Christian Brothers Employee Benefit Services
Annual Plan Change Notice

(Updated 11/17/2020)

The following Plan changes will be effective Jan. 1, 2021*:
*Not all plan changes apply to all groups.  Please contact your HR adminstrator for specifics on your group plan.

 

Urgent Care Copay

Christian Brothers Health Benefit Services will use a separate category to code for a specified copay for urgent care visits to alleviate previous billing confusion.

The change will allow patients to know what charges will be subject to various copayment levels, deductibles and coinsurance.  When reviewing national averages of costs for urgent care visits, it was determined that the costs of urgent care visits are about 30% higher than for average primary care visits, but significantly less than emergency room visits.

Please be sure to review your 2021 Summary of Benefits and Coverages (SBC) for the Urgent Care copay level.

2021 SaveonSP Specialty Medication List Changes

The number of specialty medications available at no cost to you continues to increase, with an additional 120 new medications added to the list for 2021.

Specialty medications provide unique treatments with remarkable results for complex, chronic diseases. The Plan now includes more than 200 medications.  A list of these medications and their associated monthly copay can be found here or call SaveonSP at 1.800.683.1074.



2021 Prescription Formulary Changes

Quarterly, Express Scripts Inc. (ESI), the Trust’s Pharmacy Benefits Manager, announces changes to its formulary drug list. Some prescription drugs currently covered will be excluded from coverage, while other prescription drugs move from a Preferred Brand status to a Non-Preferred Brand status.  Visit our website for more information.

The formulary is a list of drugs—generic and brand name—that offer the greatest overall value to Plan participants. Formulary management enables you and your physicians to choose clinically appropriate and cost-effective drugs for specific conditions.

Please note that while the Trust subscribes to Express Script’s National Preferred Formulary certain prescription drugs and/or preventative care inconsistent with the tenets of the Catholic Church may not apply or be covered. Please refer to your plan booklet for further details.

The exclusion list is for medications not covered on the Express Scripts drug list. For each one of those excluded drugs, there are clinically equivalent, lower-cost options available. The Formulary Exclusion List includes preferred alternatives for those medications that are not covered.

*Participants who may be affected will be notified in advance.