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New Year Brings Changes to Health Insurance

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Employees who receive health care benefits through the university have already noticed the biggest change that’s taking place when USNH switches to its self-insured medical plan on Jan. 1: they’ve received new membership and prescription drug identification cards. If you haven’t received yours yet, not to worry, they’re in the mail.

For non-union employees the health insurance cards look nearly identical to those issued last year by Harvard Pilgrim. What’s different? The information in the top right corner that lists the plan option (HMO, POS, PPO) now also reads “with deductible” ($200 individual, $400 family).

What’s missing is the prescription charge information. That’s because Harvard Pilgrim is no longer the provider. The drug program is now being offered through CVS Caremark, but that doesn’t mean employees have to use CVS pharmacies to get their medications. This is an area that has generated some confusion so it’s worth repeating: prescriptions can be filled at any of the 64,000 pharmacies in the Caremark network. Simply present your CVS Caremark prescription card���not your Harvard Pilgrim card.

Each employee received two cards with the employee’s name on them to be used for any dependent covered on your plan. Additional cards for dependents may be requested after Jan.1 by calling CVS Caremark at 866-768-4252 or emailing customerservice@caremark.com. Customer care is available 24 hours a day, 7 days a week.

CVS Caremark also has a mail service pharmacy. Existing prescriptions with the current mail in service will be transferred to CVS Caremark effective Jan.1. Any new prescriptions in 2012 can be filled through CVS Caremark mail in service by using the form provided with your new card.

You will continue to pay for generic, preferred, and non-preferred brand name medications depending on prescription’s tier classification. Copayment amounts are not changing. For more information about CVS Caremark, visit https://www.caremark.com/wps/portal.

Harvard Pilgrim will continue to administer the benefits and process claims. Health care claims and administration costs for employees and their dependents will be paid from the USNH operating budget instead of paying an insurance company. For more information about changes to Harvard Pilgrim plans, go to http://www.usnh.edu/hr/pdf/medical/USNH_StaffPlanComparison.pdf.

USNH employees can still take advantage of the annual $500 (per family) gym membership benefit at participating fitness clubs. Starting in 2012 this benefit is considered taxable income, due to IRS changes.

Wellness Connection is bringing back rewards for working out. Exercise 30 times, enter it into your online account, and choose a gift card. To log in to your account, or to create an account, visit https://www.usnhwellnessconnection.com/index.php.

New for 2012 is Tandem Health Advantage, a personal health care shopping service that provides financial incentives for making smart health care decisions. Before scheduling a doctor-ordered test or outpatient procedure, call Tandem. A nurse will tell you which provider has the lowest cost and how much you can earn as a reward for using a lower cost facility.

For more information visit www.tandemcare.com or review the information included with your new health insurance cards. Put your new Harvard Pilgrim card in the Tandem card sleeve. Next time you need a procedure, call Tandem. Save some money for USNH and put some money in your own pocket.