Agenda - 10-03-2006-5e - Laserfiche WebLink

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~3 Mr. John M. Link, Jr. - 2 - August 10, 2006 As requested, the following detail discusses the individual items outlined in your letter: Enrollment Kits -The Welcome Kits were labeled as Enrollment Kits and we apologize for the confusion this labeling caused for your employees. As a companion to the kits being mailed directly to employees, the NCACC held 22 separate informational meetings for Orange County employees prior to the mailing. ,During these meetings your employees were informed that they do not have to re-enroll and were provided the opportunity to receive answers to their questions on all aspects of the transition. It is highly likely that, for those employees who did not attend, this would have caused confusion. When we designed the envelopes, the majority of our counties were going through enrollment for 7/1, and it is understandable how this could confuse our off-cycle members. Missing C~ -The NCACC provided each member group a list of every employee and covered dependent that had an ID card printed along with the address that we had in the system. CIGNA assured us that, if a person was present on this list, they were sent an ID card. We sent this list to the HR contact at each Member Group in advance of the ID cards being mailed so that they could review and make note if any employee or dependent was missing. The County was given the option to call the NCACC and have temporary ID cards created and new ID cards prompted. Even if correct on the list, however, we did find that the new ID cards, which were sent in CIGNA labeled envelopes to our members, were often thrown out because employees did not recognize what they were receiving. We looked at the ability to review the list ahead of time as an enhancement because prior to July 2006, the NCACC was not given access by BCBS to a list of IDs nor the ability to print temporary ID cards. Card Confusion -The Pool is evaluating creating custom ID cards for the next fiscal year. CIGNA is also a Pharmacy Benefit Manager (PBM), and we hesitated to include co-pays on the front of the card for fear that the pharmacy would be confused and file the Rx claim with CIGNA instead of Caremarlc. It is incumbent upon the pharmacists to note the Caremark logo on the front and the Caremark contact information on the back of each card. We have found that, once the pharmacist figures this out and successfully gets a Rx claim through to Caremark, the rest of the process has gone smoothly. Likewise, all participating NC pharmacies were sent a faxed copy of the County Health Plan ID card and instructions on how to file claims with our plan. Michael Edmonds stated to Michelle Love that the pharmacy issues were resolved with one phone call-that the issue was really one of confizsion on the part of the pharmacist. Either way, the NCACC is looking to better the customized card for next year as a result of the confusion this year. Customer Service Misinformation -The customer service toll-free lines at CIGNA and Caremark were open on June 1 and June 16"' respectively prior to the transition for employees to call for clarification. Individual plan design information, specific to each employee, was not "live" in either of their systems until ?/1/06, the effective date of the Plan. As a result, in some instances CIGNA did give out general CIGNA plan information during that time and during the first week following the transition, as did Caremark. CIGNA had to get up to speed-that they were only the claims administrator for medical and that Caremark was the handling the pharmacy claims as our new PBM. If the caller is asking CIGNA if/how the drug was covered, they are going to say that CIGNA doesn't cover pharmacy: The omission was that CIGNA should have forwarded the caller to Caremark. If a caller gets the NCACC information line at CIGNA, they are prompted to press " 3" for pharmacy questions and are directed to Caremark. As a new administrator fresh to the program, there is some degree of human error we should expect the first couple weeks of the program. This particular issue