What's Inside:
Get to Know Prime Therapeutics: Webinar April 23 | New Group Binder Check Submission Address | Formulary Updates Effective July 1 | Free Vision and Hearing Screenings at Capital Blue | Customized Printed Provider Directory Requests | 2019 Underwriting Compliance Guidelines Updated | Drug Take Back With Swatara Township Police Department | Free Training for Small Group Business Owners May 14 |
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| Get to Know Prime Therapeutics: Webinar April 23 |
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Please join us for a webinar with Prime Therapeutics (Prime).
Prime will be our pharmacy benefit manager starting January 2020. We’d like to take this opportunity for you to learn about our new relationship and how together—with you—we can deliver unique solutions to your clients to control costs and improve member health. | When:
Tuesday, April 23
10 a.m. to 11 a.m. | |
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| New Group Binder Check Submission Address |
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Here's a head's up! Binder checks for new groups must be sent to the following address to ensure timely receipt and processing:
Capital BlueCross
Payment Processing MD 3301
2500 Elmerton Ave.
Harrisburg, PA 17177
Automated payment option also available
Encourage your new groups to take advantage of the Group eCheck Submission Form, and avoid the hassle of mailing a check. |
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| Formulary Updates Effective July 1 |
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Changes to our open, closed, and selectively closed formularies will go into effect July 1. Around May 1, we will mail information to members who use medications that will be impacted by the changes.
The July 1 formulary updates will be posted on our website’s prescription drug benefits page.
Updates include:
- Drugs changing tier status
- Newly marketed drugs
- Pharmacy utilization management programs [Prior Authorization (PAR), Enhanced Prior Authorization (EPA)/Step Therapy, and Quantity Level Limits (QLL)]
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| Free Vision and Hearing Screenings at Capital Blue |
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| Customized Printed Provider Directory Requests |
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In the past, when a member received a printed provider directory, it was a huge list that was not specific to their location. Effective May 1, that all changes. Members who request a printed copy of the provider directory can customize it by zip code, so they only receive listings of those providers in the radius they’re willing to travel.
Members won’t need to do anything different to request a printed provider directory. If our online resources are not an option, they can call Customer Service to request a printed version as usual. Customer Service will let them know of the option to receive a listing of providers within a certain zip code and radius of miles. The results will be mailed to the member. |
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| 2019 Underwriting Compliance Guidelines Updated |
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Section II. Group Eligibility—Part E. Multiple Options
Effective July 1, enrollment in the Valley Advantage EPO product is limited to subscribers who reside in or within 30 miles of Lehigh and Northampton counties. This change was previously communicated in Connect with Capital. |
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Section IV. Employee/Subscriber Eligibility—Part B. Dependent Eligibility
Clarification has been added to the definition of dependents.
Section IX. Blue Cross Dental Enrollment Requirements
Voluntary and discounted dental plans must be paired with a medical plan and/or a full benefit dental plan. Previously the requirement was to be paired with a medical plan.
Section X. Blue Cross Vision Enrollment Requirements
Voluntary and discounted vision plans must be paired with a medical plan and/or full benefit vision plan. Previously the requirement was to be paired with a medical plan. |
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| Drug Take Back With Swatara Township Police Department |
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| On April 27, Capital BlueCross will work with the Swatara Township Police Department to help the community safely dispose of their unwanted, unused, and expired medications. It’s all part of National Prescription Drug Take Back Day. And it furthers our efforts to curb the opioid epidemic, which remains a grave problem in Central Pennsylvania. The event will take place at the township police department. Please share with your groups. |
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| Free Training for Small Group Business Owners May 14 |
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| For small group (1–50) business owners only: we will soon be sending an invitation to a free Organization and Time Management training session. Encourage them to accept this great opportunity. | When: Tuesday, May 14
8 a.m. to 10 a.m.
Where: Capital Blue
Hampden Marketplace, Enola |
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| Riddle Me This | When I’m first said,
I’m quite mysterious.
But when I’m explained,
I’m nothing serious.
What am I? | Wait for the next issue of Connect with Capital
for the answer! |
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Answer to last issue’s riddle
A man leaves home and makes three left turns only to return home facing two men wearing masks. Who are those two men? Answer: The person is a baseball player. The men are a catcher and an umpire. |
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| | If you have any questions about content in this email, please contact your account executive. |
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