PayerIQ
Sun, May 24, 2026
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Tier 2MEBCBS
Florida Blue
Active pursuit — access summits + value dossier
Composite
68.1
Rank
#48
Members
7.9M
Scoring profile
Six-criterion radar
Breakdown
Weighted score contribution
Claims
25%
68
+17.0
Lives
20%
100
+20.0
Geography
20%
74
+14.8
Restrictions
15%
12
+1.8
Relationship
10%
91
+9.1
Financials
10%
54
+5.4
Composite Score68.1
Composite = Claims×0.25 + Lives×0.20 + Geography×0.20 + Restrictions×0.15 + Relationship×0.10 + Financials×0.10
= 17.0 + 20.0 + 14.8 + 1.8 + 9.1 + 5.4 = 68.1
Intelligence
Qualitative intelligence
Members
7.9M
Drug spend
$2.9B
Formulary
3-tier
PA / RA level
Moderate
Biosimilar policy
Step therapy required
Avg reimbursement
26 days
Strategic notes
PBM-managed rebate structure; volume-based rebate negotiation is primary lever
Peer set
Closest peers in BCBS
Blue Cross Blue Shield of Massachusetts Insurance
GA · Tier 2
68.0
-0.1
Anthem Blue Cross Blue Shield of Colorado
AK · Tier 2
67.8
-0.3
Blue Cross Blue Shield of Rhode Island Health Plan
TN · Tier 2
67.7
-0.4
Hawaii Medical Service Association
SC · Tier 2
67.5
-0.5
CareFirst BlueCross BlueShield Managed Care
MA · Tier 2
68.7
+0.6
Playbook · Tier 2
Engagement timeline
Week 1
Senior medical director engagement
Week 3
Formulary review submission
Quarterly
Account QBR + utilization review