suppliers, they deliver opportunities for cost reduction in various product categories.
23. Linked.Exchange
- Website: mylinked.exchange
- Headquarters: Huntersville, North Carolina, United States
- Founded: 2009
- Headcount: 11-50
Linked.Exchange is a customizable SaaS platform solution that provides technology solutions for insurance agencies, with a focus on data protection and HIPAA compliance.
24. Universal.one
- Website: universal.one
- Headquarters: Durham, North Carolina, United States
- Founded: 2018
- Headcount: 11-50
Universal Healthcare Group is a private equity-owned group of companies providing evidence-based healthcare, insurance, and technology solutions. It offers end-to-end digital insurance underwriting application, telemedicine, virtual health, home-based care, and accelerated vaccination management.
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