The takeover comes as sales of BMS's blood cancer drug Revlimid, its 3rd-largest revenue driver, withered in the face of generic rivals and its blockbuster Opdivo is also scheduled to face competition from generics later this decade.

"Family-building benefits are here to stay. I expect a continued increase in the number of employers offering these benefits," says Shelly MacConnell.

Small business owners now have a range of options depending on the number of employees, but it's essential to start early, leverage tax-advantaged retirement accounts, diversify investments and plan for an exit strategy.

Using Blue Shield of California as a precedent, more health entities may scale back their reliance on their PBMs in favor of centers of excellence that provide specific services. But this new approach to pharmacy benefits needs an organized and connected way for information to be shared.