Here is the latest edition of Model Consulting's Week in Review Newsletter. We
hope you find the Newsletter informative and helpful.
Your feedback is
extremely important to us. Please contact Tracy Duffield at 215.947.7167 or
tduffield@modelconsultinginc.com to share your ideas, comments
and/or suggestions. We look forward to hearing from you! |
Aetna: Specialty CareRx Drug List
Expanding Effective April 1, 2010
The 2010 Aetna Specialty CareRx drug list is
expanding to include more drugs as of April 1, 2010. Changes to this list will impact certain plan
sponsors and members that have Aetna Specialty CareRx under their managed
pharmacy benefit. (Most Spectrum plans and plans with a 4th tier Rx).
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Anthem:
Important Updates
Anthem has released updates on Anthem-Administered
COBRA Subsidy Extension, Healthy Lifestyle Toolkits, Retail Exception Drug List
for Refill by Mail, New Form 5500 Reports, and New FMLA Regulations.
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Capital
BlueCross: Express Scripts Mail Service
"Bill Me Later" Payment Option
With many
people managing tight household budgets, paying "up front" for a three-month
supply of prescription medication can be a challenge. Capital BlueCross members
who use the Express Scripts, Inc. (ESI) mail service pharmacy can choose to pay
for their prescription orders over time through an option called Bill
Me Later®.
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Capital
BlueCross: Introducing MyCare Advisor
With health
care costs continuing to rise and members taking on more of the financial
responsibilities associated with their health insurance, access to information
has become increasingly important to our members. That is why Capital BlueCross
will introduce MyCare Advisor in the second quarter of 2010.
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HealthAmerica: Holy Redeemer Health System
Attached you will
find an announcement regarding Holy
Redeemer Hospital.
HealthAmerica will be terminating our provider contract with them at the end of
February. A number of reasons lead to this difficult decision. The
commitment to provide acceptable access to our members will always be the
priority for HealthAmerica. Along with that commitment is to keep our
employer costs manageable. As a result of this we will no longer be able
to continue the relationship.
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Highmark Blue Shield: February Updates
Highmark
has released their "Updates" Newsletter for February. This edition includes articles on Highmark
Healthy Highlights, Medco Online Drugstore, COBRA Subsidy Extension, 90 Day Rx
at Retail Coming Soon, and Consumer Communication Toolkit.
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Horizon: Changes to New Jersey
Continuation and COBRA
Horizon
has announced information about changes to New Jersey Continuation and COBRA,
as it relates to the ARRA subsidy extension.
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Independence Blue Cross: ARRA Premium Subsidy
IBC
can no longer accept ARRA premium subsidy applications when there is only one
member remaining on the commercial policy. Groups of one do not meet
their underwriting guidelines even with the ARRA group set up. Per their
Underwriting Guidelines a group must have 2 eligible and 2 enrolled to be
eligible for group coverage, this refers to at least 2 full-time active
employees.
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