AlaskaCare Retiree News | July 2018

Alaska Department of Administration sent this bulletin at 07/16/2018 04:18 PM AKDT

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July 2018

Welcome, AlaskaCare Retiree!

The Department of Administration is excited to share this AlaskaCare Retiree Health update. We will be sending regular email newsletters to provide you accurate, timely information about your AlaskaCare retiree benefits directly from the Division of Retirement and Benefits. You will continue to receive a printed newsletter in the mail. If you prefer not to receive the email update, you can unsubscribe at any time.

This update includes helpful information about:

  • Efforts to improve the AlaskaCare Retiree Health Plan to work better for you
  • Our new Retiree Health Plan Advisory Board (RHPAB)
  • The selection of our new vendor to manage pharmacy benefits, beginning in 2019
  • EGWP (Employer Group Waiver Program): a new federal reimbursement option for pharmacy benefits

Help Us Modernize Your Health Plan!

The Division is working with the newly-created Retiree Health Plan Advisory Board to improve and modernize the AlaskaCare retiree plan. We need your help to protect, sustain, and improve the plan. Please let us know what you think is working, and what you would like to see improved. You can send comments to alaskaRHPAB@alaska.gov.

The Division and the Board have formed a working group to prioritize implementation of some potential changes you’ve already asked for. These include:

  • Adding coverage for preventive services (including vaccines)
  • Increasing or removing the $2 million lifetime maximum
  • Adding an enhanced travel benefit to provide airfare, lodging, and per diem for a member and a companion to a center of excellence for certain surgeries
  • Improving coverage for rehabilitative services including physical and occupational therapy and chiropractic care
  • Implementing an Enhanced Employer Group Waiver Program (EGWP) (see below)

The next working group meeting is scheduled for Thursday, July 26th, from 1 p.m. to 4 p.m. with locations in Juneau and Anchorage and teleconference provided. The full board will meet Wednesday, August 29th, from 9 a.m. to 4 p.m. You are welcome to attend or listen in.

For more information, including teleconference information and meeting materials, please visit AlaskaCare.gov/retiree/advisory.html.

Introducing the Retiree Health Plan Advisory Board

Created by the Governor last fall, the Retiree Health Plan Advisory Board (RHPAB) is tasked with facilitating engagement and communication among the Commissioner of Administration, the Division of Retirement and Benefits, and the retiree community. The seven-member board meets four times a year and schedules working groups more frequently for specific topics.

The modernization project working group will meet Thursday, July 26th, from 1 p.m. to 4 p.m. with locations in Juneau and Anchorage and teleconference provided. The full board is scheduled to meet Wednesday, August 29th, from 9 a.m. to 4 p.m.

To learn more about the board, please visit AlaskaCare.gov/retiree/advisory.html.

New Pharmacy Benefit Manager: OptumRx

A pharmacy benefit manager (PBM) is a company the Division hires to process AlaskaCare pharmacy claims. OptumRx has been selected as the new PBM beginning January 1, 2019. Today, these claims are processed by Aetna and CVS/Caremark, and they will continue to process them through December 31, 2018. Medical, vision and dental claims will continue to be processed by Aetna and Moda, respectively.

Why is this changing? What does this mean for me?

Periodically, the Division competitively bids these contracts through a Request for Proposal (RFP). This gives us an opportunity to seek better service at lower cost for members and the plan.

The new PBM contract will go into effect January 1, 2019. Over the next few months, you will receive information about the transition. Please carefully review any letters you receive and contact the Division if you have any questions.

Does that mean my pharmacy benefits will change?

Your pharmacy co-pays will remain the same, but you may notice some small administrative changes like the list of medications requiring preauthorization may change. The Division is working to ensure those changes are limited and members know ahead of time if they will be impacted.

All About EGWP:
A New Federal Reimbursement Option for Pharmacy Benefits

What is EGWP?

Beginning in 2019, the Division is considering changing how we receive federal subsidies by implementing an Employer Group Waiver Program, or EGWP (pronounced “egg whip”). The AlaskaCare EGWP is an administrative change to how pharmacy benefits are managed for Medicare eligible retirees and dependents. The pharmacy benefit for AlaskaCare retirees remains the same.

You can read more about EGWP on the AlaskaCare website at AlaskaCare.gov/retiree/faqs/egwpFaqs.html

Why is AlaskaCare switching to an enhanced EGWP?

AlaskaCare currently receives a federal subsidy for the retiree health prescription drug benefit. Using an enhanced EGWP plan instead, the retiree health trust would receive significantly higher subsidies than we do today, saving the trust up to $20 million annually and providing $40-$60 million each year in additional state savings through a reduction in the unfunded liability. These savings are critical if we are to consider making important changes to our plan that will benefit our members, such as wellness and preventive care, more travel benefits, and changing the lifetime maximum spending limits for care.

How will this impact me?

Your pharmacy benefits will remain the same. Starting January 1, 2019, all AlaskaCare pharmacy benefits claims will be managed by our new Pharmacy Benefit Manager (PBM), OptumRx. If you or your dependents are not currently eligible for Medicare, you will not be enrolled in the AlaskaCare EGWP. Remember, the benefits for all AlaskaCare retirees, regardless of Medicare eligibility, will remain the same with very few exceptions.

Through this transition to the AlaskaCare EGWP and the new PBM, you will keep the same pharmacy benefits you have now:

  • A typical trip to the pharmacy or a prescription refill order will be the same as it is now.
  • AlaskaCare’s pharmacy plan will continue to cover the medications you rely on now.
  • Your co-pays will also stay the same: $4 for generic medications, $8 for brand name medications, and $0 for mail order medications.
  • We understand that convenient access to fill prescriptions is important to you. AlaskaCare is working with our new vendor to maximize our network and provide options for our members to get medications filled as conveniently as possible, close to home or by mail.

Making this administrative change gives AlaskaCare more resources to consider offering important benefits you have asked us for: wellness and preventive care, travel benefits, and removing some lifetime maximums.

We will be providing more information in the coming months to ensure that our members have a smooth and successful transition under the new pharmacy benefits management. We will work closely with our new PBM to share information and make it easy for you to continue accessing the medications you need.

Sunshine and clouds

The Division wishes all of our members and their families a safe and healthy Alaska summer!