News

The Consolidated Appropriations Act of 2021 (CAA) added pharmacy reporting requirements under the Internal Revenue Code, ERISA, and the PHSA. To help brokers and groups navigate these requirements, we've created a RxDC guide. RxDC reporting deadlines are different for each carrier. Check out our RxDC Guide that organizes carrier deadlines, links to the employer survey, and additional information about this requirement from our carriers. These requirement deadlines are coming up, review the RxDC guide below. Please note this is guide is for fully insured plans. For more information about Pharmacy Data Collection Under the CAA read our Whitepaper here . Carrier Who's Reporting Employer Survey Link Survey Due Date Resources Aetna Carrier will report Employers will receive an email from Aetna. They need to click the link and provide information for Aetna to submit on their behalf. Submit survey by 4/12/24 Aetna Pharmacy Benefit and Drug Costs Reporting Notice Anthem Carrier will report View survey here Submit survey by 3/15/24 Anthem Update: Requests to collect required CAA D1 prescription drug data Blue Shield Carrier will report View survey here Submit survey by 4/5/24 Blue Shield Producer Alert Blue Shield Rx Reporting Survey FAQs Updated 3/1/24 California Choice Please refer to enrolled carrier Refer to specific carrier's guideline N/A Cigna + Oscar Carrier will report Not released yet Not released yet Covered California Small Business Please refer to enrolled carrier Refer to specific carrier's guideline N/A Health Net Carrier will report No survey required N/A Health Net RxDC Update Humana Carrier will report Survey sent to health plan sponsors directly Humana RxDC Reporting Requirements Kaiser Permanente Carrier will report Kaiser will send form from: Kaiser-PermanenteRxDC@kp.org Submit survey by 3/29/24 Kaiser RxDC Update United Healthcare Carrier will report Visit the United Healthcare employer portal Submit survey by 4/10/24 United Heathcare RxDC reporting portal tools

Selling new Aetna Small Group fully insured and Aetna Funding Advantage business plans to groups in California with 1 to 100 eligible employees, makes you eligible to earn extra credits. Groups sold through Dickerson are eligible for this program. About the program • For cases with effective dates from January 1, 2024 through December 31, 2024, you can earn: - $50 for each new enrolled employee when you sell less than 75 total enrolled employees. - $100 for each new enrolled employee when you sell 75 or more total enrolled employees. - Producers are also eligible for extra credits for new dental or vision subscribers when sold alongside medical. • For new business fully insured and Aetna Funding Advantage medical sales only. • For groups with 1 to 100 eligible employees in California. • Credits will be paid by the end of the second quarter of 2025. For More Information, Click Here For Help Quoting Aetna, Please Contact Your Dickerson Sales Rep Today!

Humana is offering an easier way for you to earn more when you sell or renew Humana Group Benefits plans. For More Information, Click Here For Help Quoting Humana, Please Contact Your Dickerson Sales Rep Today!

Did you know MetLife Dental benefits come with features designed to help you get maximum value delivered out of your employer-sponsored benefits? Brush up on the benefits listed below that are included when you enroll in MetLife Dental. Digital servicing capabilities make dental care easy MetLife’s mobile app puts your ID card, plan details, and claim information at your fingertips. For added convenience, it also includes features like: • A Find a Dentist tool with easy access to provider ratings • Online appointment scheduling for select dentists • Convenient claim status notifications via text messaging MetLife digital tools available on MyBenefits also include: • Access to a Dental Cost Estimator so you can view personalized, plan-specific, and zip code-based cost estimates for most common procedures – as well as the deductibles, plan maximums, and frequency limitations that apply. • A digital virtual assistant that’s available 24/7 to help you with common tasks like accessing coverage information, getting personalized estimates, or viewing claims. For More Information, Click Here For Help Quoting MetLife, Please Contact Your Dickerson Sales Rep Today!

Cigna Healthcare has published a research paper outlining six top health care trends and how they will impact U.S. employers and their workforces. These trends illustrate the ways employers can play a crucial role in driving progress. To Read More, Click Here For Help Quoting Cigna, Please Contact Your Dickerson Sales Rep Today!

(By Paige Minemyer) Mar 7 - Utilization management in Medicare Part D has become more restrictive over the last decade, even when compared to Medicare Advantage prescription drug plans, according to a new study. The study, conducted by researchers at the University of Southern California and Blaylock Health Economics and published this week in Health Affairs, found an increase across multiple types of utilization management, including prior authorization, step therapy and formulary exclusions, between 2011 and 2020. On average, 31.9% of drugs were restricted in some fashion in 2011, which grew to 44.4% by 2020, according to the study. By the end of the study window, 44.7% of formularies restricted brand-name-only drugs. "Increasing reliance on formulary exclusions, a particularly blunt tool for restricting patients’ access to therapies, is especially striking, as it prevents all but the few who successfully appeal or can afford to pay out of pocket from getting a restricted medication if it is prescribed by their physician," the researchers wrote. The researchers note that at the same time formularies have grown more restrictive, enrollment in Part D has grown significantly. Membership in these plans grew by 56% between 2011 and 2020, from 33.2 million enrollees to 52 million. The study found just how restrictive access to a certain drug was varied based on the cost and the availability of generic options. For example, in 2020, just 16.7% of generic-available drugs with a price of $100 or less were excluded from formularies or subject to prior auth or step therapy. By comparison, 59.5% of generic-available drugs with a price of $1,000 or more were restricted. For brand-name-only products, 15.8% of those with prices of $100 or less were restricted, while that jumped to 83.7% for drugs costing $1,000 or more. To Read More, Click Here