Getting Ready for Open Enrollment 2020

Open Enrollment is right around the corner and it is a great time to review your benefits. How often did you go to the dentist this past year? Are you filling maintenance prescriptions that might be cheaper through mail order? Did you complete your two-step wellness incentive tasks? These are questions to consider when thinking about next year’s benefit elections.

IMPORTANT: All Open Enrollment meetings will be virtual this year!

Due to COVID-19, System Benefits Administration has made the decision to conduct virtual open enrollment meetings by Webex Presentations throughout the month of July. A calendar is posted on the Open Enrollment website and below with information on how to attend your virtual Open Enrollment meeting. Please record this information in advance so you are ready to either call in or log into your meeting by computer.

Here are plan updates for September 1:

  1. The A&M Care full-time premiums are remaining the same for the 5th year in a row; however, other plan premiums, including part-time premiums and the graduate student plan premiums, are changing. Please review the premium sheets found on the A&M System Benefits Open Enrollment website.
  2. Family, group, and marriage counseling will now be covered by the A&M Care, J and 65+ health insurance plans.
  3. A new coverage tier is being added to the A&M Care 65 Plus and A&M Care Plans. Blue Cross and Blue Shield of Texas-designated Blue Distinction Centers have a proven record of delivering specialty care and results. Blue Distinction Center care includes the following categories: bariatric surgery, cardiac care, knee/hip replacement, spine surgery, and transplants. This tier will be covered at 90% coinsurance for inpatient services. The benefits of the Blue Distinction Centers are available to 65 PLUS plan members, but there is no plan savings since, in most cases, Blue Cross and Blue Shield pays what Medicare does not pay for inpatient hospitalizations.
  4. Polycarbonate lenses and standard anti-reflective lenses are now covered in full for participants and dependents enrolled in the vision plan.
  5. The vision premium will have a small increase $.60 per month for employee only and $1.72 for employee and family and include the above additional coverage.
  6. Every 6 years, the A&M System Benefits Administration office is required to bid the insurance plans. This year, during the Request for Proposal process, a new Life Insurance carrier was selected. The Hartford will be the new carrier for FY21, however, there will be no plan changes.
  7. The MDLIVE Virtual Visits copay will decrease from $20 to $10 for the A&M Care, J, and 65 Plus plans. Virtual Visits is a way to conduct doctor’s or behavioral health appointments for non-emergency conditions by phone, video, or the MDLIVE app 24/7. To register for MDLIVE, go to MDLIVE.com/bcbstx and enter the information found on your ID card.
  8. Dependent Life Insurance Plan B has been split into Spouse Life B and Child Life B. This change has not changed the coverage amount and slightly lowered the premium for some enrollees. The premium is now: Spouse Plan B – $1.05; Child Plan B – $0.32 (for one or multiple children).
  9. The Healthcare Flexible Spending Account maximum annual election will increase from $2,700 to $2,750.
  10. The credit hour requirements for voluntary graduate students will be changed from 6 to 5 hours. Continuation coverage for the Graduate Student employee Plan (Grad Plan) will be reduced from 6 months to 3 months.
  11. During a recent records audit, we determined there is no provision to name an alternate beneficiary for Dependent Life Insurance. The beneficiary is the employee or retiree, and if deceased as well, the benefit will go to the estate.
  12. Livongo for diabetes and hypertension, Omada for pre-diabetes and pre-hypertension, and Hinge Health for musculoskeletal conditions are being added as Blue Cross and Blue Shield partner programs. These programs are based on eligibility or diagnosis, and include digital tools to assist with these chronic conditions such as a scale or virtual therapy courses. There will be more information provided about these programs after September 1.

 

Virtual Open Enrollment Calendar and Meeting Presentation Schedule

July 1 – July 31

Below you will find the morning, afternoon, and Retiree Meeting presentation schedules. If your campus or agency meeting is shown on the calendar in the AM, use the AM Presentation schedule for reference. You may join the Webex at any time during the meeting to listen to the vendor presentation for which you are most interested. Click the calendar above, and click on your campus or agency name to quickly get to the Webex meeting for your event. You may also drop off the meeting at any time. You will need the Webex information below to dial in. You may also have received this information from your benefits office via email invite. Please record this information ahead of your meeting.

Call-in Information: 1.855.282.6330 (toll free)
Password: benefits

Access Codes:

TAMIU:  145 341 0876
TAMUCC: 145 785 9574
TAMU-HSC: 145 382 8386
TAMU-K: 145 824 7915?
TAMU (7/13): 145 609 6860
TAMU (7/14): 145 315 7150
TAMUS: 145 679 8555
AgriLife: 145 158 5324
TEEX/TFS/TTI: 145 241 9072
TEES/COE: 145 679 3032
Retiree Meeting: 145 623 6773
WTAMU:145 385 2677
PVAMU: 145 500 0676
TAMUSA: 145 440 6709?
TAMUCT/TAMUT: 145 959 8925
TAMUC: 145 261 3887
Tarleton: 145 863 7222

Need a New ID Card?

Misplacing your insurance ID cards can be a pain when trying to go to an appointment or get a prescription! You can follow the steps for each insurance plan below to get a new ID card, and then keep them all in one place. MyEvive also has the ability to save images of multiple ID cards, so all you need is your phone and the MyEvive app the next time you need your card. 

Blue Cross and Blue Shield of Texas
1. Log in to your Blue Access for Members account at https://bcbstx.com/tamus
2. From your dashboard, click the image of the ID card on the left hand side.
3. You can print a paper copy of your ID card, or order one from this page!
4. If ordered, a new ID card will be mailed to the address on file within two weeks.

Express Scripts
Retirees on the 65 plus plan and their spouse will have separate ID Cards.
1. Log into your Express Scripts account.
2. Select the Account tab from the main menu.
3. Click Member ID Card.
4. Download your card from this screen.

Superior Vision
Although you are not always required to present your vision ID card, it is good to keep for your records.
1. Go to Superiorvision.com and select “Member Log in” in the top right.
2. Log in using your username and password.
3. From the home page, select Print ID Card from the menu.

All of these accounts can also be linked to MyEvive with single-sign-on capability! This means, once you log in through MyEvive once, you can go straight into your vendor account from the MyEvive app.

 

Using Express Scripts Mail Order

Express Scripts mail-order is a convenient way to get your prescription drugs delivered to your home and ensure you stay adherent to your medication by planning in advance. You will also receive reduced copays for getting a 90-day supply via mail-order rather than purchasing a 60-day supply at retail for eligible drugs.

Benefits of Using Mail-Order Services

One of the greatest problems associated with maintenance medications is adherence. Maintenance drugs are medications prescribed for chronic, long-term conditions that are taken on a regular, recurring basis. Using a mail-order service to refill your maintenance prescriptions is a convenient way to ensure you have enough of the medication delivered directly to your home. Express Scripts mail-order service provides the following benefits:

  • Get up to a 90-day supply of each covered medication for a lower co-payment – two copays rather than three (subject to plan limitations, rules, and state regulations, such as controlled substances).
  • Registered pharmacists are available 24 hours a day, 7 days a week.
  • Order refills online, by mail, or by phone – anytime day or night. To order online, register at www.express-scripts.com. Refills are usually delivered within 8 days after Express Scripts receives your order.
  • Choose a convenient payment option – check, money order, credit card, or Express Scripts automatic payment program
  • Automatic Refills
  • Standard shipping is free

Submitting a Prescription through Mail Order

Your 90-day mail-order prescription should be sent to:

Express Scripts, Inc. P.O. Box 650322 Dallas, Texas 75265-0322

Or, you may ask your doctor to call 1-888-327-9791 for instructions on how to fax the prescription to Express Scripts (ESI). Your doctor will need to use your social security number or ESI member ID number to complete the transaction. (Only doctors can fax prescriptions to ESI.)

Order Delivery Times

First-time orders arrive within 8 to 11 days. Refills usually arrive in less time – 7 to 9 days, however, you can call to request expedited delivery. At www.express-scipts.com you can review detailed order status information. The best time to reorder is when you have about a 14-day supply of your medication remaining. This will help ensure that the medication is received when it is needed.

Express Scripts Value-Added Programs

Express Scripts, the prescription drug provider for the A&M Care plans, has several value-added programs. These, and other Express Scripts programs, can be found on the System Benefits Administration website at https://www.tamus.edu/business/benefits-administration/prescriptions-express-scripts/.

Pulmonary Care Value Program

Express Scripts (ESI) created the Pulmonary Care Value (PCV) program to improve adherence since a large majority of asthma patients fail to take their medication as directed.

  • Patients must fill all pulmonary care maintenance medications as 90-day prescriptions from Walgreens, home delivery, or certain other local pharmacies. Express Scripts provides access to one-on-one support from a team of extensively trained clinicians through their Pulmonary Therapeutic Resource CenterSM (TRC).
  • High-risk patients will be offered remote monitoring devices to help optimize medication use and maximize their health. When monitoring shows that patients overuse their rescue inhalers or are not adherent to controller medications, pulmonary TRC pharmacists will reach out with individualized support.
  • Some members will also be offered the Mango Health app – a patient engagement solution that gamifies health and rewards patients for making healthy decisions

 

Diabetes Care Value Program

The Diabetes Care Value Program combines a quality-based pharmacy network and a holistic approach to diabetes patient care. The program applies to all A&M Care health plan members who purchase oral and injectable diabetes drugs as well as the diabetes blood glucose test strips. The program requires that:

  • diabetes-related prescriptions be filled with a 90-day supply rather than a 30-day supply, and
  • diabetes-related prescriptions be filled through Express Scripts Home Delivery (mail-order) or a Walgreens pharmacy (retail).

The two main goals of the program are better patient adherence to diabetes medications and control of rapidly increasing costs. Aside from specialty medications used to treat debilitating diseases such as multiple sclerosis or HIV, spending on diabetic medications is the next highest spend. Controlling health plan costs helps offset premium increases and benefit reductions.

It’s Easier than Ever to get Vaccinated for the Flu and Other Illnesses

It’s Easier than Ever to get Vaccinated for the Flu and Other Illnesses

Vaccinations are now available at many convenient retail pharmacies.

Did you know that adults with the flu can be contagious from the day before symptoms begin (typically 1-4 days), all the way up to 10 days after the illness starts1 and can spread the flu to others who are sitting up to six feet away2? And to top it off, one-quarter of Americans show up to work despite not feeling well.3

One of the best ways to avoid the flu and related complications is to get a flu shot. According to the Centers for Disease Control and Prevention (CDC), every year in the U.S. 200,000 Americans are hospitalized because of problems related to the flu4, and the single best way to prevent seasonal flu is to get vaccinated each year. CDC recommends a yearly flu vaccine for everyone 6 months of age and older.

To help you stay healthy, you can now receive vaccines administered at your local retail pharmacy, covered at 100%, through your A&M System prescription-drug benefit. These typically do not require an appointment and are the same effective medications as those from your physician’s office.

Along with protection from the flu, your prescription-drug benefit plan covers several other vaccines, which can be administered by pharmacists at participating network pharmacies:

  • Flu (seasonal influenza)
  • Tetanus/Diphtheria/Pertussis
  • Hepatitis
  • Human Papillomavirus (HPV)
  • Meningitis
  • Pneumonia
  • Shingles/Zoster
  • Travel Vaccines (rabies, typhoid, yellow fever, etc.)
  • Childhood Vaccines (MMR, etc.)

There are two ways to locate a participating pharmacy:

  1. Sign in at Express-Scripts.com and click Prescriptions, then Find a Pharmacy to search for in-network pharmacies convenient for you.
  2. Call the number on your Express Scripts member ID card to find a participating pharmacy near you.

Contact your network pharmacy in advance to inquire about vaccine availability, age restrictions, and current vaccination schedules. Also, don’t forget to present your member ID card to the pharmacist.

Are there other ways to prevent the spread of illness?

According to the CDC, everyday actions can help you stay healthy:

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. If soap and water are not available, use an alcohol-based hand rub such as Germ-X® or Purell®.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.
  • Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

1,4 WebMD: https://wb.md/2FmTI80

2,3 Newsweek: https://bit.ly/2o1CUvC

Diabetes Patient Assurance Plan

Diabetes Patient Assurance Plan

Did you know that many people with diabetes have to ration their insulin because they can’t afford to take it as directed? That’s why the A&M System and Express Scripts have partnered to bring down the cost of preferred insulin products for you and your family members living with diabetes.

Through the new Patient Assurance Program, eligible members will never pay more than $25 per 30-day supply of preferred formulary insulin products. That can mean more affordable access to insulin and fewer health emergencies. It’s already included in your benefit – so there’s no additional fee! Mail-order participants will continue to pay the standard, lower copay.

Questions about the Patient Assurance Program or your benefits? Contact Human Resources or  Express Scripts at 1-866-544-6970 for more information or details about preferred medications.