January 2010
ODS news
Squares accent
 
Greetings!

Welcome to the ODS eNewsletter!

As we begin a new year at ODS we also begin a new tradition. For the first time we will be sending a regular eNewsletter to our group administrators in order to more efficiently communicate regarding our insurance plans, services and other pieces of important health information. We are aware that receiving multiple e-mails and announcements can be overwhelming and cumbersome, and we hope this eNewsletter will effectively channel all of that communication into one source.

Your feedback about this and future eNewsletters is welcome and appreciated; please send any feedback to your marketing representative.

Preferred Drug List 2010
 
There have been some changes to the ODS Preferred Drug Program for the 2010 benefit year. This list is developed and maintained by the Pharmacy and Therapeutics Committee, which is made up of physicians and pharmacists. The committee makes decisions based on information about each medication's safety, effectiveness and associated clinical outcomes.
 
The ODS Preferred Drug Program works differently than a typical drug formulary. Many drug formularies require participants to use the generic or low-cost brand drugs listed on their formulary and will not pay for any high-cost drugs that are not on the list. The ODS Preferred Drug Program offers more flexibility. Members can choose non-preferred, higher-cost drugs if they desire and still have a portion of the costs paid by their health plan administered by ODS. Members can choose between generic and value brand (Tier 1), preferred brands (Tier 2) or non-preferred brands (Tier 3) - each with a different copayment amount. The copayments will vary depending on which medications are selected.
 
Preferred Drug Program - Summary of 2010 Changes
 1. Medications Added to Tier 1
 Generic Market Additions                     Brand Equivalent
  • Ketorolac drops                                (Acular)
  • Amphetamine Mixture                       (Adderall XR)
  • Fexofenadine/Pseudoephedrine         (Allegra-D 12 Hour)
  • Brimonidine drops                            (Alphagan P)
  • Clonidine patch                                (Catapres-TTS)
  • Mycophenolate                                (Cellcept)
  • Sumatriptan                                     (Imitrex)
  • Lamotrigine                                      (Lamictal)
  • Lansoprazole                                   (Prevacid)
  • Tacrolimus                                       (Prograf)
  • Risperidone                                      (Risperdal)
  • Nateglinide                                       (Starlix)
  • Topiramate                                       (Topamax)
  • Levalbuterol  solution                         (Xolair)
Value Brand Additions
 
  • Humulin R                               (Insulin Regular)
  • Humulin N                               (Insulin Isophane)
  • Humulin 70/30                         (Insulin Mix)
  • Novolin R                                (Insulin Regular)
  • Novolin N                                (Insulin Isophane)
  • Novolin 70/30                          (Insulin Mix)
     
 2. Medications Added to Preferred Tier 2
  • Multaq                                   (drondarone)
  • Savella                                   (milnacipran)
 3. Medications Added to Non-Preferred Tier 3
  • Accolate                                (zafirlukast)
  • Astepro                                 (azelastine)
  • Byetta                                   (exenatide)
  • Diovan                                   (valsartan)
  • Diovan HCT                            (valsartan / hydrochlorothiazide)
  • Exforge                                  (amlodipine / valsartan)
  • Exforge HCT                          (amlodipine / valsartan / hydrochlorothiazide)
  • Kapidex                                 (dexlansoprazole)
  • Nucynta                                 (tapentadol)
  • Proventil HFA                         (albuterol)
  • Simcor                                   (simvastatin / niacin)
  • Skelaxin                                 (metaxalone)
  • Symlin                                   (pramlintide)
  • Tekturna                                (aliskiren)
  • Tekturna HCT                         (aliskiren / hydrochlorothiazide)
  • Valturna                                 (aliskiren / valsartan)
  • Vytorin                                   (ezetimibe / simvastatin)
  • Xopenex HFA                         (albuterol)
      
A similar notification was sent to members, with a history of prescription treatment(s) that fall within the changes listed above. We encourage participants to use the 2010 Preferred Drug List to discuss alternative therapies with their provider. If members have questions about the Preferred Drug Program or their pharmacy benefit, they will be asked to contact ODS Pharmacy Customer Service through our website, www.odscompanies.com, or by calling 503-243-3960 or 888-361-1610. 
You can see a copy of the 2010 Preferred Drug List by logging into myODS or through the link provided below.
2010 Preferred Drug List  
 
If you have questions regarding this notice, please contact your ODS Marketing Representative at 503-243-3948 or 800-578-1402. 
 
Continuation subsidy extended
 

The American Recovery and Reinvestment Act of 2009 (ARRA) was recently amended by the Department of Defense Appropriations Act, 2010 (2010 DOD Act), extending both the eligibility period and the duration of the COBRA premium subsidy. The Oregon Insurance Division responded by filing emergency rules to ensure that Oregonians working for employers with 19 or fewer employees would be able to take full advantage of the subsidy under the Oregon continuation.

Eligibility Extension Period

Both the 2010 DOD Act and the emergency rules extend the eligibility period for the subsidy, which originally ended on December 31, 2009, by two months; meaning individuals who have been involuntarily terminated on or before February 28, 2010 may now be eligible for the subsidy.

Subsidy Extension

The 2010 DOD Act also extend the duration of the subsidy from nine months to 15 months, and the emergency rules have extended Oregon continuation for those qualifying for the subsidy to 15 months in order to maximize the benefit to Oregonians under ARRA.

Additional Notices

Under the 2010 DOD Act, employers subject to COBRA are required to send additional notices to impacted individuals regarding the extension by February 17, 2010. Individuals who are eligible for the subsidy and extension under Oregon continuation will be notified by ODS.

For more information, please see our Frequently Asked Questions at on COBRA and General Oregon Continuation Premium Reductions.

2009 Oregon Mandated Changes

Bill

Title

Description of benefits

SB 24

Telemedicine

Requires that a benefit be provided for a covered telemedical health service at the same level as a comparable health service provided in person

SB 316

Clinical trials

Requires that coverage be expanded to include the routine costs of care for patients enrolled in and participating in qualified clinical trials

SB 381

Traumatic brain injury

Requires coverage of medically necessary therapy and services for the treatment of traumatic brain injury

SB 734

Tobacco cessation programs

Requires coverage for tobacco cessation programs up to $500 per lifetime for members age 15 or older. Benefits can be subject to applicable deductible and coinsurance of the plan

HB 2589

Hearing aids

Requires coverage for one hearing aid per hearing impaired ear for children under age 18, and for those aged 18 and older who attend an accredited school (ODS standard is to cover hearing aids for all eligible dependent children). Coverage will have a benefit maximum of $4,000 in a 48-month period. Benefits can be subject to applicable deductible and coinsurance of the plan as a medical supply

The benefit amount will be adjusted on Jan. 1 of each year to reflect an increase in the U.S. City Average Consumer Price Index for All Urban Consumers for medical care as published by the Bureau of Labor Statistics of the United Sates Department of Labor

HB 2794

HPA coverage

Requires coverage for the human papillomavirus vaccine for female members who are at least 11 but no older than 26

Issue: 1
In This Issue
Preferred Drug List 2010
Continuation subsidy extended
Increased benefits and convenience
myODS: New Year's Resolutions

Increased benefits and convenience 

 

At ODS, we're proud to partner with your employees in managing their health. Key to our commitment is all that we're doing to help members get and stay healthy through their personalized health website, myODS.

Soon, when members create a new myODS account or sign on to their existing account, they will be prompted to provide us with their best e-mail address. That's because we're now embracing e-mail as the main form of communicating with our members. It's faster, safer, leaner and greener.

All members' e-mail addresses will be kept confidential and only used to inform and educate members about matters relating to their health, online tools and benefits.

If you have any questions about myODS, please contact your Marketing representative.

myODS can help members keep New Year's Resolutions 

With myODS, members have access to eDocAmerica plus tons of other health tools to help them keep their New Year's Resolutions. 
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