100% pass-through of manufacturer revenue

has agreed in contracts to pass through 100% of all monies received or earned through the utilization of Travis County and its health plan members.

Recorded reference: Page 2

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Published rationale. The agenda request states that Envision has agreed to pass through 100 percent of all monies received or earned from county utilization, and the table on page 11 shows retail and mail order rebates as 100 percent pass through with stated minimums of $17.35 per Brand Rx and $66.60 per Brand Rx. That is a broad promise on its face, but the backup gives no definition of the money covered, no payment schedule, no closed list of excluded claims and no audit right to verify the amount. Because the operative contract is not in this packet, the promise cannot be read as the enforceable clause the model contract published by Mark Cuban and collaborators requires.

agreed in contracts to pass through 100% of all monies received or earned through the utilization of Travis County and its health plan members.

Recorded reference: Page 10

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Published rationale. The agenda backup states the PBM passes through 100% of all monies received, which is a strong standard. It earns a partial score because the executed agreement is missing, making it impossible to verify quarterly payment timing and the absence of excludable claims.

Envision’s business model is focused on delivering full transparency of pharmacy costs and has agreed in contracts to pass through 100% of all monies received or earned through the utilization of Travis County and its health plan members.

Recorded reference: Page 2

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Published rationale. The backup states a broad 100 percent pass-through and the page 11 pricing table also labels retail and mail rebates as 100 percent pass-through. Page 17 adds that rebates can be received at the point of sale. The packet does not define all manufacturer revenue, provide a closed exclusion list, or state a quarterly remittance deadline, and the executed agreement is not included.

Envision will put in writing that they will only accept their per employee/per month fee and not accept any other monies associated with the prescription drug spend of Travis County.

Recorded reference: Page 17

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Published rationale. HRMD on page 10 says Envision has agreed in contracts to pass through 100% of all monies received or earned through Travis County utilization, and Gallagher on page 17 says Envision will put in writing that it will accept only its PEPM fee. Page 11 labels retail and mail rebate management as 100% Pass-Through and states brand rebate minimums of $17.35 and $66.60. That is weaker than the model because this is agenda backup rather than the executed agreement, payment timing and a closed exclusion list are not stated, and additional fees are said to live in the unattached Contract.

Retail Rebate Minimum $17.35 per Brand Rx

Recorded reference: Page 11

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Published rationale. The backup states on page 10 that Envision agreed to pass through 100% of all monies received or earned through the utilization of the County and its members, and page 11 shows 100% pass-through on both retail and mail rebates with per-brand-claim minimums of $17.35 retail and $66.60 mail, which is stronger than a bare promise. The confidence is capped because the exclusions, definitions and payment timing would live in the executed agreement, which the backup does not contain.