Selling Your FBO Starts With Preparation
Selling an aviation business rarely begins with simply finding a buyer. The outcome is usually shaped long before the first buyer conversation—through valuation, documentation, and a disciplined process that positions the business correctly in the aviation market.
FBOsForSale works with aviation business owners nationwide who are considering how to sell my FBO through a confidential transaction process designed to attract qualified buyers and maintain leverage throughout negotiations.
innovate. Educate. Elevate
Your PBM Report Shows You Totals. It Was Designed Not to Show You Margins.
Fiduciary Focused
Your Interest. Our Priority.
Transparent Economics
Clarity in costs. Confidence in decisions
Vendor Accountability
Aligned incentives.
Stronger outcomes.
Data-Driven Strategy
Smarter insights. Better results.
MEasurable Results
Proven impact. Sustainable savings
A Better Way Forward
Legacy insurance companies, legacy brokerages, and their vendor ecosystems were built for a different era - with different incentives. FiduciaHealth™ was built for today and tomorrow. We empower employers with the governance, transparency, and strategy needed to control costs, eliminate waste, and improve healthcare outcomes - without compromising employee benefits.
20-40%
Typical Total Cost Savings Identified
20-40%
Typical Total Cost Savings Identified
20-40%
Typical Total Cost Savings Identified
Fiduciary Oversight. Transparent Solutions. Measurable Results.
Pharmacy costs are rising faster than medical costs at most employer plans — and the standard PBM reporting your carrier provides is structured to keep the reason invisible.
Three Mechanisms Your PBM Uses to Extract Value Without Disclosure
PBMs generate income from employer health plans through arrangements that do not appear in standard cost reporting. Three are responsible for the majority of unreported value capture:
Spread pricing — the PBM charges the plan more than it pays the pharmacy and retains the difference on every prescription fill. The spread is not a fee. It does not appear as a line item. It is embedded in the transaction and visible only through an independent audit or federal disclosure request.
Manufacturer rebate retention — PBMs negotiate rebates with drug manufacturers based on formulary placement. Those rebates are generated in the plan's name and funded indirectly by the plan's drug spend. Whether they reach the plan or remain with the PBM depends entirely on contract language most employers have never reviewed.
Administrative fee layering — fees embedded in network contracts between the PBM and pharmacy providers that are not disclosed in standard reporting and do not appear on the employer's invoice.
Together, these three mechanisms can represent a significant and quantifiable portion of pharmacy spend that a pass-through pricing structure would return to the plan.
Federal Law Now Requires the Disclosure. Most Employers Don't Know to Ask for It.
ERISA self-funded plan sponsors have legally enforceable rights under current federal law to semiannual disclosure of net drug spending, rebate retention arrangements, and spread pricing. These disclosure rights exist now. Most BUCA-affiliated PBMs are not volunteering the information, and most employers — including those with legal counsel — do not know the rights apply to their plan.
Scott's engagement facilitates the exercise of these disclosure rights as part of the PBM audit process. The
Cost Modeling Report quantifies what the disclosure reveals — translating the federal reporting requirement into a specific, employer-verified dollar figure for recoverable spread, retained rebates, and administrative fee capture.
Why the ACA's Medical Loss Ratio Works Against Pharmacy Cost Reduction
The ACA requires carriers to spend 80–85% of premiums on medical claims — a consumer protection measure designed to limit insurer profit margins. The unintended consequence for employer plans is structural: higher claims increase the dollar amount the carrier is permitted to retain as administrative profit. A carrier whose revenue is indexed to claim volume has no financial incentive to reduce it.
This incentive structure extends directly to vertically integrated PBM arrangements. A carrier that owns or contracts exclusively with a PBM benefits financially from higher drug utilization — which means the entity responsible for managing your pharmacy costs is also the entity that profits when they rise.
Independent PBM selection, arranged outside the carrier's integrated network, removes this conflict at the source.
What PBM Reform Actually Produces — Without Cutting Employee Benefits
A 30% reduction in pharmacy costs is achievable through PBM restructuring without changing what employees can fill, restricting formulary access, or increasing member cost-sharing. The mechanism is not benefit reduction. It is contract reform:
- Pass-through pricing replaces spread pricing — the plan pays the pharmacy's actual cost, and the PBM is compensated transparently
- Rebate pass-through credits 100% of manufacturer rebates to the plan rather than retaining them at the PBM level
- Competitive bidding in the open PBM market replaces carrier-controlled sole-source arrangements
- Independent audit rights give the employer ongoing visibility into pharmacy economics rather than relying on PBM-generated reporting
PBM carve-out — separating pharmacy from the carrier's integrated plan arrangement — is available to any employer operating a true
self-funded plan under
ERISA. Carrier-integrated PBM contracts can be renegotiated or replaced at plan year end with proper transition planning.
Frequently Asked Questions
How do I audit my pharmacy benefit manager for our employer health plan?
The audit begins with exercising your federal ERISA disclosure rights — requesting semiannual disclosure of net drug spending, spread pricing arrangements, and rebate retention. Scott's engagement facilitates that request and translates the disclosure into a specific dollar figure for recoverable spend. The Cost Modeling Report is the structured entry point to that analysis.
What is PBM spread pricing and how does it cost employers?
Spread pricing is the margin between what the PBM charges the plan and what it pays the pharmacy on each prescription fill. The PBM retains the difference. It does not appear as a fee in standard reporting and is not disclosed unless the employer specifically requests it under federal ERISA disclosure rules. Independent audits routinely find spread pricing represents a material percentage of total pharmacy spend.
Can we reduce pharmacy costs without restricting what our employees can fill?
Yes. PBM cost reduction through contract reform — pass-through pricing, rebate pass-through, and open-market carrier selection — targets the margin the PBM retains, not the benefit the employee receives. Scott has identified 30% pharmacy cost reductions through restructuring without formulary restrictions or employee cost-shifting.
What are our audit rights as an ERISA self-funded plan sponsor?
Federal law gives ERISA self-funded plan sponsors the right to semiannual disclosure of net drug spending, rebate retention, and spread pricing arrangements from their PBM. These rights are legally enforceable. Exercising them requires knowing they exist — and, in most cases, an advisor who facilitates the formal request process.
How do we carve out pharmacy from our carrier's integrated plan?
PBM carve-out separates the pharmacy benefit from the carrier's integrated arrangement, allowing the employer to contract with an independent PBM directly. It is available to any employer on a true self-funded ERISA plan and is executed at plan year end with proper transition management. Scott structures the carve-out, selects the replacement PBM through open-market bidding, and manages the transition without disrupting employee access.
