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| Health Plan Options |
Connect with Capital, January 2018, Vol. 2
For Deb
What's Inside:
New EOBs Are Coming! | 360° on Reform | New Specialty Drug Provider Reminders | Large Group Contract Distribution Change | Correction! 2018 Group Termination Dates | Beware: New Scam Targeting Our Members |
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This is insurance made easy. Capital BlueCross' redesigned Explanation of Benefit letters can't get any more simple: no confusing insurance language, one envelope for all visits in a 14 calendar-day period, who paid what, what is still owed (and by whom), and an easy-to-read layout with additional resources.
Check out the mock-ups of the new EOBs! |
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| The latest 360° on Reform, a publication for our employer group customers, covers the Tax Cuts and Jobs Act. Read about the impacts on health care, corporate taxes, other changes, and what role Capital BlueCross plays. |
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| New Specialty Drug Provider Reminders |
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| Effective January 1, 2018, AllianceRx Walgreen Prime became our preferred specialty medication vendor for our commercial Large Group business. In addition, they are also the exclusive specialty vendor for our Individual product and Small Group business.
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- Transitioning to AllianceRx Walgreens Prime will be mandatory for customers whose prescription drug benefit includes a closed/exclusive specialty network access arrangement (this includes our individual product and Small Group business).
- Transitioning to AllianceRx Walgreens Prime will be mandatory only when filling a specialty medication that is designated as exclusive for customers whose prescription drug benefit includes an open/closed specialty network access arrangement. (Under this arrangement, specialty medications that are designated as non-exclusive can also be filled at participating retail pharmacies).
- Transitioning to AllianceRx Walgreens Prime will be optional for customers whose prescription drug benefit includes an open specialty network access arrangement.
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| Also, AllianceRx Walgreens Prime will replace ACRO Pharmaceuticals as our pharmacy of choice to fill the medications that are covered under a customer's medical plan and administered in a doctor's office or facility. |
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| Customer Transition Information |
Customers must be enrolled with AllianceRx Walgreens Prime before filling their first medication to avoid disruption.
AllianceRx Walgreens Prime will not ship medications until the customer has enrolled. This customer action is critical.
Capital BlueCross provided a contact file of current specialty pharmacy patients and their prescriptions to AllianceRx Walgreens Prime, and also sent introductory letters to customers. AllianceRx Walgreens Prime made outbound calls to customers, encouraging enrollment, and will send a welcome packet with the first prescription fill. The packet will include clinical education materials, as applicable, and some required notices from the pharmacy. |
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| On behalf of Capital BlueCross, AllianceRx Walgreens Prime, an independent company by Walgreens Specialty Pharmacy Holdings, LLC, assists in the procurement of specialty medications for our members. |
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| Large Group Contract Distribution Change |
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| Beginning with January 2018 effective dates, Sales Services will email completed contracts and amendatory riders for large ASO and fully insured employer groups to the designated group policymaker and Account Executive. The Account Executive will provide a copy to the producer. |
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| Stop the Presses! Group Termination Dates Correction |
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Whoops!
Please revise your termination date chart. The five-day termination date for a November 1, 2018 effective date is October 25, 2018. It was erroneously printed as August 25 in the January 2018 Volume 1 of Connect with Capital. |
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| Remind Members to Protect Their Privacy (and Wallets!) |
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| Some Capital BlueCross members recently received unsolicited calls from nonparticipating providers offering durable medical equipment. During the calls, members were assured the equipment would be
covered by their health plan. For a number of reasons, this matter could have ultimately cost those members hundreds of dollars in unanticipated costs and serves as a good reminder for members to carefully protect their personal information. |
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| Members should never provide insurance member ID information over the phone when they did not initiate the call. They can report any suspicious activity to Capital BlueCross by calling 888.612.1277, or sending an email to fraud@capbluecross.com. |
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Capital BlueCross is an independent licensee of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital BlueCross in its capacity as administrator of programs. This is an advertisement.
2500 Elmerton Avenue, Harrisburg PA | capbluecross.com | © 2018 Capital BlueCross All Rights Reserved.
Nondiscrimination and Foreign Language Assistance Notice |
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