Network Update
| Riverside Health System - Coventry Health Care is pleased to announce that facilities in the Riverside Health System will begin participating in our provider network:
- Riverside Tappahannock Hospital, Essex County - Contract effective August 1, 2011 for all product lines
- Riverside Shore Memorial Hospital, Eastern Shore - Contract effective August 1, 2011 for all product lines
- Riverside Regional Hospital, Newport News - Contract effective August 1, 2011 for PPO products (The HMO contract will be effective on January 1, 2012.)
- Riverside Walter Reed Hospital, Gloucester - Contract effective August 1, 2011 for PPO products (The HMO contract will be effective on January 1, 2012.)
Advanced Orthopaedic Centers - Coventry Health Care is welcoming this full-service orthopaedic practice with offices in Richmond and Midlothian back into the provider network effective September 1, 2011.
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Changes to the Standard Product Portfolio
| Effective October 1, 2011 we have made the following changes to all standard HMO, POS, and PPO products:
- Early Intervention Services - no $5,000 per benefit year maximum
- Behavioral Health/Substance Abuse - copayments now match the PCP copayment
In addition to the above-referenced benefit changes, we have made the following changes to the POS product portfolio:
- Out-of-Pocket Maximum - separate in- and out-of-network out-of-pocket maximums
- New Plan Selections - Qualified High Deductible Health Plans and Consumer Driven Health Plans on the POS platform. Call your Account Representative for details.
For more information on these product changes, please visit the Schedule of Benefits section of the Broker Tool Kit. Updates will be posted as they become available. |
Proposed Merger Between Medco and Express Scripts
| On July 21, Express Scripts announced its intention to purchase Medco Health Solutions, the pharmacy benefits administrator with whom we contract to provide a retail and mail order pharmacy network for our members. The proposed merger remains subject to regulatory approval by the Federal Trade Commission (FTC) and shareholder approval. Although we will be watching the progress of this merger closely, it is important to note that although Medco provides the pharmacy network and processes claims, Coventry Health Care, Inc. manages the Prescription Drug List and establishes all of the medical management policies surrounding it. Therefore, even if the FTC approves the merger, members will not experience changes related to benefit designs or preauthorization criteria. We will keep you informed as further information becomes available.
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Safe Senders
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If you are not receiving emails notifying you that a new commission statement is available, please check to make sure that the following address is in your "safe senders" list. You may also use this address to send questions about your commissions.
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| | Coventry Health Care and Southern Health are registered trade names of Southern Health Services, Inc., a Virginia HMO. PPO products are underwritten by Coventry Health and Life Insurance Company and administered by Southern Health Services, Inc. in Virginia. |
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Charlottesville Office:
434.951.2500
Richmond Office:
804.747.3700
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