Empire BCBS Small Group Transition to New Pharmacy Benefits Manager

Starting January 1, 2020, Empire pharmacy benefits will be managed by Ingenio Rx. To ensure a smooth transition, Empire will be providing notifications to Small Group policyholders with several mailings to introduce Ingenio Rx and provide information on any changes that will occur.  What to expect after the transition: Improvement in care coordination Closed coverage… Read More

Horizon BCBSNJ Broker Education Webinar Series: IHC Medical Products 2019-2020

Horizon will be offering an upcoming broker webinar to discuss IHC Medical Products for 2019-2020.  If you would like to attend this webinar please register below by clicking on the link for the date and time you prefer then click “Register“. On the registration form, enter your information and then hit “Submit“. Thursday, October 24,… Read More

Horizon BCBSNJ Creditable Coverage Notices, Applies to All Markets

Horizon BCBSNJ Creditable Coverage Notices, Applies to All Markets Date: 9/25/19   Groups that offer prescription drug coverage to Medicare-eligible employees and their dependents are required to notify those employees and dependents whether their coverage is creditable or non-creditable. Notifications must be sent before the 2020 Medicare Annual Election Period, which begins on October 15,… Read More

Empire Has Reached an Agreement with Westchester Medical and Bon Secours 

As a result, effective immediately, all Westchester Medical and Bon Secours hospitals and affiliated physicians will rejoin Empire’s network of participating providers under a new multi-year agreement that is retroactive to June 1, 2019. (As previously communicated, these hospital systems had left the Empire network on June 1, 2019) That means that all Empire members… Read More

Horizon BCBS NJ Hospital Network Continues to Expand

Horizon Blue Cross Blue Shield of New Jersey has announced that Bergen New Bridge Medical Center (formerly Bergen Regional) in Paramus, New Jersey, is now part of the Horizon Hospital Network. This agreement allows Horizon BCBSNJ members to access care at an in-network level of benefits, getting the most out of their coverage, while keeping… Read More

Oxford Risk Management Audit/Eligibility Verification Update

Email Sent: 7/10/19 As previously communicated by Oxford, going forward Oxford will require strict adherence to the deadline for a group under a Risk Management Audit to submit documentation to Oxford confirming eligibility for renewal. Oxford will no longer have any flexibility in the process as per their legal team. Below is an example of… Read More

Amerihealth’s Local Value Network enhanced with the addition of Summit Medical Group and Penn Medicine

Email Sent: 6/27/19 Effective July 1, 2019, in addition to Children’s Hospital of Philadelphia, AmeriHealth’s Local Value Network will offer even more value as AmeriHealth welcomes Summit Medical Group for all segments and Penn Medicine for Small and Large group segments only. With this addition, AmeriHealth’s Local Value Network has over 90% overlap when compared… Read More

MinuteClinic® Services Now Available at No Cost* to Members

Email Sent: 6/19/19 Aetna has announced that they are now offering members access to MinuteClinic® services at no cost to them. They are currently offering this benefit to self-funded customers only. The benefit is scheduled to become available to Small Group AFA effective September 1, 2019 and all other segments effective January 1, 2020. Access… Read More