RxBenefits, Inc.advocacy. expertise. service.800.334.8134RXBENEFITS.COM

Prescription Drug Coverage Effective 1/1/17

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Your Prescription Drug CoverageWhat’s Changing?

• Effective 1/1/2017, your prescription drug coverage will be provided through Express-Scripts (ESI). Aetna will continue to provide your medical coverage.

• RxBenefits will administer your pharmacy plan. This means you will contact RxAssure (member services) for prescription drug questions.

• ESI offers over 68,000 pharmacies, including most national chains and many independents

• Current plan copays will not change; however, there is a change in formulary (meaning how drugs are covered).

• During open enrollment, you may call RxAssure to find where your current drugs fit on the new formulary.

• In addition, before 1/1/17, ESI will send you a notification in the mail if your drug is not covered under the new formulary. Alternatives will be offered.

• Mail order member will require a new prescription, as well as will need to register with ESI’s Home Delivery Program.

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What Does This Mean to You?

• Before 1/1/17, all enrolled employees will receive a pharmacy ID card from Express Scripts. This will be a separatecard from your Aetna medical card.

• Please make sure you show this new ID card to your pharmacy on and after 1/1/2017.

New Pharmacy ID Card

• The processing information and contact phone numbers on your new Express-Scripts ID card will notbe the same as your previous Aetna med/rx ID card.

The new information is: • RxBIN: 610014• RxGroup: 35242Rx• Provider Pharmacy Help Desk:

1-800-922-1557• RxAssure Member Services:

1-800-334-8134

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What To Do Prior to January 1st, 2017

• Refill all retail and mail order prescriptions through your current Aetna coverage to ensure you have adequate supply in case of transition issues.

• If you have particular prescription drug needs, call RxAssure to identify any impact in coverage.

• Look for your new ID card and welcome packet in the mail.

• Set up mail order through Express Scripts

– Mail Order can take up to two weeks for the initial order, so members should make sure to have enough medication on hand to last until delivery.

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Specialty Medication

• Specialty medications are covered though Accredo (Express Scripts Specialty

Pharmacy).

• Prior to 1/1/2017, you will receive notification if your specialty drug is not covered

under ESI, and what action needs to be taken.

• Be proactive – call RxAssure during Open Enrollment to ensure you know how your

current prescriptions will be covered.

• Specialty medications may require prior authorization and quantity limits may apply.

• Specialty medications are limited to a 30-day supply.

DURING OPEN ENROLLMENT:Call RxAssure, your Member Services Team, to discuss how your prescription will be covered.

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Mail Order

• Member will utilize ESI ‘s Home Delivery Program for their mail order

prescriptions. You will need to register thru the website, and provide your new

member number and payment information.

• New prescriptions after 1/1/17 can be attached to a completed mail order form

and mailed to ESI.

• Mail order forms will be provided at the Open-Enrollment Events

NOTE: Mail Order can take up to two weeks for the initial order, so members should make sure to have enough medication on hand to last until delivery.

ESI Home Delivery can be reached at 877.503.4073. Express Scripts

P.O. Box 66564St Louis, MO 63166-6564

Send completed Mail Order forms to:

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Your Member Services Team (RxAssure)

RxBenefits is your pharmacy benefit administrator (PBA) effective 1/1/17.

• We partner with the country’s largest Pharmacy Benefit Managers (PBMs) to bring greater discounts, enhanced access, and improved Member Services to our clients and their employees. Your coverage will be with Express Scripts.

• You will have access to RxAssure, our Member Service Team. We are available Monday–Friday, 8:00 am till 7:00 pm EST to assist you with questions such as:

• Calls received after hours and weekends will allow members to leave a message or be routed to Express Scripts Member Service; which is 24/7.

Is my pharmacy in the network?

Are there lower cost alternatives?

Can you assist me with my claim questions?Is my drug covered?

What will it cost?

Can you help me transition my

mail order scripts?

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Mobile Apps: myDrugCosts (offered through RxBenefits)Research drug costs and alternatives

EASY TO USE

Tailored to your CompanySee options specific to your health plan

Quickly Find a DrugType a few letters to lookup your drug

Learn More about DrugsEvidence-based information from Consumer Reports about best buys, safety & quality

WAYS TO SAVE

Therapeutic AlternativesExplore opportunities to switch to lower cost drugs in the same class

$4 Generics (not shown)See available $4/$10 generics

Generic EquivalentsKnow when you can switch to the generic

Medication ListsTrack medications for yourself & others

InstructionsLinks to instructions, frequently asked questions and demos

Online HelpSearch Help and access online support

Your Plan CostSee your out-of-pocket cost and further information with in-network Pharmacies

Cash PriceSee the cash price if you bought without insurance (non-covered or out-of-network)

Your

Company

Access anytime from your smartphone or computer browser

• At your physician’s office• At home• At work

A simple web based tool to help reduce the costs of your prescription drugs

Your Mail Order CostSee your out-of-pocket cost & information about home delivery of your medications

GET HELP

PLAN SPECIFIC DRUGS COSTS

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Mobile Apps: Express Scripts Manage Prescriptions

• Register your account from their mobile device.

• Transfer eligible maintenance medications to Express Scripts Pharmacy.

• Select and schedule prescription refills and enroll eligible prescriptions in auto refills.

For Members-on-the-Go

• Check Express Scripts Pharmacy order shipping information.

• Locate a nearby pharmacy using GPS technology.

• Access DrugDigest database for information, uses, possible side effects, etc.

• Set a reminder for medication doses.

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Who Is Who? RxBenefits, RxAssure & Express Scripts……

• RxBenefits

– Pharmacy Benefits Administrator

• RxAssure (through RxBenefits)

– Member Services:

• Denied claims

• Copay inquires

• Plan questions

• Customer service issues/questions

• Locate a pharmacy

• Pricing questions

• Included/excluded medication

• Express Scripts

– Pharmacy Benefit Manager

– Specialty pharmacy, Accredo

– Pharmacy Help Desk

– Back-up customer service

– Mail Order pharmacy