Making Bigger "Shrimp" in a Sea of "Whales": Managing Employer and PBM Roles in Healthcare Notes 41 Ohio State Journal on Dispute Resolution 2026

About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline

41 Ohio St. J. on Disp. Resol. 301 (2026)
Making Bigger "Shrimp" in a Sea of "Whales": Managing Employer and PBM Roles in Healthcare

handle is hein.journals/ohjdpr41 and id is 301 raw text is:

MAKING RIGGER SHRIMP IN A SEA OF

WHALES:
MANAGING EMPLOYER AND PBM ROLES IN
HEALTHCARE

S. JENNIFER SHIN*

I. INTRODUCTION

II. UNDERSTANDING EMPLOYER-SPONSORED HEALTH INSURANCE
PLANS
A. Types ofEmployer-Sponsored Health Plans
B. Key Factors Influencing Employer Health Plan Choices

III. ENSURING FAIR ADMINISTRATION OF ESI PLANS
A. Understanding ERISA
B. The Impact of Healthcare Transparency Laws on ERISA Claims
1. FEDERAL DEVELOPMENTS IMPACTING HEALTHCARE
TRANSPARENCY
2. STATE DEVELOPMENTS IMPACTING HEALTHCARE
TRANSPARENCY
C. Wells Fargo and Johnson & Johnson as Case Examples

IV. CHALLENGES TO DECODING EMPLOYER-PBM NEGOTIATIONS
A. Role ofPBMs
B. Shopping for PBMs
C. Challenges with PBMs
1. LACK OF TRANSPARENCYAND DRUG PRICEMANIPULATION
2. CONFLICTS OF INTEREST

S. Jennifer Shin is a 2026 graduate of The Ohio State University Moritz College of
Law, where she served as Managing Editor of the Ohio State Journal on Dispute
Resolution. She earned her bachelor's degree in Psychology and Philosophy from the
University of Dayton. The author thanks her family, friends, and mentors for their support,
and the Journal's editors for their assistance with this Note.