Flashes

Group Medicare Supplement Renewals Delayed

December 5, 2018

Last week we sent the renewal mailing to group Medicare supplement members without the 2019 rates included, as these have not yet been approved by Department of Insurance (DOI). The renewal mailing informs members of the 2019 Original Medicare benefits. A cover letter explains that we’ll mail the rates separately once we receive approval.

We are required to give members and groups a 30-day notice before changing their rates, so the new rates will not go into effect on January 1, 2019. Even though we aren’t changing the rates on January 1, we will not extend the 2020 renewal. That renewal date will still be January 1, 2020.

We filed within the appropriate time frame, and we are working diligently with the DOI to receive approval. We will provide an update once we receive the 2019 rate approval. 

If you have any questions, call Broker Support at 1-877-917-8489 or email BrokerServices@healthalliance.org.

Online Quoting Available for 2019 Small Group Plans

November 28, 2018

Our 2019 small group rates and plans are now available for quoting in the private exchange at HealthAlliance.org/Groups/Small-Group-Plans.

For a refresher on using the private exchange, check out our small group private exchange guides under Broker Resources in the Forms & Resources section of Your Health Alliance for brokers.

If you have questions, call Broker Support at 1-877-917-8489 or email BrokerServices@healthalliance.org.

Clarification on Pharmacy Deductibles for 2019 HMO 3500a Plans

November 28, 2018

This week, we’re mailing individual members on 2019 HMO 3500a plans a letter explaining that the deductible listed in the Prescription Drugs section of the benefit summary posted online and included in the printed sales brochure refers to a separate pharmacy deductible, not the plan year (medical) deductible listed near the top of the page. The deductible listed in the Summary of Benefits and Coverage (SBC) is accurate.

The pharmacy deductible for the HMO 3500a plans listed below is $400/individual or $800/family.

  • HMO 3500a Elite Silver – Direct
  • HMO 3500a Methodist Silver – Direct
  • HMO 3500a OSF Silver – Direct
  • HMO 3500a Elite Silver – Marketplace
  • HMO 3500a Elite Silver CSR 73– Marketplace
  • HMO 3500a Methodist Silver – Marketplace
  • HMO 3500a Methodist Silver CSR 73 – Marketplace
  • HMO 3500a OSF Silver – Marketplace
  • HMO 3500a OSF Silver CSR 73– Marketplace
  • HMO 3500a Elite Silver Ind CSR – Marketplace
  • HMO 3500a Methodist Silver Ind CSR – Marketplace
  • HMO 3500a OSF Silver Ind CSR – Marketplace

We’ll update printed sales brochures and online benefit summaries with a note explaining the deductible and which plans it applies to. For more information about HMO 3500a and other plans, visit HealthAlliance.org/Individual.

If you have questions, call Broker Support at 1-877-917-8489 or email BrokerServices@healthalliance.org. Members can call Customer Service at 1-866-247-3296 with questions.

Retro Change Policy for Exhibit Bs

November 20, 2018

The Exhibit Bs for your groups contain eligibility terms of the contracts and more. These documents must be reviewed and re-signed upon renewal. We do not accept retro changes to the Exhibit B more than 30 days after a group’s renewal or effective date.

Retro changes beyond that time period are not accepted due to the potential risk to the employer group from a discrimination standpoint. The Exhibit B must be signed by the owner of the company or an authorized employee of the company and returned to us as soon as possible, and no later than 30 days after the group’s renewal or effective date.

If you have questions, call Broker Support at 1-877-917-8489 or email BrokerServices@healthalliance.org.

Roy’s Pharmacy in Washington Now Closed

November 20, 2018

Roy’s Pharmacy in Tonasket, WA has closed and will no longer be a preferred cost-sharing pharmacy for Health Alliance Northwest members. According to information on Roy’s voicemail recording, all prescriptions have been transferred to Rite Aid at 609 Omache Dr. in Omak.

Lakeside Pharmacy in Oroville and Omak Pharmacy in Omak are the closest preferred cost-sharing pharmacies, and we will look for opportunities to offer additional preferred pharmacies in the area. There are also several other in-network pharmacies nearby where members can get prescriptions filled at the standard cost-sharing coverage amount.

A preferred cost-sharing pharmacy is an in-network pharmacy that has signed a contract with us to offer certain prescription drugs at a lower cost. At these pharmacies, members can get $0 Tier 1 generics and a 90-day supply of their medication for 2 copays. At standard cost-sharing pharmacies, members have a small copay for Tier 1 generics and can get a 90-day supply of their medication for 2.5 copays.

If you have clients on Companion plans who may use Roy’s Pharmacy, please let them know about its closing and their other options.