Source: Business Wire, 11/25/2025
Leveraging Capital Rx’s spread-free, full pass-through pharmacy benefit model, Capital Equilibrium is bringing Rx cost savings and renewal stability to the self-funded municipality and commercial markets
NEW YORK — Capital Rx, Judi Health’s transparent pharmacy benefit management (PBM) line of business, is powering a new level-funded product, Capital Equilibrium. Unlike legacy level-funded products, Capital Equilibrium leverages Capital Rx’s full pass-through model, clinical programs, and contact center for member care – all powered by modern enterprise health technology (Judi®) – to offer clients a combination of cost savings, flexibility, and budgeting security.
“What I love about this new option for pharmacy benefits is that it’s powered by Capital Rx’s transparency and gives municipalities and employers an opportunity to shop for a better deal – one that works for their group.” – Mike Miele, FSA, MAAA.
“The skyrocketing health insurance premiums we’re seeing across the country are in no small part due to rising spend on the medicine people need,” said Justin Leader, President and Chief Executive Officer of BenefitsDNA, a Pennsylvania-based employee benefits advisory, brokerage and consulting firm. “This problem predates concerns about tax credits expiring. Municipalities and other entities with fixed budgets or an inability to assume the risk of extremely volatile benefits expenses have dealt with compounding costs for years. Now, New Jersey’s state benefit plans, for example, must worry about 30% – 60% rate increases for medical and pharmacy premiums, respectively?2 We’ve reached a breaking point.”
By partnering with an A-rated stop-loss carrier for reinsurance and Capital Rx for conflict-free pharmacy benefit administration, Capital Equilibrium can bend the curve for plan sponsors through its unique features across all 50 states and provide:
- A fixed monthly payment plan covering expected claims, administrative fees, and stop-loss, with these monthly amounts often below market rates
- Stop-loss insurance to back claims exceeding monthly amounts, offering cost control for claims covered by the policy
- A fair pricing structure that eliminates the traditional PBM gameplay around discounts and rebates, which often results in overstated, unachievable savings expectations
- Individualized client reporting
- The option to participate in a risk-sharing program to share in any gains or losses related to stop loss coverage
- An experience refund or rate credit after the end of the plan year if claims are better than expected
- 24/7/365, U.S.-based, multilingual, award-winning call center support to plan members
For more information about Capital Equilibrium, please visit: www.judi.health/solutions/level-funded-pharmacy-benefits
About Judi Health
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. Visit judi.health.
