The employers paying one company for both
295 self-funded health plans buy their pharmacy benefits and their medical administration from the same conglomerate. The plans cover 3.29 million employees. Their federal filings disclose $620 million in PBM compensation. Every row below links to the filing behind it.
"The greatest trick the insurance companies ever played was putting the PBMs out there to take all the hits and pushing people to ignore everything else that they're doing."
Mark Cuban, Healthcare Brew, April 2026
Where the 3.29 million sit
Four parents account for every same-parent plan. Employees covered, plan year 2023:
Walmart alone is 1.64 million of UnitedHealth's 1.95 million: Optum Rx for pharmacy, UMR (a UnitedHealth company) for medical administration. A further 21 plans covering 151,444 employees pair Prime Therapeutics with a Blue Cross carrier; Prime is owned by Blue Cross plans, so they are counted separately, not as same-parent.
Why it matters
When one parent sells an employer its medical administration and its pharmacy benefits, the company negotiating drug prices answers to the company that profits from them. The Break Up Big Medicine Act, which Mark Cuban publicly backs, would force insurers to divest exactly these assets. The three companies the bill targets, UnitedHealth Group, CVS Health, and Cigna, are the top three parents in this table.
The larger finding is the opacity. Of 47,796 self-funded plans that filed for plan year 2023, only 987 name both a PBM and a medical carrier clearly enough to classify: 295 same-parent, 671 split, 21 Blues-affiliated. The other 46,809 filings do not say who manages their drug benefit, what they pay, or both. Transparency is the exception.
The 295 plans
Search by employer, PBM, carrier, state, or metro. Click a column to sort. "Same-parent carrier" is the medical carrier or administrator that shares a parent with the plan's PBM; large plans often name several regional carriers, and the others sit behind the "+ others" note. "PDF" opens the signed Form 5500 filing on the Department of Labor's public server.
| Employer | Employees | PBM | Same-parent carrier | Parent | Disclosed PBM comp | Filing |
|---|
Download CSV Download JSON 295 rows, one per plan.
Method
Source: Form 5500 annual filings from the Department of Labor's EFAST2 system, plan year 2023, all industries. Schedule C names each plan's paid service providers and their compensation. Schedule A names insurance contracts. Self-funded plans buy administrative services rather than insurance, so their medical administrator appears on Schedule C.
A plan counts as same-parent when its PBM and its medical carrier or administrator belong to one company: Optum Rx with UnitedHealthcare or UMR under UnitedHealth Group; Caremark with Aetna under CVS Health; Express Scripts with Cigna; CarelonRx with Anthem under Elevance. Prime Therapeutics is owned by a group of Blue Cross plans, so Prime beside a Blues carrier counts as blues-affiliated and is excluded from the 295.
Caveats. Compensation is the direct compensation disclosed on Schedule C. It is fees paid to the PBM, not drug spend. 15 filings report negative amounts (adjustments or clawbacks) and appear here as filed. Employee counts are active participants on the Form 5500. Large plans often use several carriers and administrators at once; a plan counts as same-parent when at least one of them shares a parent with the PBM. Plans below 100 participants generally do not file, so the true overlap is larger than 295.