What we measure.
| Vendor | Examples of what is measured |
|---|---|
| PBM | Pricing guarantees, rebates passed through, generic dispensing rate, data delivery |
| Administrator | Claims accuracy, turnaround time, call answer time, eligibility processing |
| Stop-loss | Reimbursement turnaround and accuracy |
| Navigation and advocacy | Response time, resolution rate, employee satisfaction |
| Specialty programs and direct contracts | Participation, outcomes reported, and the savings claimed against the data |
When a vendor falls short.
The contract decides what your plan can do. That is why service levels and guarantees are negotiated during procurement, not after a problem appears. When a standard is missed, Ethos documents it, collects what the contract provides, and brings the options to your committee.