Employer Group Waiver Plan Prescription Drug Plans: Consistency, Compliance, Confidence

Since their inception, Employer Group Waiver Plan Prescription Drug Plans (EGWP PDPs) have been a valuable tool for brokers with retiree clients, thanks in large part to their enhanced flexibility, rich benefit design options, and a seamless continuation of coverage for beneficiaries.  

Today, with nearly 4.9 million retirees enrolled and an addressable market valued at $20 billion, EGWP PDPs are thriving in a shifting market – continuing to prove their strategic value for brokers and their retiree clients.  

A Growing Market  

EGWP PDPs have become a favorable solution for brokers serving retiree clients, largely due to their ability to deliver continuous coverage, support customized plan designs, and unlock substantial savings through federal subsidies and rebates. As illustrated in the 2025 chart below, EGWP PDP adoption continues to rise, underscoring both demand and confidence in this model.*KFF analysis of Centers for Medicare & Medicaid Services 2006-2024 Part D enrollment data.

Interestingly, as EGWP PDPs have carved out their niche, the market has seen many PBMs exit the space. Reasons may include a lack of resources, competing priorities, or an inability to meet rigorous compliance and performance expectations. PBDRx: An Industry Leader  

In contrast, Pharmacy Benefit Dimensions (PBDRx) has not only remained committed to administering a high-quality EGWP PDP – we’ve elevated the standard. As a recipient of the CMS 5-Star Rating, PBDRx’s strategy is focused on delivering industry-leading access and affordability, strategic oversight, and beneficiary satisfaction.

• Built on Experience – Over a decade of proven performance in the EGWP PDP market
• Driven by Data – Leverages clinical data to inform smart plan design and comprehensive chronic condition management
• Administered with Excellence – Delivers seamless implementation, consistent compliance, and reliable support  

EGWP PDP: Strategic Advantages  

Brokers that partner with an experienced EGWP PDP administrator such as PBDRx gain a level of control and customization that is rarely available in alternative retiree benefits such as a Retiree Drug Subsidy (RDS) or Medicare Advantage Prescription Drug (MA-PD) program. To build a solution that’s aligned with your clients’ clinical and financial goals, EGWP PDPs offer:

• Plan Flexibility – Maintain uniformity in plan design OR implement customized formulary enhancements
• Improved Direct Savings – Federal subsidies, rebates, and reimbursements offer significant cost reductions  
• Operational Ease – EGWP PDP administrators work directly with CMS on their clients’ behalf, drastically reducing administrative burden
• Reliable Performance Metrics – CMS Star Ratings and audit scores provide a clear evaluation of plan effectiveness and quality

At PBDRx, our deep expertise in EGWP PDPs can help elevate your strategy and provide a strategic differentiator in the retiree benefit space. As a trusted and proven PBM partner, brokers can feel confident in PBDRx’s ability to deliver a clear, reliable path to long-term success in the retiree benefit market.