Definition

The list of prescription drugs a plan covers, organized by tier. Tier 1 = generics (lowest cost), Tier 2 = preferred brand, Tier 3 = non-preferred brand, Tier 4 = specialty. The formulary changes annually and impacts member out-of-pocket more than any other plan-design lever.

Related in plan design

SBC

A standardized plain-language summary of what a health plan covers and what it costs.

SPD

The detailed legal document that describes how a self-funded ERISA health plan operates — eligibility, contributions, claims procedures, appeals, fiduciary roles.

RFP

A document an employer (or their broker) sends to carriers asking for medical / dental / vision / ancillary plan quotes for a renewal cycle.

Deductible

The dollar amount a plan member pays out-of-pocket each year before the plan starts paying for covered services.

Velora speaks the broker domain natively.

SIC, enrolled lives, renewal month, current carrier — every term in this glossary corresponds to a field Velora's outbound engine actually uses for targeting, segmentation, and cadence selection.

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