pharmacy benefit manager (PBM)

Company under contract with managed care organizations, self-insured companies, and government programs to manage pharmacy network management, drug utilization review, outcomes management, and disease management. The goal is to save money. For example, a pharmacy benefit manager may fill drug prescriptions by mail order as part of a corporate health insurance plan. Also called a pharmacy benefit management organization or prescription benefit manager (PBM).

Pharmacy claim

Formal request for payment (bill) generated because of an insured’s purchase of prescription drugs dispensed by a pharmacist from a physician’s written instructions (prescription form).

Phased retirement

Pension option allowing the member to ‘phase in’ retirement by drawing segments from his fund at intervals. Each withdrawal funds an annuity and a tax free lump sum and builds up the pension payments. The main constraint is the age 75 rule. This option, also called ‘staggered vesting phased retirement, should be compared with income drawdown.