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RxResource Home > Pharmacy Resources > Pharmacy Benefit Management

2441 Warrenville Road, Suite 610 Lisle, IL 60532-3642

Susan Fleming, Vice President, Marketing

Phone: (630) 577-4880

http://www.catamaranrx.com/

Catamaran offers a true alternative to the status quo in pharmacy benefit management. You don't have to choose between the scale and purchasing power of the largest providers and the flexibility and agility of smaller ones. We offer the best of both.

At Catamaran, we put your individual needs - and those of your members - at the center of our services. We connect pharmacists, doctors and caregivers with prescription data to improve health outcomes, offering the clinical intelligence, technology and scale to lower payer costs while improving member health.

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Catamaran officially becoming OptumRx

Effective October 1, 2015, Catamaran, Caterpillar's pharmacy benefit manager (PBM), will change its name to OptumRx. This PBM branding change doesn't impact design or coverage under our prescription drug plan.

Plan participant materials mailed from Catamaran will start to show OptumRx branding. Catamaran ID cards will continue to be accepted at pharmacies and won't need to be replaced. The processing information and phone number listed on the cards are not changing.  

Nothing! It's a name change only. If you're a plan participant, you can continue to access your pharmacy records and drug information using the same website ( mycatamaranrx.com ) and mobile app (OptumRx/CatamaranRx in your mobile device's app store) as always. You may also access prescription drug benefit information at benefits.cat.com .

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Pharmacy – Catamaran

Submitting 2016 pharmacy claims only.

All 2016 pharmacy claims should be directed to Catamaran at 877-235-2017 or www.mycatamaranrx.com .

Prescriptions

2 ways to save, by catamaran rx.

Members can save from 10% to 85% on name brand and generic prescriptions at over 65,000 select pharmacies nationwide or while using the mail order service.

In Pharmacy

– prescription card.

The discount benefit is simple to use. The member simply shows the membership card and prescription at a participating pharmacy to receive the discounted rate. There are no additional forms required.

• 10% to 85% on name brand and generic prescriptions
• Over 65,000 select pharmacies nationwide
• While our provider lists are continually updated, provider status can change. We recommend that you confirm the provider you selected participates in the program before dropping off your prescription.

To Find a Participating Pharmacy Near You Go To: www.findbestbenefits.com

 Mail Order 

Prescription Pricing and Mail Order services are included.

* Pharmacy discounts are Not Insurance, and are Not Intended as a Substitute for Insurance.  The discount is only available at participating pharmacies.

Prices will always vary on prescription drugs and therefore it is impossible to estimate specific dollar savings through any non-insured drug program. Your membership offers two avenues for drug purchases: The Catamaran Prescription Benefit offers 10% to 85% on name brand and generic prescriptions.

Not necessarily. Drug stores, like hardware and grocery stores determine their own pricing structures. Due to large discounts from manufacturers, some drugs may already be priced at or below the discount price.

No. A co-pay card is an insured product where the customer pays a preset amount and the insurance company pays the remainder. This membership is a discount card offering reduced prices. You are responsible to pay the pharmacy 100% of the discounted price.

Catamaran Insurance: Reported Costs, and What Impacts!

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Calculating the costs of your catamaran involves considering more than just the purchase price. You also have to consider maintenance, marina costs and the insurance fees of your boat, which can be hefty, especially for larger vessels. So what are the catamaran insurance costs, and how do they differ with the size of your boat?

The standard insurance cost for most sailing catamarans is 1.5% of its value. However, this rate can go as high as 3% or more. Some factors that influence cost include sailing area, length and age of the catamaran, surveyor’s findings.

In this article, I will discuss the various insurance costs for different- sized catamarans , providing examples of how much you would need to pay for some popular catamarans. I will also discuss the insurance costs associated with charter use, ocean crossings, and private use in different parts of the world. 

Table of Contents

How Much Are Catamaran Insurance Costs?

A Lagoon 380 Catamaran valued at $399 000 will cost between $6000 and $12 000 per year considering that insurance costs are between 1.5% to 3% of the value of the boat. 

On average, therefore, insurance costs will be approximately 2% of your catamaran’s value. Unless your catamaran has a negative past loss experience or you are sailing in a limited market or politically restricted zones, your cost of insurance should be roughly 1.5% of the cost of your catamaran. 

These costs also vary by supply, location, and demand.

The table below summarizes the insurance costs you would expect based on the value of your catamaran. 

Summary of expected insurance costs at 1.5% and 3%

As shown in the table above, owners of a Lagoon 380 can expect to pay between $5,997.36 and $11,994.72. The latter figure considers the higher limit for insurance costs and the former the lower limit. 

As evident from the above table, the cost of insurance will be significantly affected by the value or the price of the catamaran.

As explained by Yacht International , catamaran owners may sometimes enjoy a premium of only 1.2% if the value of the catamaran exceeds $500,000. Accordingly, you may pay lower fees in terms of insurance when your boat is valued over this price. 

Other factors such as your relationship with the insurer may also lower the insurance premium rates.  

Ultimately, the insurance cost will vary across different underwriters and will be affected by factors such as the age and condition of the boat and the specific areas you want to sail in.

For second-hand catamarans, the percentage for insurance will be based on the survey-assessed value.

Other Factors That Influence Catamaran Insurance Cost

It is vital to pay keen attention to ensure that the insurance also covers ocean crossings, storms, and more. Below, I will discuss how this insurance may vary across ocean crossings, charter use, and private use worldwide.

Ocean Crossings

Based on cost or surveyor-finding, the standard 1.5% to 3% of the catamaran’s value will apply for catamarans insured for ocean crossings. However, you will be required to pay a one-time crossing fee. For instance, the Pacific Ocean crossings require a one-time fee of $500 to $1,000 .

You, therefore, have to consider this figure when computing your total insurance fees.

Charter Use

Catamarans under charter use are generally covered under a fleet policy . This policy tends to have better rates as compared to ocean crossings and private use , but this rate will vary from company to company. On average, this rate will fall between 1.5% and 3% of the boat’s value. 

Private Use

The annual premium for private catamaran use ranges from 1.5% to 2% of the boat’s declared value. Like charter use and ocean crossings, this will vary across underwriters and regions. With insurance, it is most often worth to seek out several quotes to get the best possible rate. 

Regional Differences

The regional differences play a major part in a catamaran’s insurance cost, primarily due to the risks associated with hurricanes and other natural disasters. 

There are four main regions insurers consider when setting their premiums and the impact this may have on your insurance costs. They include:

• California and pacific islands 
• Mediterranean regions
• Hurricane zones
• Non-hurricane zones

I’ll look at each of these a little closer down below. 

California and Pacific Islands vs. the Mediterranean Region

The insurance rates in California and the Pacific Islands region are higher than the insurance rates and costs in the Mediterranean region.

While you may expect to pay approximately 1% of your catamaran’s value in insurance costs for the Mediterranean region, this rate doubles for the California and Pacific Islands region.

Hurricane Zone

Your navigation area will play a significant role in the cost of insurance, especially when you sail through the hurricane zone during the hurricane season. This includes the areas south of the Florida and Georgia border, the Bahamas, and the Caribbean.

The hurricane season starts from 1st of june to the 1st of November, during which insurance rates will be significantly higher.

Insurance for navigation areas will generally have higher rates than non-hurricane areas. It is important to note that you may also pay higher rates if you intend to sail in areas prone to strong winds.

Out of the Hurricane Zone

Unlike the hurricane zones, areas falling outside the hurricane zone will have lower insurance costs than those in the hurricane zone. This is especially true for the North of Florida, where insurance costs for catamarans can fall below 1% of your catamaran’s value. 

As a rule of thumb, it is essential to discuss with the underwriter your navigation area for more information on what changes it may have on your insurance premiums. 

The cost of insuring your Catamaran averages at about 2% of your catamaran’s value. The main factors affecting your insurance costs include the price or value of your catamaran, its age and condition, and your navigation area.

Areas with limited coverage or areas prone to storms or strong winds will generally attract higher rates as compared to non-hurricane areas. Therefore, it is essential to discuss your navigation area with your insurance broker to ensure that you are adequately covered wherever you decide to sail.

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Owner of CatamaranFreedom.com. A minimalist that has lived in a caravan in Sweden, 35ft Monohull in the Bahamas, and right now in his self-built Van. He just started the next adventure, to circumnavigate the world on a Catamaran!

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UnitedHealth Group buying Catamaran pharmacy benefits manager for $12.8 billion

Catamaran serves about 25 million americans with retail pharmacy network management, mail-order pharmacy, claims management and other services..

Photo of UnitedHealth Group Corporate Headquarters from Facebook

UnitedHealth Group, the nation’s largest insurer, on Monday said it would acquire Catamaran, the country’s fourth-largest pharmacy benefits manager, for $12.8 billion. Under terms of the deal, Schaumburg, Illinois-based Catamaran will merge with OptumRx, the drug management division of UHG’s highly profitable technology and services subsidiary Optum.

In the $12.8 billion deal, expected to close by the end of the year, UHG is paying $61.50 a share, 27 percent more than Catamaran’s closing stock price on March 27.

“Catamaran’s capabilities are impressive and their leadership team has delivered the fastest growth in the industry,” said Larry Renfro, chief executive officer of UGH’s Optum, in a statement. “Optum’s longstanding business relationship with Catamaran as a technology partner means we operate on the same adjudication platform, simplifying integration and giving us confidence our combined organizations will quickly become an innovative force moving the pharmacy care services marketplace forward.”

Mark Thierer, chairman and CEO of Catamaran, said the company’s board considered a range of options for its future and unanimously decided to accept UHG’s offer.

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“The creation of a differentiated, channel-agnostic delivery model will provide payers and individuals a broader portfolio of services and a deeper product offering while aggressively focusing on managing costs,” said Thierer, Catamaran’s CEO since 2006.

Catamaran was founded in 1993 as Systems Xcellence in Toronto, gradually growing through the 2000s after relocating to suburban Chicago and a handful of acquisitions. After buying Catalyst Health solutions in 2012 for $4 billion, the company was renamed to Catamaran.

[Also: Tracking 2015 mergers and acquisitions ]

Renfro said Catamaran and Optum already had similar business strategies. OptumRx uses “clinical synchronization” to connect pharmacy and care management systems, as well as specialized teams to pursue “more consistent and compliant patient outcomes and savings for individuals and plan sponsors,” such as large employers. That approach is particularly important, Renfro said, “given the growth in U.S. spending on specialty pharmaceuticals,” which is driving a wave of drug spending that could top $500 billion by 2020.

Catamaran serves about 25 million Americans with retail pharmacy network management, mail-order pharmacy, pharmacy claims management and patient-centric specialty pharmacy services to health plans and employers. This year, the company will fill about 400 million prescriptions, and when combined with OptumRx, the new company will fill more than 1 billion scripts each year.

Currently, specialty pharmaceuticals account for only 1 percent of all U.S. prescriptions but more than 20 percent, or $100 billion, of national drug spending, and that could rise to $400 billion by the end of the decade, according to UHG. 

Twitter: @AnthonyBrino

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UnitedHealth Group acquires Catamaran for $12.8 billion

UnitedHealth Group’s announcement that its free-standing pharmacy care services business, OptumRx, will merge with Catamaran Corp., the fourth largest pharmacy benefit manager in the U.S., makes sense, according to industry experts.

UnitedHealth Group’s announcement that its free-standing pharmacy care services business, OptumRx, will merge with Catamaran Corp., the fourth largest pharmacy benefit manager (PBM) in the U.S., makes sense, according to industry experts.

UnitedHealth Group  plans to acquire  Catamaran for about $12.8 billion in cash, the Wall Street Journal reported.

“This is a smart acquisition well aligned with UnitedHealth’s strategy-increasing their market power, adding to their suite of technology and benefit management offerings, further diversifying their non-risk business, and better positioning them for the rapidly changing post-ACA delivery system and specialty pharmacy market,” says Kip Piper, MA, FACHE, advisor with Sellers Dorsey , a Medicaid consultancy in Washington, D.C.  “It will increase their already formidable leverage in pharma, biotech, and pharmacy price negotiations. UnitedHealth will no doubt take advantage of the wealth of data, IT savvy, and diverse client base Catamaran brings to the deal.”

This merger is consistent with the types of consolidation being seen within the industry, according to Robert Taketomo, PharmD, MBA, president and CEO, Ventegra .

“However, it remains to be seen in this particular case how the desired efficiencies from scale will impact the ability to adapt to a healthcare environment in flux, and how potential channel conflict with health plan clients will be addressed,” Taketomo says.

The agreement calls for the acquisition of Catamaran’s outstanding common stock for $61.50 per share in cash. The transaction is expected to close during the fourth quarter of 2015, subject to Catamaran shareholders’ approval, regulatory approvals and other customary closing conditions. The combination diversifies OptumRx’s customer and business mix, while accelerating its technology leadership and flexible service offerings.

NEXT: Purchase details

The acquisition is expected to be accretive to UnitedHealth Group’s net earnings in the area of $0.30 per share in 2016. UnitedHealth Group plans to finance the acquisition from existing cash resources and new debt. The company affirmed its $6.00 to $6.25 per share earnings outlook assuming the absorption of all merger costs, the ongoing commitment to advance its dividend policy as planned, and a continued but moderated level of share repurchase.

“It is generally acknowledged that most such takeovers result in a transfer of wealth or value from the acquirer's shareholders to the seller's shareholders. As such, it is a good deal for Catamaran,” says Mark O. Dietrich, CPA/ABV, cpa.net , a certified public accounting firm specializing in healthcare valuation, and author of “The Financial Professional's Guide to Healthcare Reform.” “Initial reaction in the market, however, was positive for United with its share price increasing, so perhaps this deal will be an exception.

“Pharmacy costs represent a significant portion of healthcare spending in the United States, reportedly rising 12% last year, and cost control is critical,” Dietrich adds. “The pharmacy chain CVS controls one large PBM, while its competitor Walgreens sold its PBM. At least from a standard view of economics, it would appear to make more sense to have PBMs under insurer control rather than the control of the industry they attempt to manage the costs of.”

This combination is expected to create a dynamic competitor in the PBM market by combining the strengths of Catamaran’s industry-leading technology platform with the data and analytics capabilities of Optum. The combined company is expected to deliver an innovative and compelling consumer and payer services offering that will link demographic, lab, pharmaceutical, behavioral and medical treatment data to engage individuals to make better decisions as they seek the best, most effective care and improve compliance with pharmaceutical use and care protocols.

Given the business imperatives of post-Affordable Care Act policy and market environment, super low cost of capital, large corporate cash reserves, the increasing power of data and technology, and intense pressures on pricing and cost efficiency, the industry can expect more M&A activity in many segments of healthcare, according to Piper. 

“The marketplace is ripe for further vertical and horizontal consolidations in the drug supply chain and beyond,” Piper says.

“Consolidation leads to fewer choices for the users of PBMs, which of course include managed care executives,” Dietrich says. “Pharmacy costs and formularies are one element of a managed care plan's product design and may contain features regarded as competing with other managed care plans. For plans presently using, for example, United's OptumRx, a competing plan may be using Catamaran. Now, both competing managed care plans would be serviced by the same PBM.”

NEXT: OptumRx's approach

OptumRx’s advanced Clinical Synchronization approach connects pharmacy and care management systems, processes and teams to create deeper insights for higher quality, more consistent and compliant patient outcomes and savings for individuals and plan sponsors. Synchronization presents the entire patient health profile, rather than discrete pieces of an individual’s profile – a distinctive and critically important capability given the growth in U.S. spending on specialty pharmaceuticals.

Catamaran offers retail pharmacy network management, mail service pharmacy, pharmacy claims management and patient-centric specialty pharmacy services to a broad client portfolio, including health plans and employers, as well as healthcare information technology solutions to the industry. In 2015 Catamaran expects to fulfill more than 400 million prescriptions which, combined with OptumRx’s roughly 600 million annual scripts, will enable the combined entity to be a competitive force in the PBM industry. Enhanced purchasing and administrative improvements from the combination are expected to drive substantial value, with the majority of savings expected to directly benefit clients and individuals through reduced costs for prescriptions and enhanced pharmaceutical services.

Both companies have distinctive, rapidly growing specialty pharmacy services businesses. The combined organization will help customers manage the complex costs and outcomes as this portion of the pharmaceutical market expands from an estimated $100 billion in revenues in 2014 to potentially $400 billion annually by 2020.

“With pharmaceutical costs rising rapidly and the increasing prevalence of expensive specialty drugs targeting rare conditions, pharmacy costs are likely to represent an increasing share of healthcare spending in the future,” Dietrich says. “The PBM companies that control access to millions of insureds will play a critical role in determining pricing and insurance premiums.”

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Catamaran Corporation Unveils New Specialty Pharmacy Offering

Catamaran Corp, a leading provider of pharmacy benefit management (PBM) services and technology announced it has launched its new specialty brand, BriovaRx.

Catamaran Corp, a leading provider of pharmacy benefit management (PBM) services and technology announced it has launched its new specialty brand, BriovaRx. BriovaRx marks the beginning of a new day in the specialty sector, delivering personalized, holistic care to patients with complex and chronic conditions to improve health outcomes.

“Patients diagnosed with complex medical conditions often face insurmountable challenges in managing their conditions - financially, emotionally, and physically,” said Mark Thierer, chairman and chief executive officer of Catamaran. “In contrast to an industry that’s focused solely on the drug, BriovaRx focuses on the patient, ensuring they receive one-on-one support and a personalized plan that addresses all conditions — not just the underlying chronic illness – to help them lead healthy, vibrant lives.”

As the fifth largest specialty pharmacy in the nation, BriovaRx has the skill and scale to effectively manage costs for health plans and other payers challenged by escalating specialty drug prices and increased utilization. According to projected trend figures, specialty plan spending is estimated to grow from 18% of total pharmacy costs (2010) to 43% by 2020.

“Since 11 of the 16 most utilized drugs in the nation are classified as specialty, BriovaRx addresses a growing need in our communities to better manage complex conditions like hepatitis C, cancer, crohn’s Disease, HIV, multiple sclerosis, and others,” said Albert Thigpen, senior vice president, Pharmacy Operations, Catamaran. “BriovaRx provides a support system for the patient and coordinates the efforts of providers and payers to streamline delivery and administration of treatment to ensure a more positive experience for every patient and more time for physicians to focus on care.”

Catamaran, under its former name SXC Health Solutions, has more than 15 years of experience within specialty pharmacy. BriovaRx replaces its former specialty pharmacy offering, Medfusion/Ascend.

About Catamaran

Catamaran, the industry’s fastest-growing pharmacy benefits manager, helps organizations and the communities they serve take control of prescription drug costs. Managing more than 200 million prescriptions each year on behalf of 25 million members, our flexible, holistic solutions improve patient care and empower individuals to take charge of their health. Processing 1 in every 5 prescription claims in the United States, Catamaran’s skill and scale deliver compelling financial results and sustainable improvement in the overall health of members. Catamaran is headquartered in Lisle, Illinois, with multiple locations in the United States and Canada. For more information, please visit www.catamaranRx.com .

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