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Pharmacy Benefits Manager

• State Employees’ Prescription Drug Plan administered by Medco– All health plans (except CHP and FHCP Medicare Advantage)

– Plan benefits the same– Mail order requirements the same for PPO Plan– Preferred Drug List and Maintenance Drug List– Transfer prescriptions– Limited Network – Walgreens out of network

Medco

• www.medco.com/sofrxplan (now)• Toll-free (877) 531-4793• Welcome kit• Medco ID cards• www.medco.com (starting January 1)

Procurement Results

• One HMO per county in most counties• Single pharmacy benefits manager (Medco)• Reduce costs – $400 million over two years

How HMO Changes Affect You

• Eligibility– Employees – live or work county– Retirees – live county

How HMO Changes Affect You

• Mapping if your HMO is going away– One HMO option – new HMO– More than one HMO option – PPO Plan

• Plan benefits stay the same• Most providers in more than one network– Show new member ID card in January– Nominate out-of-network providers with new

HMO

Premium Information

• Employee health insurance premiums the same• Retiree HMO rates changing in December – see personalized

benefits statement• Dental plan rates increasing for:

CompBenefits Network Plus Prepaid

CIGNA Dental Prepaid CompBenefits Preferred Plus PPO

2011 2012 2011 2012 2011 2012

Employee Only $21.90 $23.00 $26.32 $27.38 $29.50 $30.98

Employee + Spouse $43.18 $45.34 $47.32 $49.22 $54.58 $57.32

Employee + Child/Children $51.48 $54.06 $55.68 $57.92 $60.98 $64.04

Employee + Family $65.76 $69.06 $67.56 $70.26 $88.56 $92.98

Other Changes

• HSA contribution limits increasing– Individual $3,100– Family $6,250

• Alta now CIGNA Health and Life Insurance Company (CHLIC)

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