Regulatory, operational, and vendor oversight support helping EGWP organizations stay compliant, implement plans effectively, and meet employer group expectations.
EGWPs require a unique balance of Medicare compliance, operational excellence, and employer group expectations. BluePeak helps EGWP sponsors, administrators, PBMs, and employer groups navigate regulatory requirements, strengthen vendor oversight, support new plan implementations, and address complex operational challenges with practical, real-world solutions tailored to the EGWP market.
BluePeak can provide a comprehensive approach to reviewing your current enrollment operations. Enrollment transaction codes require action and response which can be cumbersome to plans. We will review your enrollment processing including disenrollment, late enrollment penalty, low-income subsidy, and coordination of benefits for accuracy and timeliness.
PBM audits are an integral part of a plan’s overall risk assessment strategy and are essential in ensuring that financial and contractual terms are being administered as intended. BluePeak can perform comprehensive or targeted PBM audits for all lines of business, including Financial, Formulary Administration, Benefit Design, Rebate Administration, and Medicare Audit Review.
These aren’t just words—they’re the foundation of everything we do.
