Anthem and the SBC are implementing a strategy designed to help members select the most effective and affordable prescription medications available.

Atorvastatin, a new generic drug for the brand name Lipitor, was recently added to the SBC’s drug list/formulary. Our goal is to encourage all members currently taking Lipitor to switch to Atorvastatin. This generic alternative costs less and is just as safe and effective as Lipitor.

Beginning April 1, 2012, the SBC pharmacy benefit will automatically cover Atorvastatin and will only cover Lipitor through its step therapy program.

Step therapy is a process whereby prescriptions are filled with an effective, but more affordable medication (Step 1). When appropriate, a more costly (Step 2) medication can be authorized by a physician if the Step 1 prescription is not effective in treating the condition.

Letters explaining this change have been sent out to all members that currently have a prescription for Lipitor.

For members using home delivery, Express Scripts will continue to dispense Lipitor from its home delivery pharmacy using the standard house generics program. However, in July Express Scripts will begin to dispense generic Atorvastatin from its home delivery pharmacy. At this time, prescriptions for brand name Lipitor will require step therapy depending on the member’s pharmacy benefits.

Questions?

If you have any questions about this change, please contact:

Rachel Smith
Capstone Benefits Group
rsmith@capstonebenefits.com
317-328-7880, ext. 132

For a variety of reasons, there is often a lag between when medical claims are incurred and when they are paid. You should note that claims incurred prior to the transition to Anthem (prior to 1/1/2012), will be processed and paid by Principal.

Although the number of “run-out” claims will decline each month, we wanted to let you know that Principal will soon transition Trust claims payments to its Springfield, IL office. Click here to access a pdf document with the contact information for this new office. We recommend that you share this with your employees.

Please contact Carol Jobe if you have any questions.

Carol Jobe
317-328-7880, ext. 135
cjobe@capstonebenefits.com

As we noted in previous correspondence, the SBC intends to thoroughly review the Wellness program that is currently in place with Principal Wellness Company.   With Principal exiting the health insurance business and the Trust’s transition to Anthem, this is a good opportunity to determine how well the wellness program is functioning for members of the SBC.

Recently, we formed an eleven member panel of Human Resource representatives from member co-ops and the Trust’s benefits consultants.  The panel met on January 12^th to develop a set of criteria by which we will screen potential wellness vendors.  At this time, bid specifications based on those criteria are being developed and will be sent to potential wellness vendors.  The panel will meet again in the coming weeks to review a list of finalist and determine if a change of vendors from the Principal Wellness Company is warranted.  We hope to have a final decision on the ongoing wellness vendor sometime in April.

It is important to note that a decision to terminate the relationship with Principal has not been made.  So, with that in mind, we suggest you proceed with the current wellness program as follows:

1. Do not schedule screenings with Principal or distribute take home kits to your employees.  If the Trust chooses a different vendor they will assuredly want to conduct their own screenings.
2. Other than the screenings, we would suggest that you continue to distribute any information Principal Wellness sends to you.  In essence, keep doing what you have been doing in case we decide to stay with Principal.  Likewise, any health related information is good information.

Finally, it is important to remember that your  wellness rate credit for 2012 was established during 2011.  The 2013 credit will be established  during 2012 and the Trust will make certain that accommodations are in place so that you will be able to earn the full credit for 2013.

Rachel Smith is currently on maternity leave and will be returning to the office in March.  In the meantime, if you have any questions about Wellness or the SBC in general, please feel free to contact Carol Jobe or Drew Tomasik at 317-328-7880.  Thank You.

The Anthem web site has wonderful information, tools and tips to help your employees manage their health plan and manager their health. Below, you will find links to materials that you can share with your employees to help them get started using this valuable resource:

Login Instructions

Website Overview

Finding a Provider

RX Tools

Special Offers

Website Tutorials

These material have also been posted on the home page of the Statewide Benefit Cooperative web site: www.isabenefits.org

Through Express Scripts, you can easily manage all of your mail order prescriptions online. To get started:

1. Login to the Anthem web site at www.anthem.com <http://www.anthem.com>. If you don’t have a login, click on “Register Now” below the login area and follow the instructions

2. After logging in, click on “Order Refills” and then click through to get to the Express Scripts web site.

Once there, use the menus on the left to:

* Order Refills
* Set-Up Auto Refills
* Fill a New Prescription
* Check Order Status
* Check Prescription Requests Made to Your Doctor
* See How to Save on Prescriptions
* View Prescription History

The site also provides other helpful information about prescription drugs and your prescription drug plan.

Express Script’s GenericSelect(tm) program lets members try certain generic drugs and get their first prescription at no cost. By selecting a generic, members get the same type of medicine they need, but it most often costs less. Click here to download a brochure about this program that you can distribute to your employees.

We have posted a transition timeline for Anthem to help you stay informed on important upcoming dates. Please visit www.isabenefits.org and download the timeline from the homepage (you will find it located in the yellow box on the right-hand side).

Check back frequently for updates as we continue through this transition.

If you purchase long term disability (LTD) insurance through the SBC for your employees, new summary plan descriptions were mailed to you recently to distribute to your full-time participating employees. These booklets we reprinted to incorporate two riders for changes that had been previously made. You may recall that the SBC went to a new LTD contract on January 1, 2009 and also increased the maximum to $10,000 on July 1, 2009.

Please let us know if you have any questions. Thank you for distributing these booklets to your employees.