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Pharmacy Benefit Manager (PBM)

A company that manages prescription drug benefits for health insurance companies, Medicare Part D plans, and large employers. They negotiate with drug manufacturers and pharmacies, and process claims.

Third Party Administrator (TPA)

A company that processes insurance claims or certain aspects of employee benefit plans for a separate entity, such as an employer, often handling administrative tasks like claims processing, enrollment, and record-keeping.

ERISA (Employee Retirement Income Security Act of 1974)

A federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans.

Employer-sponsored health plan

A health insurance plan offered to employees and their dependents by an employer as part of their benefits package.

Direct compensation

Money paid directly from one party to another for services rendered, such as a fee for service.

Indirect compensation

Payments or other valuable considerations received by a service provider from a third party that are related to the services provided, but not paid directly by the client (e.g., commissions, rebates, or referral fees).