Highmark | Producer blast 2025

This email is intended for producers with large group business in Delaware, New York, Pennsylvania, and West Virginia.

Pharmacy Benefit Manager (PBM) Connectivity

What do I need to know?
Integrating pharmacy benefit administration with Highmark offers the most streamlined and cost-effective experience. However, clients can choose to carve out their pharmacy benefits administration to other Pharmacy Benefit Manager (PBM) vendors. Carving out to other PBMs will increase setup costs and implementation time, especially for platforms without existing Highmark connectivity.

Regardless of the path chosen, we are committed to collaborating with you to find the optimal solution for the client, and we’re sharing the attached PBM Vendor Connectivity for Self-Insured Clients information for your use. The document includes size restrictions, where applicable.

What do I need to do?
Inform your clients about the benefits and cost savings associated with integrated pharmacy administration. If a client wants to carve out pharmacy benefit administration to another PBM, help the client understand their options by sharing the attached information.

PBM Vendor Connectivity for Self-Insured Clients
Blue Shield branded for client use in central and Southeastern Pennsylvania, and Northeastern New York

PBM Vendor Connectivity for Self-Insured Clients
Blue Cross Blue Shield branded for client use in Northeastern and Western Pennsylvania, Delaware, West Virginia, and Western New York

Questions?
Please contact your Highmark Sales Executive or Client Manager with questions.

Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association:
Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company.
Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company.
PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418.
Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield.
West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Visit https://www.highmarkbcbswv.com/networkaccessplan to view the Access Plan required by the Health Benefit Plan Network Access and Adequacy Act. You may also request a copy by contacting us at the number on the back of your ID card.
Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield.
Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.
Highmark Blue Cross Blue Shield and Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal.
All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.

This email and any attachments contain important information about Highmark, including its products, customers and business
processes, and may include information which Highmark considers to be confidential and proprietary ("the Highmark Information").
The Highmark Information is intended solely for the use of the individual or entity to which it is addressed, including employees of that
entity with a need to access such information. Unauthorized use, disclosure or copying of the Highmark Information, including the
posting of such information on a website or social media sites that can be accessed by third parties, is strictly prohibited.

® Highmark is a registered mark of Highmark Inc.

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