Welcome to Pequot Plus Health Benefit Services
Pequot Health Care (PHC) founded in 1991, which includes both the Pequot Plus Health Benefit Services and the Pequot Pharmaceutical Network® (PRxN®) began as a pharmacy service to treat Tribal members and employees of the Mashantucket Pequot Tribal Nation. PHC expanded our services to provide this same level of comprehensive health plan and prescription management to other self-funded Native American Tribal Nations and employer group insurers. This ability to assist in managing both the medical and pharmacy “spend” enables PHC to support clients in administering their health care expenditures.
Pequot Health Care is a wholly-owned business of the Mashantucket Pequot Tribal Nation, long recognized as a leader in managing health care plans for Native American Tribal Nations and other commercial enterprises. Members and employees of Tribal Nations located throughout the country, businesses (including the Foxwoods Resort Casino) and hospices participate in PHC managed health and prescription plans.
Pequot Health Care provides third-party claims administration (TPA) services to self-funded employer groups for medical, dental, vision and pharmacy services. Our efficient, accurate and friendly staff utilize state-of-the-art technology (computer systems, robotics, electronic services) with the highest level of customer service to provide your plan with the perfect combination of traits to administer your plan. PHC prides itself on exceptional metrics, claim and prescription processing turn-around times and superb customer service response protocols using our internal, on-site Account and Customer Service Representatives.
Pequot Health Care partners with national and regional provider networks that allow our clients access to the best care and service in your local area. Hospitals, physicians, behavioral health and ancillary networks are available to provide your medical needs, while PRxN® operates our own mail-service pharmacy and offers access to a nationwide network of over 65,000 retail chain and independent pharmacies to meet your members’ prescription needs.
Pequot Health Care works closely with each Plan to review utilization and case management. Medical and pharmacy utilization review under one roof allows plans to accurately manage your health care expenditures, while ensuring your membership is provided the appropriate quality of care and cost effectiveness to the plan.
Our plan designs are developed to maximize our contracting and buying power and the flexibility to meet your organizational goals and membership expectations, all with superb customer service and expeditious administration.