Educate employees about their benefits with the January Benefits & Me Newsletter.
Optima Pharmacy & Vendor Changes
Effective January 1, 2023, Optima changed their pharmacy benefit manager (PBM) from OptumRx® to Express Scripts (ESI). These changes went into effect on January 1 regardless of a group’s effective date, and all members were sent new ID cards in December.
These changes impacted some pharmacy networks, and communications were sent out by Optima to members who were using Kroger Pharmacies. Kroger Pharmacies include Kroger, Harris Teeter, Fred Meyer Pharmacy, Payless Pharmacy, Pick N Save, Ralph’s Pharmacy, Smith’s Food and Drug, and Smith’s Pharmacy.
Valley Health Returns to Optima Network
Valley Health is re-joining Optima's network effective January 1, 2023. Valley Health is now in-network for all Optima Health products, including Medicare, Medicaid, Group and Individual products.
Valley Health hospitals, primary care providers, and specialists are located in the northern Shenandoah Valley of Virginia and the eastern panhandle of West Virginia. Optima Health and Valley Health have enjoyed a strong partnership for more than 15 years, providing access to high-quality care for members throughout the region.
Blue Cross NC Offering Identity Theft Protection to Members
As an added precaution and benefit to their members, Blue Cross NC is making identity protection services available to eligible members and their dependents. Subscribers (the person who holds the eligible medical health plan policy) and dependents on their policy are eligible for identity protection services, including those insured through an employer or those who purchase their own individual medical coverage.
Mary Washington Healthcare Leaving Anthem's Network March 2023
Anthem and Mary Washington Healthcare have been working on contract negotiations for several months but have not come to an agreement. Starting March 1, 2023, employees may pay more for care they receive from Mary Washington doctors and facilities.
Anthem is recommending members consider scheduling or re-scheduling any elective procedures at alternative in-network facilities. If Mary Washington does leave the Anthem network, those procedures would be billed by the hospital at higher rates, which would adversely affect members.
You can click here to learn more about this, as well as find other in-network doctors and facilities.
The information herein should not be construed as legal or tax advice in any way. This content is provided for informational purposes only. You should seek the advice of your attorney or tax consultant for additional or specific information.