DocSmart - Rx (Prescription Drug Benefit Plan and SPD/Summary)

There is a big gap in the group benefit plan documentation environment.  It is becoming more common for self-funded group benefit plan sponsors to separate pharmacy benefits from medical benefits in self-funded group health plans.  Plan Sponsors of these plans hire separate Pharmacy Benefit Managers and reap the economic benefits from separating these two important benefit deliverables.

While Pharmacy Benefit Management companies do a great job of delivering pharmacy benefit management services, they almost never provide a compliant Plan Document or Summary Plan Description in a usable form. Samples, when available, are hard to use and difficult to employ.  A Plan Document and Summary Plan Description are unquestionably required under ERISA for the Pharmacy Benefit portion of your group health plan.  It must have a formal Plan Document (ERISA Section 402) and Summary Plan Description (“SPD”) (ERISA Section 102).  It is also very important to have appropriate documentation and terms to advise your covered persons of the terms and conditions and to protect the Plan Sponsor and the processes involved.

Even governmental and church entities that are not subject to the ERISA requirements must have solid contract documents in the form of a Plan document and summary to meet the same goals to advise your covered persons of the terms and conditions and provide identifiable benefits, with appropriate risk mitigation and protections for all concerned.

The EZERISA’s DocSmart-Rx solution offers and ERISA and a non-ERISA Pharmacy Benefit Plan document technology solution, that is unique in the industry.  Developed by the EZ ERISA industry leading Compliance solutions team, DocSmart-Rx employ’s EZ ERISA’s AdviceSmart Compliance Intelligence Technology into a self-guided document creation system to prepare your Pharmacy Benefit Plan Document and Summary Plan Description (Plan document and summary for non-ERISA Plans).

Incorporated into this system is the EZ ERISA AdviceSmart Compliance Guidance which better protects clients and users, because we incorporate our knowledge, experience and capability in regard to the applicable rules and the inter-workings of pharmacy benefit management and pharmacy plans and programs to provide an easy, accurate and simple-to-use interface.  These are all built into the EZERISA DocSmart-Rx product experience.

For entities subject to ERISA, you will receive your fully compliant Pharmacy Benefit Plan Document and Summary Plan Description in a Unified Form to comply with the ERISA Plan Document and SPD Requirements.  As always, this comes with the AdviceSmart Intelligence Compliance Portal Technology that intelligently guides you through the document-building process and steers you past common compliance mistakes.

For governmental and church entities that are not subject to ERISA, you will receive your fully compliant Pharmacy Benefit Plan Document and Summary in Unified Form to provide clear and detailed contract language to support your Pharmacy Benefit Plan and Program.  As always, this comes with the WrapSmart Portal Technology that intelligently guides you through the document-building process and steers you past common compliance mistakes.