Frequently Asked Questions:
General
The University’s contract with its current TPA, Highmark, ends on December 31, 2017. It is standard business practice to complete requests for proposals on a periodic basis to ensure that employees and the University are benefiting from the most competitive prices and accessing high quality providers of healthcare.
Medical Benefits
Prescription Benefits
In the event your physician does not think a formulary drug would be comparable or equivalent, the doctor will need to request a prior authorization in order for you to continue use of the non-formulary drug. For a prior authorization to be considered by CVS Caremark, your doctor will need to certify that there either was a previous trial and failure of the formulary drug; or, you have experienced an adverse reaction to the formulary drug. Without a prior authorization, if you choose to continue to take your current medication, you will be responsible for the higher cost-sharing (co-insurance amount).
for drug cost information. Questions should be directed to CVS at (844) 462-0203
for the formulary listing, effective 1/1/2018.
Yes. Click here to find medication that will require prior authorization, effective 1/1/2018. After 12/1/2017, have your physician contact CVS Caremark at (844)-462-0203.
HealthEquity
Any FSA balance still remaining as of April 1, 2018 will be carried over (up to $500) and added to the account holder’s 2018 FSA balance and can be used for 2018 dates of service until exhausted. The carried over FSA funds will be accessible via the Health Equity debit card.
Beginning January 1, 2018, any FSA claims submitted for 2018 dates of service will be debited against the account holder’s 2018 FSA balance. The Health Equity FSA debit card may also be used to pay 2018 claims.
Unum (Life Insurance/Disability)
• You elected the optional life insurance coverage for the first time
• You requested an increase to your current optional life insurance coverage for more than 1x your salary
• You applied for the optional spousal life insurance coverage
• You increased your current optional spousal life insurance coverage
• You elected LTD coverage or elected to increase your LTD coverage with RIP
If a person is not pregnant in the 3 month window before the 1/1/18 effective date but then becomes pregnant after January 1, 2018, then this would NOT be considered a pre-existing condition.
The 12 months means that if I did have a pre-existing condition (i.e. insulin dependent diabetic) in the 3 months prior to your effective date of coverage (for example, 1/1/18), then any disability resulting from that Diabetic condition, would not be covered if the disability occurred in the first 12 months of coverage. Once you have been on the plan for at least 12 months, the pre-existing condition exclusion does not apply.