On January 1, 2016, a new pharmacy benefit manager (PBM) will be administering the drug benefit for the PSC-CUNY Welfare Fund (WF). Express Scripts is being replaced by CVS/caremark.
Active members and retirees have already begun receiving mailings from the WF and the new PBM, introducing them to the CVS/caremark system. Retired members currently participating in the Express Scripts Medicare Part D drug program are being notified of their transfer to the CVS/caremark Medicare D program called SilverScript. Everyone should read the CVS/caremark and SilverScript mailings with careful attention.
New cards and welcome kits to both groups will be in the mail by the end of December. Information on the new program is online at the Welfare Fund website (psccunywf.org), the CVS/caremark website and the Silverscript website. The SilverScript Medicare D customer care phone line (866-881-8573) went live on October 27, and the CVS/caremark line (866-209-6177) went live earlier this month.
Same Level of Care
The WF Board of Trustees voted unanimously to change pharmacy benefit managers in August after assessing a deteriorating relationship with Express Scripts, marked by increasing member complaints and rising costs. A detailed request for a proposal was given to four competitive pharmacy benefit managers through a special consulting firm hired by the board. All returned bids were reviewed carefully by trustees and WF professionals, who considered a number of factors.
Changing the administration of the drug benefit for more than 17,500 active members and 6,500 retirees is complicated. It would not have been undertaken by the WF Board without distinct benefit to fund members, as well as state-of-the-art cost control improvements that continue this benefit into the future. The transition will involve no changes to benefit parameters, such as copayment levels. There will be a very small number of members notified of “formulary” changes – when the drug currently being used must be replaced by an equally effective medication that costs less. Targeted notifications will be mailed in mid-December and will give people a chance to discuss any changes with their doctors.
Although the new benefit manager is part of CVS, members who get their prescriptions at brick-and-mortar pharmacies will not be limited to CVS and may continue to use their current pharmacies, whether they are small businesses or part of a big chain. However, the relationship with the CVS chain of retail pharmacies is viewed as a positive aspect of the new program. One significant advantage offered by CVS pharmacies will be “mail order at retail” – the ability to fill a 90-day prescription for maintenance medication right at a local CVS store. And CVS will offer further inducements by issuing a 20 percent discount card and promoting its in-store mini clinics.
Information on current mail-order refills will be transferred from Express Scripts to CVS/caremark. For the protection of our members, payment information will not be transferred to CVS/caremark. Members who have enjoyed the convenience of receiving drugs automatically and having charges posted to a credit card will need to provide payment information to CVS/caremark. All information regarding this is provided in the mailings, on the websites or via the CVS/caremark customer care phone lines.
If anyone currently participating in the Express Scripts system has not received notification from CVS/caremark or SilverScript, it is possible that an incorrect address is on file. In this case, please immediately email the Welfare Fund.
Larry Morgan is executive director of the PSC-CUNY Welfare Fund.