Impacted: Prime's mid-market book of business

What you need to know

Prime Therapeutics' (Prime) dedicated operational teams are diligently preparing for the upcoming peak season and new plan year. Prime is requesting information from our clients to ensure we are ready on Jan. 1, 2026. The first deadline for ID card printing services is Nov. 3, 2025.  
 

Overview
As we prepare for the busiest time of year for our business, we are sharing the 2025 year-end deadlines in the chart below. Any benefit configuration and identification card (ID) requests received after these dates will be processed in the order in which they are received. 
  
Thank you for your support as we work together on this timeline. Our goal is to provide you and your members with a high-level of service. We appreciate your partnership and look forward to the new year.

Due date

 Category

Action item

Nov. 3

Prime ID card printing services*

ID card requirements and updates to existing cards are due. 

Nov. 21

Benefit configuration

Submit new benefits by this date to ensure new benefit plans are documented and approved on time. 

Nov. 21

Prime ID card printing services*

Client approval of new or updated ID card proofs are due. 

Dec. 1

Prime ID card printing services*

Eligibility production file is due. 

Dec. 1

Eligibility interfaces**

New eligibility interface test files are due. 

Dec. 5

Benefit configuration

All finalized requirements for benefit plan configuration revisions and new implementations must be received and approved by this date to ensure they are fully tested and in production by Jan. 1, 2026. 

Dec. 8

Benefit configuration 

Benefit configuration requests that are received and approved after Dec. 5, 2025, will have an autoload benefit option available; business requests will still be accepted after this date. This allows for a plan to go live with basic plan parameters, copays and accumulations. The complete benefit build will be completed on a first-come, first-served basis.  

Dec. 12

Group structure 

Finalized group structure must be received by this date. Group structure is required to successfully load eligibility. 

Dec. 15

Eligibility interfaces**

Production files are due for new eligibility interfaces and existing eligibility interfaces that require additional processing.

Additional processing includes, but is not limited to, files that require crosswalk analysis to retain existing Prime member claims, prior authorizations, and accumulation balances. 

Dec. 26

Eligibility interfaces**

Existing eligibility interface production files are due. 

*Prime ID card printing services include new ID card layouts and updates to existing ID card layouts, including changes to benefit values on combination (Rx + Medical) ID cards produced by Prime. 
**Eligibility interfaces with 3rd party ID card printing services when Prime is not printing ID card. 
 

Holiday hours
Please see below for our holiday operating hours. 

• Thanksgiving: Closed Thursday, Nov. 27 and Friday, Nov. 28, 2025  
• Christmas Eve, Christmas Day: Closed Wednesday, Dec. 24 and Thursday Dec. 25, 2025 
• New Year’s Day: Closed Thursday, Jan. 1, 2026 

As a reminder, members can reach our Prime customer service department 24/7 (including holidays) by calling the Rx number on their ID cards. Additionally, members can access their information by logging into the member portal or through the Prescription Hub mobile app. To download the app, search 'Prescription Hub' in the Apple App Store or Google Play Store.