Private Insurance

ACA complaint filed with West Virginia Insurance Commissioner on Highmark Marketplace Plans

We are writing to submit a formal complaint regarding plans offered on the West Virginia Marketplace by Highmark Blue Cross Blue Shield West Virginia.  Our formulary review has found that Highmark plans offered in the 2026 plan year appear to violate federal Essential Health Benefits (EHB), discrimination, and preventive health coverage requirements in the following ways: (1) use of a copay maximizer; (2) adverse tiering; and (3) non-compliant coverage of preventive health, specifically of HIV pre-exposure prophylaxis (PrEP).

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ACA complaint filed with Delaware Insurance Commissioner on Highmark Marketplace Plans

We are writing to submit a formal complaint regarding plans offered on the Delaware Marketplace by Highmark Blue Cross Blue Shield Delaware.  Our formulary review has found that Highmark plans offered in the 2026 plan year appear to violate federal Essential Health Benefits (EHB), discrimination, and preventive health coverage requirements in the following ways: (1) use of a copay maximizer; (2) adverse tiering; and (3) non-compliant coverage of preventive health, specifically of HIV pre-exposure prophylaxis (PrEP).

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Letter to the Dept. of Labor on improving transparency into pharmacy benefit manager fee disclosure

We strongly support the Department of Labor’s proposed rule to increase transparency in pharmacy benefit manager (PBM) compensation and financial arrangements. Greater transparency is essential to improving accountability across the prescription drug supply chain and ensuring that plan fiduciaries have the information necessary to assess the reasonableness of PBM contracts and practices. We urge the Department to finalize and implement this rule without delay, with the recommendations outlined in this letter.

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