C and O Employees' Hospital Association
JANUARY 1, 2013
PLEASE DESTROY YOUR FORMER INFORMED RX PRESCRIPTION DRUG CARDS AND BEGIN USING THE NAVITUS PRESCRIPTION CARD
Navitus Health Solutions, LLC ("Navitus")
You should have received notification earlier this year regarding a change to your prescription drug plan. Effective January 1, 2013, your prescription drug coverage will be managed by Navitus. Your new prescription ID card will be mailed under separate cover. You must present this card to the pharmacy when you fill a prescription. For information regarding your prescription drug copayments, please refer to the enclosed Summary of Benefits and Coverage.
There will be no change to the benefits provided under your current prescription drug program. Navitus is contracted with the same retail pharmacies currently utilized by our membership. You will not have to get new prescriptions for the retail pharmacies. We are enclosing a listing of the Navitus network pharmacies (national and regional chains). The Navitus network also includes the independent pharmacies utilized by our membership such as: Stultz, Big Four Drug Store, Owens and Brothers & Brown. Some of the local retail chain pharmacies such as Walmart, Kroger, Rite Aid, CVS and Target will handle 90-day fills for the same copayments as the mail-order copayments. There are also a few independent pharmacies that have agreed to do this.
Navitus offers a mail-order service through WellDyne Rx for your convenience for up to 90-day fills of maintenance medication. We are enclosing a WellDyne Rx Prescription Drug Program Mail Service Form. Mail-order prescriptions will arrive within 7-10 business days. You will need new prescriptions for the mail-order program.
For information regarding your formulary (a list of covered drugs), you can call us or visit the Navitus website at www.navitus.com>Members>Member Login.
Navitus offers a tablet splitting program which saves you money by breaking a higher-strength tablet in half to provide the needed dose. You will receive the same medication and dosage while purchasing fewer tablets and saving on your copayment. You can check with your pharmacist or physician to see if tablet splitting is right for you. They can assist you in getting your prescription changed to one that can be split. Not all medications are appropriate for splitting. Tablet splitting is not required, but is simply offered to you as a way to control costs.
We are listing below the medications that are appropriate for splitting:
Abilify escitalopram tab (Lexapro equiv)
Actos Exforge Tab
Azilect irbesartan tab (Avapro Tab equiv)
Baraclude Januvia (QL=1 tab/day)
Bystolic Lexapro Tab
Crestor Tab (QL=1 tab/day) Lipitor Tab
Crestor Tab 20 MG (QL=1.5 tab/day) olanzapine tab (Zyprexa equiv)
Diovan Tab Vesicare
If you would like to receive a free tablet splitter, please call COEHA Customer Service.
If you have any questions, please call COEHA Customer Service toll-free at 1-800-679-9135 or if you are a local resident at 862-5728.
Kenneth R. Farley
GRANDFATHERED HEALTH PLAN UNDER THE PATIENT PROTECTION AND AFFORDABLE CARE ACT
The C and O Employees’ Hospital Association believes our plan is a "grandfathered health plan" under the Patient Protection and Affordable Care Act ("the Affordable Care Act"). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. A grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans. For example, the requirement for the provisions of preventative health services without cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits.
Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from a grandfathered health plan status can be directed to the plan administrator at 1-800-679-9135 or locally in the Clifton Forge, VA area at 862-5728. You may also contact the Employee Benefits Security Administration, U. S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans.