Benefit Configuration Technology
Your Plan, Your Way
At PDMI, the high level of support we provide our clients is the backbone of our operation.
Our technology – backed by our years of experience – gives clients the flexibility to configure and implement their plan and program. Driven and directed by the client’s business rules and directives, PDMI’s system can help our clients to achieve their specific goals regarding:
- Indemnity
- Health Maintenance Organizations (HMO)
- Preferred Provider Organizations (PPO)
- Self-insured Benefit Plan Models
Additionally, we can work with our clients to customize reports and processes to help them better analyze:
Our technology offers flexible customization for each client's plan and rules, ensuring a unique and tailored program. PDMI's flexible system and advanced technology are designed to handle a wide range of client copay requirements, such as:
- Copays based on the greater of a dollar amount or percentage of cost basis – PDMI’s system has the ability to apply fixed dollar amount minimum or maximum copays. For example, if the percentage copay is greater than the maximum amount, the maximum amount will apply. If the percentage copay is less than the minimum amount, the percentage copay will apply.
- Brand vs. generic copays by dollar differential – PDMI’s system can differentiate brand vs. generic copays by dollar amount. It also has the ability to charge "plus the difference" on products, which is calculated only if the brand has a generic available and there is a MAC price on the generic drug.
- Individual and family deductibles – PDMI’s system can track deductibles three ways: individually, at the family level and in combination. We can also maintain different deductible periods (e.g., yearly, quarterly).
- Individual and family maximums – PDMI’s system can track maximums three ways: individually, at the family level and in combination. We can also maintain different maximum periods (e.g., yearly, quarterly)