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GOVERNMENT OF PUERTO RICO OFFICE OF THE COMMISSIONER OF INSURANCE PUERTO RICO FORM FILING CHECK LIST SMALL GROUP MARKETCOMPANY:ATTACHMENT 7BFORM NUMBER:REVISED 02/2021SERFF TRACKING NUMBER: TYPE OF

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How to fill out ehb benchmark- drug formulary

01

Step 1: Gather all the necessary information related to the EHB benchmark-drug formulary.

02

Step 2: Review the provided instructions or guidelines on how to fill out the formulary.

03

Step 3: Start with the basic details such as the name of the organization, contact information, and formulary year.

04

Step 4: Identify the specific drug classes or categories required in the formulary and list them down.

05

Step 5: For each drug class, include the corresponding drug names or generic names.

06

Step 6: Provide the appropriate codes or identifiers for each drug entry, if required.

07

Step 7: Indicate the coverage tier or formulary status for each drug (e.g., preferred, non-preferred, specialty, etc.).

08

Step 8: Include any additional details or notes specific to certain drugs or drug classes.

09

Step 9: Double-check all the filled information for accuracy and completeness.

10

Step 10: Submit the filled EHB benchmark-drug formulary as per the provided submission instructions.

Who needs ehb benchmark- drug formulary?

01

Health insurance companies or providers who offer essential health benefits (EHB) coverage.

02

Pharmacy benefit managers (PBMs) responsible for managing drug formularies.

03

Government agencies or organizations overseeing healthcare programs that require EHB benchmark-drug formulary.

04

Healthcare professionals involved in prescribing or recommending medications within the EHB coverage.

05

Pharmacists or pharmacy staff responsible for maintaining and updating the formulary.

06

Consumers or patients who want to understand the drug coverage options under their health insurance plan.

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What is ehb benchmark- drug formulary?

The EHB benchmark drug formulary is a list of prescription medications that are covered under the Essential Health Benefits (EHB) by health insurance plans, ensuring that a range of necessary medications are available to enrollees.

Who is required to file ehb benchmark- drug formulary?

Health insurance issuers and providers that offer plans which include EHBs are required to file the EHB benchmark drug formulary.

How to fill out ehb benchmark- drug formulary?

To fill out the EHB benchmark drug formulary, insurers must provide a comprehensive list of covered drugs, including brand and generic names, drug categories, and any applicable restrictions or exclusions.

What is the purpose of ehb benchmark- drug formulary?

The purpose of the EHB benchmark drug formulary is to ensure that consumers have access to essential medications as part of their health insurance coverage, promoting comprehensive healthcare.

What information must be reported on ehb benchmark- drug formulary?

The information that must be reported includes the names of covered medications, dosages, drug categories, any cost-sharing requirements, and any special conditions for coverage.

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