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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: COBRA Subsidy Extension
On April 15, 2010, President Obama signed the Continuing Extension
Act of 2010, which extends the COBRA subsidy period under the American Recovery
and Reinvestment Act (ARRA) from March 31, 2010 to May 31, 2010.
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Aetna: Details on
Dependent Coverage to Age 26
Aetna is working with customers to allow dependents to remain on their
parents plan prior to the portions of the Patient Protection and
Affordable Care Act that go into effect later this year. Aetna has decided to allow Self-Funded and Fully Insured
Plan Sponsors to extend coverage to dependents, who are currently covered under
their parents plan, until age 26 effective on or after June 1, 2010.
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Capital
BlueCross: New Pharmacy Benefit Manager - CVS Caremark
Capital
BlueCross is pleased to announce it has selected CVS Caremark as its new
pharmacy benefit management (PBM) vendor, beginning January 1, 2011. This
decision was made after thorough evaluation of vendor capabilities and
opportunities for enhanced programs, cost containment and care management.
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Capital BlueCross: Update on Early Implementation of Dependents
to Age 26
Important clarification for you to know now as you deal with customer
questions on this issue: ˇ For plan years beginning 9/23/10, the new Federal
health care reform law provides for coverage of adult children up to age 26.
Capital BlueCross will implement this provision on 6/1/10 for dependents who
are enrolled under their parent's coverage.
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Horizon BCBSNJ: Extends Eligibility for Dependents Under Age 26
Years Prior to
Effective Date
Health
care reform legislation signed into law in March 2010 by President Obama
requires that plans (whether fully insured or self-funded) make coverage
available to adult dependents under age 26 for plan years on or after September
23, 2010. Many young people may lose their coverage prior to this date because
of their age, student status, including graduation from school, or other
factors.
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Independence Blue Cross: Introduces New Physician Payment Model
As part of our ongoing commitment to help improve
the quality and affordability of health care in southeastern Pennsylvania, Independence Blue Cross (IBC)
is changing the way we pay primary care physicians to encourage safer, higher
quality, and more cost-effective care. Because of the importance of primary
care in keeping members well, we are investing an additional $47 million to
supplement primary care physicians' compensation.
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Independence Blue Cross: Update on Early Extension of Dependents
Last week, we announced that we would allow our
group customers and individual members to extend coverage for adult children up
to age 26, effective June 1, 2010. Independence Blue Cross, along with the
other Independent Blue Cross and Blue Shield plans, made this decision to allow
these young adults to remain on their parents' plans and help families avoid a
potential gap in coverage until the coverage to 26 provision of the new federal
health care reform law becomes effective.
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Independence Blue
Cross: ZegeridŽ
Available Over the Counter April 2010
Effective April 1, 2010, ZegeridŽ 20 mg capsules, which are proton pump inhibitors
used to treat heartburn, became available over the counter. Drugs that have an
over-the-counter equivalent are excluded from all IBC and its affiliated
prescription drug programs. Therefore, effective June 1, 2010, Zegerid will no
longer be a covered drug. IBC members who are currently taking Zegerid will be
notified that this medication is now available over the counter at the retail
cost of the medication and will no longer be covered under their prescription
drug plan.
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