2022 UnitedHealthcare and CVS Caremark and Rx Savings Solutions Benefits Overview - Replay link: ...
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2022 UnitedHealthcare and CVS Caremark® and Rx Savings Solutions Benefits Overview Replay link: https://onlinexperiences.com/Launch/QReg/ShowUUID=0FA75F01-3540-44C0-9981-235A585A3C85 September 23, 2021
Presented by:
Anthony Arato, Sr. Client Manager
Get to know Presented by
your benefits. Anthony Arato, Senior Client Manager
9126775.1 8/19 19-13383 1
Welcome
What You Should Know for 2022
Advocate4Me Elite
2022 Medical Plans Overview
Key Terms
Preventive Care
Virtual Visits
UnitedHealthcare Broad and Narrow Networks
Transition of Care
Digital Features
myuhc.com
Finding a Network Provider
Premium Providers
Clinical Support
Programs & Services
Questions?
3
What You Should Know for 2022
• The $900 Deductible Plan has been eliminated for 2022.
The following three medical plans will continue to be offered in 2022.
$400 Deductible Plan
$1,500 Deductible Plan (HSA Compatible)
$2,850 Deductible Plan (HSA Compatible)
You will receive a new ID card if this is the first time you are enrolling in
UnitedHealthcare coverage or if you change your elections at annual
enrollment (such as switch plans or add a dependent). Your new ID card
will be sent prior to January 1st.
• New Pharmacy Benefit Manager for 2022 CVS Caremark® (see details in
CVS Caremark section).
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 4
Advocate4Me® Elite Service, support and access that goes above and beyond
Contact us for help with a personal touch
Phone: Call the member number at 866-540-5954
Chat: Log on to myuhc.com® and click the “Call or Chat” button
We’re available Monday through Friday 8am-8pm. You can also call anytime to speak with a Nurse.
5
2022 Medical Plans Overview – Broad and Narrow Networks
Service $400 Deductible Plan
Deductible (Individual/Family) (Embedded) INN: $400 / $800
OON: $2,500 / $5,000
Out-of-Pocket Maximum (Individual/Family) INN: $2,200 / $4,400
*includes deductible and copayments
*includes Rx (Embedded) OON: $4,400 / $8,800
General Coinsurance INN: 80%
OON: 60%
Office Visit – Preventive INN:100%, no deductible
OON: 60%, after deductible
Office Visit – INN: $20 copay
Primary Care OON: 60%, after deductible
Office Visit – Specialist INN: $40 copay
OON: 60%, after deductible
Outpatient Surgery INN: 80%, after deductible
OON: 60%, after deductible
Hospital INN: 80%, after deductible
OON: 60%, after deductible
Emergency Room (waived if admitted) INN/OON: $150, then 80% after deductible
Urgent Care / Convenience Care INN: $50 copay
OON: 60%, after deductible
INN: In-Network
OON: Out-of-Network
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 6
2022 Medical Plans Overview – Broad and Narrow Networks
Service $1,500 Deductible Plan (HSA $2,850 Deductible Plan (HSA
compatible) compatible)
Deductible (Individual/Family) (non- INN: $1,500 / $3,000 INN: $2,850 / $5,700
Embedded) *includes Rx OON: $3,000 / $6,000 OON: $5,700 / $11,400
Out-of-Pocket Maximum INN: $3,000 / $6,000 INN: $5,500 / $11,000
(Individual/Family)
*includes deductible and copayments OON: $6,000 / $12,000 OON: $11,000 / $22,000
(non-embedded for $1,500 Plan,
embedded for $2,850 Plan)
*includes Rx
General Coinsurance INN: 80% INN: 70%
OON: 60% OON: 50%
Office Visit – Preventive INN: 100%, no deductible INN: 100%, no deductible
OON: 60%, after deductible OON: 50%,after deductible
Office Visit – INN: 80%, after deductible INN: 70%, after deductible
Primary Care OON: 60%, after deductible OON: 50%, after deductible
Office Visit – Specialist INN: 80%, after deductible INN: 70%, after deductible
OON: 60%, after deductible OON: 50%, after deductible
Outpatient Surgery INN: 80%, after deductible INN: 70%, after deductible
OON: 60%, after deductible OON: 50%, after deductible
Hospital INN: 80%, after deductible INN: 70%, after deductible
OON: 60%, after deductible OON: 50%, after deductible
Emergency Room (waived if admitted) INN/OON: 80%, after deductible INN/OON: 70%, after deductible
Urgent Care / Convenience Care INN: 80%, after deductible INN: 70%, after deductible
OON: 60%, after deductible OON: 50%, after deductible
INN: In-Network
OON: Out-of-Network
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 7
Preventive care is
covered 100 percent
in our network.
For more information, check your plan documents.
For a list of preventive care guidelines, visit uhc.com/preventive care.
8
Preventive Care
Preventive Health Care Coverage
Preventive care is covered at 100% in-network
• Immunizations and wellness visits for children
• Adult Screenings
• Prostate Cancer Screening
• Colorectal Cancer Screening
• Mammography/PAP Smear
• Age and frequency may apply reference your plan
documents for details or visit uhc.com/preventive
care.
No Deductible
A preventive health visit can help you see how No Copayment
healthy you are now and help identify any health No Coinsurance
issues before they become more serious. You and 100% Coverage
your doctor can then work together to choose the
care that may be right for you.
9
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 9
Virtual Visits
AmWell®, Doctor on Demand® and Teladoc®
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 10UnitedHealthcare Broad (Choice Plus)
Network
UnitedHealthcare
Passport Connect® with Harvard
Broad (Choice Plus) National
Pilgrim
Network
Ability to access Harvard Pilgrim and UnitedHealthcare No matter where you are in the country, a
networks
• If you receive care in the Harvard Pilgrim network service UnitedHealthcare network doctor, pharmacy,
area, you receive network benefits from Harvard Pilgrim hospital and convenience care clinic are likely
network
• If traveling and receiving care outside the Harvard nearby.
Pilgrim network service area, you receive network
benefits when you use UnitedHealthcare’s network
The UnitedHealthcare network covers
99% of the U.S. population and is
available in 96% of all U.S. counties.
Combined Features
• Access to myuhc.com • Search for a doctor or hospital at
• Co-branded health plan ID card www.myuhc.com®
• Call the number on the back of your health
plan ID card for help from myNurseLineSM or
Customer Care
• Use UnitedHealthcare Health4Me™ on your
smartphone
*Residents of MA, ME or NH ( Harvard Pilgrim Network Area)
11
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 11UnitedHealthcare Narrow (Core) Network
UnitedHealthcare Narrow (Core) Medical Plan Network
UnitedHealthcare’s Narrow Network (Core) benefit designs feature a smaller, more focused
network.
Narrow (Core) networks plans offer the same services and tools of other UHC health benefit plans.
• 181,400+ primary care physicians
• 379,400+ specialists
Visit – www.myuhc.com (do not sign in)
Choose - Find a Provider
Choose “Core” Network
Validate your Provider is in-network
Note: Before searching for providers, be sure to check that your home zip code is eligible for the Narrow Network in your benefits
enrollment website.
Available to Residents in NY,NJ,MD,DC,VA,SC,GA,AL,FL,TN,MI,*IL,*IN,MO,TX,CO,CA,OR,WA,AK, MS and AR. For 2022 KS, MI have been
added to the service area.
*IL & IN: Core available within Chicago (Boone, Cook, DeKalb, DuPage, Grundy, Iroquois, Kane, Kankakee, Kendall, Lake, La Salle,
McHenry, Will and Winnebago counties) and NW Indiana (Lake, La Salle and Porter counties) only
12
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 12Transition of Care
Transition of care gives new UnitedHealthcare members the option to request extended
coverage from their current, out-of-network provider at in network benefits for a limited time
due to a specific medical condition.
o Some examples include 3rd trimester of pregnancy and/or high risk
pregnancy or non-surgical treatment for cancer (radiation/chemotherapy).
• A member must call UnitedHealthcare Customer Service to initiate the process. If the
preliminary criteria is met, a Transition of Care application will be mailed to the member
to be filled out and returned.
• The Transition of Care application must be made within 30 days of the effective
date of coverage.
• Examples of conditions that do not qualify for Transition of Care include:
o Chronic conditions such as diabetes, arthritis, asthma, kidney disease,
and hypertension that are stable.
o Elective scheduled surgeries.
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 13Digital Features: Go digital and get the
most out of your benefits.
Activate your myuhc.com account after enrolling
and gain access to:
• Find network providers and locations.
• Check account balances.
• View and pay claims.
• Estimate costs for care.
• Learn about covered preventive care.
14myuhc.com: Home Page and Log In
*Find care and costs, including virtual care.
*Review plan information, including deductibles and copays/coinsurance.
*Access health and wellness programs and resources.
*Check on claim status and pay bills.
*Contact UnitedHealthcare, including 24/7 nurse support (live or chat).
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 15Finding a network provider: 3 easy ways to find a
network provider.
Look for the “Find a Doctor”
1 button on myuhc.com®
Call the number on your
2 health plan ID card
Search using the
3 UnitedHealthcare® mobile app
16Want to save?
Use network providers.
Network providers help you save because they provide services at a contracted rate.
UnitedHealthcare’s Covered services
networks include: include1:
978,000+ Doctor office visits
physicians and
health care professionals*
[Prescription drugs]
6,100+
hospitals*
67,000+ Hospital care
pharmacies**
And more
*UnitedHealthcare internal analysis Q2 2019
**As of 3/31/17. Facts 2017 Q1 UnitedHealth Group.
1 This is not the complete list of covered services. For more details, see your official health plan documents.
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 17Premium Providers: Promoting Quality &
Affordability
The UnitedHealth Premium® program evaluates doctors for
quality and cost efficiency to help you choose a doctor with
confidence.
The Premium Care Physician blue hearts symbol will help you
find doctors who have been recognized for following evidence-
based medicine.
18
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.HEALTH4ME
Clinical Support
Call us any time
You may contact the nurse team at
any time if you have questions
about:
• Your health and prescription
benefits
• A new diagnosis
• Finding a primary care physician
• A medical claim
Simply call 1-866-540-5954
for help with any questions related
to your health care. We are here
for you.
19
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 19Programs & Services
Cancer Resource Services
• Personal support from an experienced cancer nurse.
• Help understanding your diagnosis.
• Information to help you make decisions about your care.
Spine and Joint Solution
• Designed to improve surgical outcomes, reduced repeat
hospital visits and more.
• Connect 1-on-1 with experienced orthopedic nurses for
answers to your health questions.
• Understand treatment costs and how you could save
money
• Included as part of your health plan at no additional cost.
• Learn more at myuhc.phs.com/sjs
Asthma Support Program can help you:
• Manage your asthma.
• Avoid triggers.
• Reduce hospital stays.
• Reduce missed days at work or school.
20Programs & Services
Diabetes Support Program
• Connect with experts who can help you:
• Manage your diabetes.
• Manage your medications.
• Improve your diet.
• Exercise.
Bariatric Resource Services Program
• Get education and support before and after weight-loss surgery.
• Our nurse care managers will be there
to help you along the way.
Fertility Solutions Program provides:
• Access to trained fertility nurses who will answer questions and help explain treatment
options.
• Help with finding network doctors, clinics and facilities that are right for you.
• Support in navigating the healthcare system and how to best use your health benefit.
Autism Benefit Management:
• Dedicated doctorate and board-certified behavior analyst-led master’s-level team
• Network of more than 7,900+ ABA practices
• Online tools and resources via liveandworkwell.com
21Key Terms
Deductible
The amount you owe for health care services before your medical plan begins to pay. For example, if
your deductible is $400, your plan won't pay anything except for preventive services until you've met
your $400 deductible for covered health care services subject to the deductible. The deductible may
not apply to all services.
Non-Embedded Deductible - “True Family” (applies to only the $1,500 Deductible
Plan)
The family deductible must be met before anyone in the family can receive benefits. The
combined total of eligible expenses of all family members must equal the family deductible before
any plan benefits are paid for any one member.
Embedded Deductible - Not “True Family” (applies only to the $400 and $2,850
Deductible Plans)
With embedded deductibles a member can satisfy his or her individual deductible for coverage and
coinsurance to apply. When a family member on the plan meets his or her individual deductible,
plan benefits and coinsurance will apply to subsequent claims for that member.
Co-insurance
Your share of the costs of a covered health care service, calculated as a percent (for example,
20%) of the allowed amount for the service. For example, if the health insurance or plan's allowed
amount for an office visit is $100 and you've met your deductible, your co-insurance payment of
20% would be $20. The health insurance or plan pays the rest of the allowed amount.
Out-of-Pocket
The most you pay during a policy period before your health insurance or plan begins to pay 100%
of the allowed amount. This limit never includes your premium, balance-billed charges or health
care your health insurance or plan doesn't cover.
22Questions?
Learn more:
UnitedHealthcare Call
Center
1-866-540-5954
Proprietary information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. 23Your 2022 Prescription Benefit Overview Presented by: Sonal Gupta, Client Executive JT MacMannis, VP Business Development
Reminder during today’s webcast
For privacy purposes, please refrain from asking questions that are
specific to medications that you or a family member may be taking.
© 2021 Marsh & McLennan Companies, Inc. All rights reserved. 25Agenda
Intro to CVS Caremark®
About Your Prescription Drug Benefit Administered by CVS Caremark®
Features of Your Prescription Drug Benefit
Making the Best Use of Your Benefit
Transition Information
Questions
Rx Savings Solutions
© 2021 Marsh & McLennan Companies, Inc. All rights reserved. 26Intro to CVS Caremark® 27 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.
CVS Caremark®
You’ve probably heard of:
CVS Pharmacy
MinuteClinic
CVS HealthHUB
We’re all part of the CVS Health family, working
together to help you on your path to better health
Hi, we’re CVS Caremark.
You automatically receive prescription drug coverage
We will manage Marsh from CVS Caremark when you elect medical
McLennan’s prescription drug coverage under one of the following plans:
• $400 Deductible Plan
benefits starting January 1, 2022. • $1,500 Deductible Plan
• $2,850 Deductible Plan
28 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.2022 Prescription Benefits
CVS Caremark will be Marsh McLennan’s
new prescription carrier, but most of
your benefits are not changing
You will receive a new ID card in the mail
Your new ID card will have your pharmacy plan information. You
can also view/download a virtual ID card using caremark.com or
the CVS app.
Make sure to bring your new ID card to the pharmacy when you
need your next prescription starting January 1, 2022.
You will have broad access to your local
pharmacies
CVS Caremark has a national network of over 68,000
pharmacies which includes all major chains, grocery stores and
independent pharmacies.
To see if your pharmacy is in network, use the pharmacy locator
tool on Caremark.com or contact CVS Caremark.
You will have a new customer care team
CVS Caremark has a dedicated phone line for Marsh McLennan
employees to contact them 24/7 with any questions on your
prescription benefits.
Contact CVS Caremark at: (844) 449-0362
29 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.
©2020About Your Prescription Drug Benefit Administered by CVS Caremark® © 2021 Marsh & McLennan Companies, Inc. All rights reserved. 30
2022 PRESCRIPTION BENEFITS
Your Plan’s Drug Coverage
$400 Deductible Plan $1,500 Deductible Plan1 $2,850 Deductible Plan1
Retail Pharmacy Mail Pharmacy Retail Pharmacy Mail Pharmacy Retail Pharmacy Mail Pharmacy
In Network In Network
$1,500 Individual / $3,000 Family $2,850 Individual / $5,700 Family
Deductible Does not apply to prescriptions
Out of Network Out of Network
$3,000 Individual / $6,000 Family $5,700 Individual / $11,400 Family
In Network In Network In Network
$2,200 Individual / $4,400 Family $3,000 Individual / $6,000 Family $5,500 Individual / $11,000 Family
Max Out of Pocket ²
Out of Network Out of Network Out of Network
$4,400 Individual / $8,800 Family $6,000 Individual / $12,000 Family $11,000 Individual / $22,000 Family
Generic $10 $25 20% 20% 30% 30%
Preferred Brand $30 $75 20% 20% 30% 30%
Non-Preferred Brand $60 $150 20% 20% 30% 30%
¹ The $1,500 and $2,850 Deductible Plans are combined medical and prescription drug benefits. You may make pre-tax contributions to your HSA and use the funds to help pay for medical and prescription drug
expenses. You pay 100% of your medical and prescription drug expenses until you meet your annual deductible. Once you have met your deductible, you pay the applicable coinsurance amounts until you
reach your maximum out-of-pocket.
² The Maximum Out-of-Pocket (MOOP) is combined with your medical carrier. CVS Caremark will share claims with your medical carrier and track yearly spending – this will reset every year on January 1st. Once
the maximum out-of-pocket is met, your copay will be $0 for prescriptions (excluding applicable penalties).
The Health Savings Account is a tax-advantaged account available to employees who elect the $1,500 Deductible Plan or the $2,850 Deductible Plan.
Under the Affordable Care Act (ACA) certain preventive medications will be covered at 100% and are not subject to a deductible or copayment. Please note that over the counter (OTC) drugs under ACA
require a prescription to be covered at 100%.
Maximum Day Supply: Participating Retail Pharmacies up to a 30-day supply, CVS Pharmacy or Mail Order up to a 90- day supply
31 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.2022 PRESCRIPTION BENEFITS
Managing your high deductible
health plan (HDHP)*
What you need to know
You’ll pay 100% Once you meet the If you or your The amounts you
of the cost of your deductible, you’ll enrolled family pay toward your
medications until pay the appropriate members meet deductible and
you or your coinsurance your maximum MOOP DO NOT
enrolled family out-of-pocket roll over from
$1,500 Deductible Plan – 20%
members meet the $2,850 Deductible Plan – 30% amount (MOOP), year to year
annual deductible 100% of the cost
Your deductible combines
Some preventive pharmacy and medical of your medication
medications may expenses – see your plan is covered
bypass the summary document for (you pay $0)
deductible or be details
covered at 100% ̶
see your plan
summary document
for details
*Applies to the Marsh McLennan $1,500 and $2,850 Deductible Plans
Note: $1,500 Deductible Plan has a true family deductible and Maximum OOP. Entire family deductible and Maximum OOP must be met before
benefits begin to pay out for any family member.
32 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.Features of Your Prescription
Drug Benefit
33 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.2022 PRESCRIPTION BENEFITS
Maintenance Choice (90 Supply
of Maintenance Medications)
With Maintenance Choice, medications you take
regularly (such as diabetes, asthma or high
blood pressure medications) must be filled in
90-day supplies at a CVS Pharmacy or through
CVS Caremark Mail Service Pharmacy.
You can choose pickup at CVS Pharmacy or
have your prescription delivered by mail –
either way, the cost is the same. You may
also be eligible for same-day delivery from
your local CVS.*
90-day supplies are more convenient and
usually cost less
After the first three fills of your
maintenance medications at a non-CVS
retail pharmacy, you will be responsible for
100% of the cost if your prescription isn’t
transferred to CVS retail or mail for
subsequent fills.
*Restrictions may apply
Need to transfer your prescription to CVS?
Visit Caremark.com/MoveMyMeds
34 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.PrudentRx applies to the $400
Deductible Plan
Pay $0 for any medication on the PrudentRx
Specialty Drug List even if there is no copay
program available
PrudentRx works with manufacturers to get
copay assistance for your medications
PrudentRx handles all the details for you — no
need to worry about renewals or expiration
dates
Watch your mailbox for more information.
You are required to participate in the program.
Some additional steps may be required.* You
will be responsible for paying 30%
coinsurance of the specialty medication if you
do not speak with PrudentRx, you do not
2022 PRESCRIPTION BENEFITS enroll in any copay assistance as required by
a manufacturer, or choose to not participate in
the PrudentRx program, i.e. opt out. This 30%
Pay $0 for specialty member responsibility will not apply towards
your deductible or MOOP.
medications with PrudentRx
* Some manufacturers require you to sign up to take advantage of the copay assistance they provide for their medications
* The amount paid for your medication by manufacturers is not applied to your deductible/MOOP Please note: The amount paid for your medication by
* To contact PrudentRx with any questions or concerns regarding the program, call (800) 578-4403 manufacturers is not applied to your deductible/MOOP.
35 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.Blood sugar and blood pressure monitoring
Transform
Diabetes Care
Pharmacists and nurses who can help you provides guidance and support
based on your needs and
preferences.
With the CVS Health Tracker app,
Prescription refill reminders you can monitor your glucose,
blood pressure, calories and more.
To stay on track, you can message
with a health coach and get
personalized support from a
Certified Diabetes Care Nurse.*
Preventive health screenings
If you’re managing diabetes,
you’re enrolled automatically, so
stay tuned for program details –
Managing diabetes? we’ll be in touch soon to help
Nutrition plans for your likes and needs you get started.
Extra support is here.
*Certified Diabetes Care Nurses do not
diagnose or treat conditions. Their role is to
connect members to appropriate resources and
help identify and close gaps in care. Your
CVS Health Tracker app privacy is important to us. Our employees are
trained regarding the appropriate way to handle
your private health information.
36 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.What is Hello Heart?
Hello Heart is a program that helps you track, manage, and improve
your heart health from the privacy of your own phone. It is offered at
no cost to eligible members and includes a free blood pressure
monitor that connects to an app on your smart phone.
Members who are
What do you get with Hello Heart?
enrolled in the
• Free, FDA-approved blood pressure monitor that connects to medical plan, have
your phone high blood pressure
• Blood pressure, medication and weight tracking technology or are taking blood
• Instant, clear explanations of what your numbers mean
• Personalized tips for maintaining a healthy heart pressure medication
• Progress reports to review and share with your physician are eligible to enroll
• Auto-imported lab results from clinics, with personalized for free.
explanations
• Support team available to answer any questions via phone or Eligible members should receive
email communication by December. You
may also reach out to Hello Heart
to discuss and enroll. Email
support@helloheart.com, call Hello
Heart at (800) 767-3471, or call
CVS at (844) 449-0362.
37 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.WW Digital 360 Program
WW Digital 360* delivers a program based on your body, your goals, and the
foods you love. Start by taking a personal assessment and you’ll be matched to a
WW food plan for you.
* Formerly Weight Watchers
Leading weight loss and wellness programs
for real life
Eight apps in one with unique benefits —such
as barcode scanner, 9,000+ recipes, meal
planning tools, on-demand workouts, and curated
meditations
Community support —Access to coaches and
our private social network where members can
connect with others to share their experience and
receive support
All colleagues will receive a communication in
December with additional information about
enrolling in WW Digital 360 in 2022
38 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.Making The Best Use of
Your Benefit
39 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.2022 PRESCRIPTION BENEFITS
Everything you need to manage your
medications anytime, anywhere
Visit https://info.caremark.com/oe/marshmclennan to learn more about your plan
options:
• Review details about prescription drug benefit coverage under the Marsh McLennan
medical plans
• Check prescription drug costs*
• Locate a network pharmacy using the pharmacy locator*
• Access prescription drug lists to better understand coverage*
*Subject to change – please check appropriate resource for most up to date information.
Review Check medication Find in-network Order mail service View history Track progress toward Set alerts and
your plan costs and find pharmacies or start refills and track of your your deductible or reminders to help
details ways to save delivery by mail shipments prescriptions out-of-pocket maximum you stay on track
Once you’re registered, download the CVS Caremark App from your preferred app store to manage
your medications on your smart phone.
Caremark.com and the CVS Caremark App will be available starting 1/1/2022
40 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.Transition Information 41 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.
2022 PRESCRIPTION BENEFITS
Proactive support for
Marsh McLennan employees
CVS will transition open refills, including:
Mail Order / Home Delivery medications
Specialty medications
Specialty Prior Authorizations (PA)
If you have a PA in place with Express Scripts, it will be
valid with CVS Caremark for the same time period
previously approved
If your drug is currently covered but is moving to an
exclusion list 1/1/2022, you may call (844) 449-0362 to
request an exception. Your drug can be grandfathered
through the 1st 6 months of 2022, after which formulary
CVS Caremark is working behind the scenes with Express Scripts exclusions and utilization management may apply.
to make this change in vendors seamless for Marsh McLennan.
Communications will be sent to members that may
experience a change in prescription cost or coverage
for January 1, 2022.
Any Questions?
Contact CVS Caremark at 1 (844) 449-0362
Please note: Your exact benefits may vary – see your benefits materials for details
42 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.
©20202022 PRESCRIPTION BENEFITS
What may be different in
2022?
Prescription cost or coverage may change
Prescription costs and drug lists change periodically
regardless of the pharmacy provider. CVS Caremark will
notify you in writing prior to 1/1/2022 if your medication is
excluded or it is required to go through a prior approval or
step therapy process.
You may call CVS Caremark directly or use the annual
enrollment microsite to price out your medications.
CVS Pharmacy is replacing Walgreens as the
preferred 90-day pharmacy
If you currently fill a maintenance medication (90 day supply) at
Walgreens– your prescription will need to be transferred to CVS
Caremark.
You may transfer these prescriptions by calling the pharmacy you
wish to transfer, request that your Walgreens pharmacist transfer
the prescription to a CVS pharmacy or visit
www.Caremark.com/MoveMyMeds
CVS will be your exclusive specialty
pharmacy
If you currently fill a specialty medication – you will receive
mailed communication and a phone call to assist with
transitioning your specialty medication from Accredo to CVS.
43 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.Communication Roadmap*
SEGMENT / MESSAGING TIMING
Annual • Marsh McLennan Distributed Information about the
Enrollment Prescription Drug Benefits administered by CVS Caremark 10/11/2021 – 10/29/2021
• Sent to all members by CVS Caremark welcoming them to
Welcome CVS Caremark
Letter with • Information included: Benefit details, FAQs covering general 10/15/2021
FAQs questions, Maintenance Choice
Clinical • Sent to targeted members by CVS Caremark
Week of 11/22/2021
Disruption • Mailings include: Formulary, Specialty, Utilization
Mailings Management, Network
• PrudentRx December 2021
New • Hello Heart
TDC (post 1/1/22)
Programs • WW Digital 360
• Transform Diabetes Care (TDC)
Welcome Kit/ • Prescription Benefit ID Card sent to all members by CVS 12/15/2021
ID Cards Caremark
*CVS communication dates are subject to change.
44 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.Questions? 45 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.
Questions • Contact Customer Care at 1-844-449-0362, 24/7 • Visit https://info.caremark.com/oe/marshmclennan starting October 11th to learn more about your plan options before coverage begins • Visit www.Caremark.com starting January 1, 2022* and download the CVS Caremark app to manage your prescription benefit once coverage begins *You will be able to login and create an account after you receive your member ID card in December 2021. 46 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.
Deductible ǀ An individual or family needs to spend this amount on medications each plan year before coverage
starts; may be combined with medical benefits
Copay or coinsurance ǀ The amount you pay for medications once you or your family reaches the deductible and
coverage starts; a copay is a flat amount and coinsurance is a percentage of the cost of the medication
Terms you
should know Maximum out-of-pocket (MOOP) ǀ Once you or your family reach this amount, all medications are covered
at 100%
Generic medication ǀ Has the same active ingredients as the brand-name medication; usually your lowest-cost
option
Preferred brand medication ǀ Medication that will cost less under your benefit plan
Non-preferred brand medication ǀ Highest-cost option under your benefit plan
Maintenance or long-term medication ǀ Medication you take regularly, like high blood pressure, diabetes
or high cholesterol medications
Acute or short-term medication ǀ Medication you take for a short time, like an antibiotic
Preventive medication ǀ Affordable Care Act (ACA) preferred medications are covered at 100%; High deductible
health plan (HDHP) preventive medications bypass the deductible, which means they are covered even if you haven’t met
your yearly deductible yet
47 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.Quantity limit ǀ A limit on the amount of medications your plan will cover. You can continue to fill prescriptions
after you’ve reached the limit, but you’ll be responsible for any additional costs.
Prior authorization ǀ This means we need more information on why your doctor has prescribed a specific
medication for you. The information is reviewed to determine whether or not your medication will be covered by your
Terms and plan.
ways to Dispense as written ǀ If your doctor indicates “dispense as written” on your prescription, your pharmacy can’t
substitute a generic for a brand-name medication and you may have to pay more for the brand.
manage your
Appeals ǀ If your or your doctor’s request for coverage of a non-covered medication is denied, you have the right
medication to appeal that decision.
Some medications
require you to take
additional steps, or
receive additional
approvals, before they
are covered under your
plan. These could Use the Check Drug Costs & Coverage tool at Caremark.com to find out what medications are
covered, if there are extra requirements for coverage, and how much they will cost.
include:
Remember: Medications are only covered when you fill your prescriptions at a network pharmacy.
Find pharmacies near you with the Pharmacy Locator at Caremark.com.
48 ©2021 CVS Health and/or one of its affiliates. C.
Confidential and proprietary.Thank you Legal disclaimers Products that qualify as preventive services may be available at a lower cost share or no cost share, depending upon your plan, and may change from time to time. Please check your plan benefit materials should you have any questions about your coverage. Flu shots and vaccines may not be available in all pharmacies at all times. Call for availability and to make an appointment, if needed. Most vaccines require a prescription (except for the flu shot). Contact your medical carrier directly to find what vaccine benefits are available at other medical facilities such as a doctor’s office, urgent care, etc. Certain drug options identified above may be subject to additional prior authorizations or other plan design restrictions. Please consult your plan for further information. Copayment, copay or coinsurance means the amount a plan member is required to pay for a prescription in accordance with a Plan, which may be a deductible, a percentage of the prescription price, a fixed amount or other charge, with the balance, if any, paid by a Plan. This information is not a substitute for medical advice or treatment. Talk to your doctor or health care provider about this information and any health-related questions you have. CVS Caremark assumes no liability whatsoever for the information provided or for any diagnosis or treatment made as a result of this information. This document may contain references to brand-name prescription medications that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark. Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. This presentation contains trademarks or registered trademarks of CVS Pharmacy, Inc. or one of its affiliates; it may also contain references to products that are trademarks or registered trademarks of entities not affiliated with CVS Health. 49 ©2021 CVS Health and/or one of its affiliates. Confidential and proprietary.
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51 ©2021 CVS account
Health and/or today
one of its affiliates. at myrxss.com/mmc
Confidential and proprietary. to get started, or call 1-800-268-4476Questions and Answers
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