Heads-Up: Benefits Changes are Coming

By County magazine

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The TAC Health and Employee Benefits Pool (TAC HEBP) on Oct. 1 will roll out important prescription benefits changes to its members, more than 43,000 Texas county and district personnel across the state.

Pressed to tackle rising prescription costs head-on, the TAC HEBP Board negotiated a new pharmacy benefits manager (PBM) contract with Navitus Health Solutions. Navitus provides Rx benefits for over 5 million people nationwide and has 5000+ in-network pharmacies in Texas.

“The changes will help our members’ county and district operations through lower costs and expanded budget flexibility,” said TAC Health Benefits Services Director Quincy Quinlan. “They will also allow TAC HEBP to continue to improve the quality of coverage options it provides.  TAC HEBP’s goal is to provide the highest quality health care coverage at the best long-term cost possible to Texas county entities.”

While TAC HEBP’s average member contribution rates have remained well below the market trend for almost two decades, the cost of health coverage has continued to rise. New, extremely high cost specialty drugs and expensive brand name drugs, compared to their generic equivalents, contribute significantly to increasing health care premiums. Those costs have a direct effect on ever-tightening county budgets. The prescription benefits changes are in response to these challenges.

NEED TO KNOWS FOR TAC HEBP MEMBERS:

• The new PBM will continue to allow members to choose a preferred pharmacy.

• Every TAC HEBP member will receive a new ID card.

• In some cases, the PBM will communicate directly
with doctors, pharmacists and individual TAC HEBP members regarding current prescriptions to help meet patient needs.

• In some cases, a patient may be asked to accept the generic equivalent of a name brand prescription (if available). A generic equivalent medicine is the same as a brand name medicine in dosage. The Federal Drug Administration (FDA) requires that the generic version be as effective, pure and stable as the original drug. Generic drugs may differ in color, shape, taste, and packaging, but they work the same as the brand name drug. Even though some drug changes will be required or recommended, your medication decisions will still be guided by you and your doctor. 

These enhancements complement the wide range of services already available to all TAC HEBP members, such as Medicine Match reduced prescription copays (for patients with asthma, diabetes, high cholesterol and high blood pressure), Retail 90 (a 90-day supply for the cost of two copays), the Healthy County wellness program, condition management and more.

MORE INFORMATION AVAILABLE

Members with questions about this pharmacy benefit change can contact their county or district’s Pool coordinator, their HR/benefits manager or visit the Navitus website at www.navitus.com. Beginning Sept. 5, members will be able to contact Navitus Customer Care directly at (866) 333-2757.
 


Effective Oct. 1, TAC HEBP is pleased to offer these additional programs to its services:

VISION COVERAGE THAT’S EASY TO USE

TAC HEBP has implemented a voluntary vision coverage program, through Dearborn National/EyeMed. Members have the freedom to choose any in-network provider for any contact lenses, any glasses frame and any lens with no unnecessary restrictions. 3D virtual try-on technology also allows members to shop right from their homes. The vision program has competitive rates and no claim forms to file.

TELEMEDICINE FOR YOUR CONVENIENCE

With MDLIVE, TAC HEBP members are able to connect and interact online with doctors or therapists for general health, pediatric care and behavioral health concerns. Immediate or appointment-based care is available 24 hours a day, seven days a week via website, mobile app or phone. If the doctor prescribes medication, it will be sent electronically to a pharmacy of your choice.