As stated in the last edition of the Highlighter, the district recently completed a review of pharmacy providers. Based on this review, the district will switch its pharmacy provider from Express Scripts to OptumRx effective January 1, 2020.
With the decision to switch pharmacy providers, the district will experience additional costs savings that can be passed onto employees through a lower-than-market-average insurance premium increase. For 2020, the district’s premiums will increase by 5-6%, while the market average is 8-10%. OptumRx is a provider under UMR, which means members will have a single point of contact for any medical or prescription drug questions.
What does this mean for you?
- The tiered system of employee drug costs ($10/$30/$45) will not change.
- Employees will have continued access to all of the same level of care and drug options:
- Any mailorder prescriptions that you have with Express Scripts at the end of 2019 will be transferred to OptumRx.
- You will still be able to fill any prescriptions you are currently prescribed under the current cost structure ($10/$30/$45).
- For prescriptions filled at a retail pharmacy, beginning 1/1/2020 you will need to provide the pharmacy your updated pharmacy insurance information that can be found on your 2020 health insurance ID card. Those ID cards will be sent after the open enrollment period ends. HR will send a notification to you when those cards are on the way. Make sure you have your address up to date in Skyward Finance as that is where the cards will be sent.
- For newly prescribed maintenance medications, members will be allowed to fill two prescriptions at a retail pharmacy. After those two fills, maintenance medications will be required to be filled through mail order.
