How Do Rebates Work and Who Receives Them?

Self Fund Health partners with CapitalRx as our Pharmacy Benefit Manager (PBM). Unlike traditional PBMs—where rebates are often hidden, delayed, or retained—CapitalRx provides full transparency into rebate dollars.

What rebates are

Rebates are payments that drug manufacturers make after certain brand-name drugs are dispensed. They function as a kind of back-end discount to reduce overall plan costs.

How it works with CapitalRx and Self Fund Health

1. When a brand drug is filled, CapitalRx collects any applicable manufacturer rebate.
2. Rebates are sent from CapitalRx to Self Fund Health on a fixed schedule: six months after the end of each quarter.
3. Once received, rebates are deposited directly into the employer’s Claims Fund within the Yuzu system.

Who receives the rebates

Rebates flow Manufacturer → CapitalRx → Self Fund Health → Employer.

They are never retained by CapitalRx or Self Fund Health. While members don’t see rebates at the pharmacy counter, these funds support $0 care options and help lower overall plan costs.

Key takeaway

All rebates flow transparently back to the employer’s health plan through the claims fund. The process is predictable, fully auditable, and aligned with employer interests.