PayerIQ
Production
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Tier 2LACommercial

Superior HealthPlan

Active pursuit — access summits + value dossier

Composite
58.3
Rank
#149
Members
2.4M
Scoring profile

Six-criterion radar

Breakdown

Weighted score contribution

Claims
25%
57
+14.3
Lives
20%
66
+13.2
Geography
20%
71
+14.2
Restrictions
15%
57
+8.5
Relationship
10%
42
+4.2
Financials
10%
39
+3.9
Composite Score58.3
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 14.3 + 13.2 + 14.2 + 8.5 + 4.2 + 3.9 = 58.3
Intelligence

Qualitative intelligence

Members
2.4M
Drug spend
$0.6B
Formulary
3-tier
PA / RA level
Low
Biosimilar policy
Case-by-case review
Avg reimbursement
74 days
Strategic notes

Geographic advantage in target region; growing Medicare Advantage enrollment

Peer set

Closest peers in Commercial

PreferredOne
RI · Tier 3
58.0
-0.3
Sutter Health Plus
OH · Tier 3
57.2
-1.1
Excellus BlueCross BlueShield
MS · Tier 3
56.0
-2.3
Sunshine Health MCO
NH · Tier 2
61.2
+2.9
ConnectiCare
DE · Tier 3
54.7
-3.6
Playbook · Tier 2

Engagement timeline

Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review