| The Division of Retirement and Benefits sends monthly e-newsletters to provide you with accurate, timely information about your AlaskaCare retiree health benefits. You can expect to receive an e-newsletter each month, and the Division may also send out timely information and updates through this email list. If you prefer not to receive these email updates, you can unsubscribe at any time. Either way, you will continue to receive the Health Matters newsletter in the mail, as well as your important health plan information.
The January 1, 2019 DRAFT Retiree Health Insurance Information Booklet and DRAFT DCR Benefit Plan Booklet are now available for review!
These drafts include important changes to take effect January 1, 2019 including:
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The pharmacy benefits have changed to reflect the implementation of an enhanced EGWP for Medicare-eligible retirees and Medicare-eligible dependents.
The AlaskaCare enhanced EGWP is a Medicare Part D group pharmacy plan and represents an administrative change to how the health plan receives federal subsidies for Medicare-eligible retirees and dependents. Read more about the enhanced EGWP on the AlaskaCare website.
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The booklets are updated to reflect the change from Aetna/CVS Caremark to OptumRx as the pharmacy benefit manager.
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AlaskaCare is expanding habilitative services for pervasive developmental delays such as Autism Spectrum Disorder (ASD). Habilitative services can include occupational therapy, speech therapy and other services, including early intensive behavioral interventions such as applied behavioral analysis for treatment of ASD. Applied behavioral analysis will require precertification. Not all habilitative services are covered. Those services provided in an educational or training setting, to teach sign language, or vocational rehabilitation or employment counseling continue to be excluded under the plan.
We want to know what you think!
Your feedback is important to us. The draft booklets are available on AlaskaCare.gov:
The booklets are available for review and public comment through December 3, 2018. Please submit comments on the draft documents by email to: doa.drb.alaskacare.retiree.plan@alaska.gov.
The Division is hosting monthly Tele-Town Halls for all interested AlaskaCare retirees to ask questions about your health plan. This format gives retirees a chance to connect directly with Division staff, ask questions and learn more about the health plan.
We Want To Hear From You! Tele-Town Hall 3: October 25.
Hosted by the Alaska Department of Administration, Division of Retirement and Benefits for all interested AlaskaCare retirees and families.
Thursday, October 25, 2018 | 10 to 11 a.m. AKDT (1 hour).
Join the call to learn more about the transition to our new Pharmacy Benefit Manager, OptumRx, the Employer Group Waiver Program (EGWP), and to ask Division staff any questions you have about your benefits.
If you haven’t participated in a tele-town hall before, here’s how it works: Many AlaskaCare retirees will be called into a shared line automatically when the event starts. If you would like to participate, just answer that call and stay on the phone! Division staff will give a brief introduction and update, and the rest of the event will be dedicated to answering your questions. We will answer as many questions as we can during the call.
Please pre-register to make sure we have the correct phone number for you. Register online here.
Registering for this event means that we will have your correct phone number to call when the event begins!
If you don’t want to register or participate over the phone, you can listen online. The audio of the call will be streamed live here once the event begins. This event will be recorded. The audio recording and a written summary will be available online following the event.
Still Have Questions?
You can read more about EGWP and the 2019 pharmacy benefits transition on the AlaskaCare website. You can also contact the Division at (907) 465-4460 or by email at doa.drb.benefits@alaska.gov.
 As you probably know, fall is an important time of year for AlaskaCare members! Members receive a number of important communications in the mail: required notices from Medicare for eligible members, information about open enrollment for those who pay a premium for their medical care, and other legal or administrative notices we must provide annually. Please review this information carefully and take any necessary actions related to your health plan, for yourself and your dependents enrolled in the plan.
Important AlaskaCare Benefit Program Notices
The Division has mailed the fall HealthMatters newsletter to all AlaskaCare members, including all of the required notices and other information we need to provide before the start of the new plan year. Look for this in your mailbox on or after October 18, 2018. You can find electronic versions of the newsletter, including the current issue and past issues on the AlaskaCare website.
Changes Related to AlaskaCare Pharmacy Plan in 2019
You will receive a letter from Division of Retirement and Benefits Director Ajay Desai with some information about changes related to the AlaskaCare pharmacy plan:
Beginning January 1, 2019, OptumRx will become the Pharmacy Benefits Manager (PBM) for all AlaskaCare plans. Aetna through their subcontractor CVS/Caremark, is currently the PBM for AlaskaCare. Aetna will continue managing the health plans’ medical benefits in 2019. OptumRx offers flexibility in how you choose to receive your medications—via home delivery or through your local retail pharmacy—and maintains a network of 67,000 retail pharmacies in Alaska and across the U.S.
OptumRx will send out a welcome kit in November with important information about your pharmacy plan, including:
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A new ID card
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A toll-free number to reach an OptumRx health care advisor 24 hours a day, 7 days a week (phone lines will open on October 31, 2018)
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How to register and access your account online after January 1, 2019 to actively manage and get the most from your prescription benefits, including how to sign up for text message reminders to refill or take your medications
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How to easily manage prescriptions from your mobile device using the OptumRx app
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How to get started with OptumRx’s home delivery or BriovaRx specialty pharmacy
OptumRx Concierge Service Opens October 31, 2018
We know that members will have questions about how this transition will impact them, and some members may need assistance with their specific prescriptions. OptumRx will open their concierge service for AlaskaCare members on October 31, 2018 to answer your questions, assist with any needed paperwork for your current prescriptions, and help you get ready for this change in 2019. You can reach OptumRx Member Services at (855) 409-6999. Representatives will be available Monday through Friday, 8 a.m. to 8 p.m. AKST, and Saturday and Sunday, 8 a.m. to 5 p.m. through December 31, 2018. Beginning January 1, 2019, representatives will be available to assist you 24/7.
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An Employer Group Waiver Plan, known as EGWP or “Egg Whip,” is a program offered by the federal government that will increase federal subsidies for prescription drugs for the retiree health trust. This 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.
AlaskaCare will implement an enhanced EGWP in January 2019, enrolling Medicare-eligible retirees and dependents in the new plan. The new is plan is a combination of Medicare Part D, and wraparound benefits through AlaskaCare to cover all prescriptions drugs that are covered now, but are not part of Medicare Part D. Medicare-eligible members will be automatically enrolled as of January 1, 2019, and do not need to separately enroll in an individual Medicare Part D plan.
The Division has shared information about this change over the last few months. You can read more about EGWP and the 2019 pharmacy benefits transition on the AlaskaCare website. You will also receive more information in the mail in November. In the meantime, see how the old and new Defined Benefit retiree pharmacy plans compare!
 We cannot prevent all the health issues we will experience in a lifetime, but taking care of ourselves and our family’s physical, mental, and emotional well-being helps us avoid or address problems early and maintain a good quality of life. This month’s prevention tip is about the shingles vaccination, which will be available to all AlaskaCare retirees starting January 2019.
The AlaskaCare retiree health plan has only limited coverage of preventive services such as vaccinations. However, beginning January 2019, all retirees will have access to the shingles vaccine. This vaccine, as well as other vaccines covered by Medicare Part D, will be covered by AlaskaCare when administered at pharmacy after the AlaskaCare enhanced EGWP goes into effect on January 1, 2019. This coverage will extend to all retirees as of that date, including retirees who are not Medicare-eligible and are therefore not enrolled in the enhanced EGWP.
Shingles is a viral infection (the same virus that causes chickenpox) that causes painful, itchy rashes. Shingles is common in older adults, even if you have previously been exposed to chickenpox, and can have other health complications in addition to considerable pain and discomfort. The Division encourages retirees and others at risk of shingles to get vaccinated when this service is covered beginning in 2019!
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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 community of AlaskaCare retirees. The seven-member board meets four times per year.
New Member: Nanette Thompson
Nanette Thompson, of Moose Pass on the Kenai Peninsula, is a retired lawyer who practiced law in Anchorage for 30 years in the private and public sectors. She holds a Bachelor of Arts from Stanford University and a Juris Doctorate from University of Washington School of Law. She served as a commissioner on the Alaska Public Utilities Commission and the Regulatory Commission of Alaska, worked as an Assistant Attorney General and worked for Department of Natural Resources' Division of Oil and Gas during her tenure in state government. After retiring, she served as the President of the Seward Community Health Center Board from 2015-2017.
Nanette’s appointment fills the seat formerly held by Mark Foster, whose term ended on October 2, 2018. Thank you to Mark for his service on the board!
Next Modernization Committee Meeting: October 30
The board’s modernization subcommittee is tasked with in-depth review and discussion about the modernization project, a collection of initiatives and proposed changes to the health plan under consideration by the Division to provide updated and improved benefits for all retirees. The modernization committee is meeting regularly this fall to continue its review of the changes under consideration, including the Division’s ongoing research and analysis about each initiative.
On Friday, September 28, the committee met to review the current list of options and discuss some proposed initiatives being considered. Discussion topics included rehabilitative care benefits, travel benefits for some non-emergency surgeries, and considering coverage of alternative therapies such as acupuncture and rolfing massage.
The next modernization committee meeting will be Tuesday, October 30, 9:30 a.m. to 12:30 p.m. with locations in Anchorage and Juneau, as well as an opportunity to join the meeting online and via phone.
Location information and agenda packets for all meetings are posted at the board’s web page.
Next Quarterly Board Meeting: November 28
The next full board meeting is scheduled for Wednesday, November 28, from 9 a.m. to 4 p.m., with locations in Juneau and Anchorage and teleconference provided. Members of the public are always welcome to attend and observe the meeting or listen in via phone. Each RHPAB board meeting includes time on the agenda for public comment. Written comments may be submitted to the board at mailto:alaskaRHPAB@alaska.gov If you want to be sure that your comments are included in the agenda packet for the next quarterly board meeting, please submit them at least thirty days in advance of the next scheduled meeting. Please see the RHPAB public comment guidelines(PDF) for more information and for what to expect in a board meeting. For more about RHPAB and upcoming meetings, including teleconference information and meeting materials, please click here.
On Friday October 12, the Division released a Request for Proposals (RFP) for vendors to bid on providing Third Party Administrator (TPA) services for AlaskaCare plans, effective in 2020. This contract provides claims administration and network services for the employee and retiree health plans and dental plans. The current health plan contractor is Aetna and the current dental plan contractor is Moda. Periodically, the Division competitively bids the TPA contracts through an RFP. This gives the Division an opportunity to seek better service at lower cost for members of the AlaskaCare plans.
The procurement process began with the release of the RFP and will end with contract award and negotiation in the summer of 2019. After seeking solicitations from vendors through the competitive bid process, Division staff and one or more RHPAB members will review the proposals through an evaluation committee and select the most competitive vendor(s). The Division will then negotiate a new contract with the selected vendor(s) for services beginning in 2020. Depending on the outcome of the procurement process, the State may select the same vendor(s) or new vendor(s) to administer the plans, but this will not be determined until the process has concluded in 2019. The Division will communicate with members in advance of any changes to the health and dental plan vendors.
The RFP and associated attachments have been posted to the Online Public Notice system.
 You worked hard during your service to Alaska, and you’ve earned many excellent benefits! We want you to understand your AlaskaCare benefits, so you can make the best use of them for yourself and your family. For questions about your benefits, you can always reach out to the Aetna concierge at (855) 784-8646.
This month’s featured benefit: Progressive Lenses – The “Uncovered” Benefit
Your eyes, and your corrective vision needs, can change as you age. Many people rely on multifocal lenses to improve their vision at various distances, helping with activities from reading the newspaper to driving a car. The traditional lens options have been single vision, bifocal, and trifocal, with one, two, or three distinct areas of each lens designed to focus at different distances. Progressive lenses are eyeglass lenses that have a smooth transition between the parts with different focal lengths, correcting vision at all distances without a “line” in the lens. Progressive lenses have become increasingly popular for adults experiencing vision changes and although progressive lenses look like single-vision lenses, they may provide better, more flexible corrective power than bifocals or trifocals for some people.
If you are enrolled in the AlaskaCare vision plan, progressive lenses have never been covered. If you obtained progressive lenses in the past, you may recall that the plan covers up to the cost of two (one for each eye) single vision, bifocal, trifocal, or lenticular polycarbonate lenses per calendar year. Scratch resistant and antireflective coatings are also covered. If your provider bills for progressive lenses only, rather than as an add-on to a standard order for corrective lenses under the plan, progressive lenses may be covered up to the cost of bifocal or trifocal lenses. If your provider bills a base charge for the bifocal or trifocal lenses and a separate charge for the progressive upgrade, the additional progressive upgrade charge will not be allowed.
If you are considering progressive lenses or have questions regarding vision plan benefits, please contact the Aetna Concierge at (855) 784-8646 to learn more. Concierge agents are dedicated to the AlaskaCare plans and can advise you regarding your vision benefits and the reimbursements you can expect for spectacle frames, lenses, and covered lens options, as well as when you are eligible for your benefits (for example, members may obtain new frames every two years and new spectacle lenses annually).
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