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

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Attachment 1 Page 3 of 3 ~~ the Pool investigated the cost of recreating this program, we decided that our money was better spent in other ways. BCBS's program is due to expire this December. • Blue Points -The Blue Points exercise and "get free stuff 'program does not currently exist with the County Health Plan, although we will be rolling out the County Lifestyles program in the 2007, which will be more geared to our Counties and their wellness initiatives. Retail Dispensing Quantities - At retail, your prescription drug benefit is available for up to an initia130-day supply. According to BCBS they allowed some maintenance drugs to be filled more often and in some cases for up to a 90 day supply. The NCACC will allow up to a 90-day supply, but only through our Caremark Mail Order program. You are limited to a maximum of 30 days at a time at retail. Vision - Your ID card does not have vision listed on it as the plan includes vision for all members. It also does not list your pharmacy co-pays, so that the pharmacist would not confuse CIGNA with Caremark and send a drug claim to CIGNA. • .Participating Provider Network Differences -Aside from the physician disruption between CIGNA and BCBSNC, which both CIGNA and CAPE are working to eliminate, there are other areas where a new or different network for health care services will be applicable with the County Health Plan. See examples below: Dialysis Centers -BCBS has and exclusive arrangement with the corporate dialysis centers called BMA. CIGNA uses several different facilities and has contracts with Gambaro and Dialysis Care CIGNA Behavioral Healthcare - CBH provides the mental health benefits for the program, whereas BCBSNC used the Magellan Behavioral Health network. Durable Medical Equipment -CIGNA uses several different local facilities and has contracts with APRIA Healthcare and several others. In-network optical centers - In order to receive discounts for eye glasses and contact lenses, these items must be provided by a "Health Rewards" network provider. CIGNA uses several different opticians and has contracts with Pearle, Target, Sears, and several others. While it was our intention to make this program as close to the former program as possible, we were not able to replicate everything. However, we did strive to include some very important program enhancements, while making sure your plan designs were the same. Financially, we are striving to spend your healthcare dollars on the items that make the most sense and provide the best services.