Why Capital Equilibrium is the right choice
No surprises. Just a consistent PEPM-based premium rate.
If your pharmacy costs come in lower than expected, you get rewarded with refunds or credits.
Your entire claims experience, including rebate and non-rebate dollars earned by the plan, is used to establish your renewal premium.
Members love us. We offer 24/7/365, U.S.-based, multilingual support.
What is a level-funded pharmacy benefit plan?
A level-funded plan combines the security of defined monthly payments with the opportunity to benefit if the overall experience is better than expected.
Your monthly rate covers claims, admin fees, and stop-loss protection. Capital Equilibrium stands apart by offering a fair pricing structure that eliminates the traditional PBM gameplay around discounts and rebates, which often results in overstated, unachievable savings expectations.
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Aligned with industry-leading partners
An A-Rated stop-loss carrier for reinsurance to back claims exceeding monthly amounts means cost control for claims covered by the policy.
Capital Rx provides conflict-free pharmacy benefit administration, allowing Capital Equilibrium to bend the curve for plan sponsors through its unique features across all 50 states.
FAQ
Frequently asked questions
What is a level-funded pharmacy benefit plan?
A level-funded pharmacy benefit plan offers a defined monthly premium rate covering expected claims, admin fees, and stop-loss. There are benefits to a plan sponsor if plan performance is better than projected.
Who should choose Capital Equilibrium?
Municipalities and employers looking for a combination of cost savings, flexibility, and budgeting security.
How is Capital Equilibrium different?
Capital Equilibrium leverages the financial value offered by Capital Rx, a 100% passthrough PBM, to support this product offering.
When developing our premium requirements, we blend both manual rates and experience-based rates. Capital Rx’s historical performance across its entire book of business is also factored into the rating methodology.
How do refunds and credits work?
It depends on the performance of the plan. If your actual pharmacy costs are less than expected, you may receive a refund or rate credit.
