Keep the benefit. Take back the cost
Dropping GLP-1 coverage is a spreadsheet decision your employees experience as a values decision. There is a third option between paying whatever the plan charges and covering nothing.
Let’s talk
The renewal math stopped working
Weight management GLP-1s went from an occasional claim to a standing monthly line for a meaningful share of your workforce. Inside a carrier pharmacy benefit, you pay a price you cannot see, shaped by spread and rebate flows you cannot audit, for a category you cannot negotiate at your size.
The usual levers make it worse. Exclusion pushes the cost onto employees and the message lands badly. Prior authorization slows everyone down without changing unit cost. Copay increases quietly turn coverage into non coverage.
The structural fix is to take the category out of the plan and run it directly, with pricing you set in a contract instead of pricing that happens to you.
What the program changes for you
A cost you can state
One fixed monthly price per member, the same at every dose. No spread, no markup, no service fee. Your finance team can put a number in the budget and watch it hold.
Liability that sits elsewhere
Every prescription runs through a licensed clinician who evaluates, monitors, and manages dosing. You are not making medical decisions and you are not sourcing medication. You are offering a program that does both under a documented standard.
Implementation that fits a small team
Carve out language for your carrier, enrollment materials for your people, and a launch handled by us in 45 to 60 days. Built for an HR team of one or two, because that is who we serve. No open enrollment dependency.
How the carve out works in practice
- The carve out
- Weight management GLP-1s come off your carrier's pharmacy formulary. Your medical plan and the rest of your pharmacy benefit stay exactly where they are.
- The program
- An employer directed benefit with one fixed monthly price per member and documented U.S. pharmacy sourcing takes over the category. You decide eligibility rules and contribution design.
- The clinical layer
- A licensed clinician evaluates each employee before any prescription and stays with them through therapy. Monitoring and dose management are in the base program, not priced as extras.
- The employee experience
- Low or zero cost at the point of sale, set by your plan design. No claims maze, no surprise bills, and a clinician who answers when something changes.
- The term
- Twelve month initial term with no early termination penalty. If the program does not perform, leaving is straightforward and continuity of care for members mid therapy is part of the offboarding.
The three things every CFO asks
What medication do members get?
Compounded semaglutide or tirzepatide, prescribed by licensed U.S. clinicians and prepared for each member by state-licensed U.S. 503A pharmacies with documented sourcing. Compounded medications are not FDA-approved.
What is my exposure?
The clinical program carries the clinical accountability, under contract, with the indemnification language in writing. Your exposure is a benefit decision, the kind you already make every year.
What does it cost?
A fixed monthly price per member you see before you sign, with no service fee on top. Bring your current pharmacy report to the demo and we will put the two numbers side by side, yours and ours, in the first meeting.
Three ways to handle GLP-1s.
Only one is built for it.
Drop coverage
- Your cost
- Lower on paper. Shows up in turnover and morale.
- Employee access
- Gone. People pay retail or stop.
Leave it in the plan
- Your cost
- A price you can’t see or negotiate.
- Employee access
- Until prior auth and copays quietly end it.
Run it through 
- Your cost
- One fixed monthly price per member. No spread, no markup, no service fee.
- Employee access
- Low or zero cost, set by the coverage you choose.
One price per member.
You decide who pays what.
Inside a carrier pharmacy benefit you pay a price you can’t see, shaped by flows you can’t audit. Here one monthly price per member is quoted for your company, there is no service fee, and you set the contribution. That’s the whole model.
Fully covered
- Strongest recruiting and retention story
- Employees start with nothing out of pocket
- Pay only for members who enroll
Shared cost
- Predictable budget per enrolled member
- Members keep skin in the game
- Change the split at renewal
Access only
- Add a benefit with no spend
- Provider-led care and a care team for every member
- Easy first step before covering more
SemaglutideCompounded in the U.S.
TirzepatideCompounded in the U.S.See the member store Prescribed only when a licensed clinician decides it is appropriate. Compounded medications are not FDA-approved.
See the program before your renewal does the deciding.
Thirty minutes, your broker welcome in the room. Bring your current pharmacy numbers and we’ll show you exactly where the program fits.
- Pricing structure in writing, before you sign
- Clinical protocol summary and sourcing documentation
- Contract terms, including the exit
