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November 6, 2019
Annual formulary updates include cost-share and tier changes, new pre-authorization requirements and exclusions for certain drugs. Changes that will lower costs and improve access for members include moving drugs to lower-cost tiers and adding medications to the Optimum Value List for common conditions such as asthma, seizures and mental health.
Members who need to act based on the formulary changes will receive letters between the end of October and mid-November.
Contact your Asuris representative for a copy of the 2020 formulary. Or, visit asuris.com and select Member > Pharmacy Benefits > select group size > select Find a Drug.
The 2020 formularies are available as PDFs on that page.
Over the past year, we've worked with our PBM to develop a coupon management program that reduces costs for employer groups. Effective Jan. 1, 2010, members may continue to use manufacturer coupons to offset the cost of their drugs, but coupon values for drugs purchased at AllianceRx Walgreens Prime (ARxWP) will no longer apply toward their accumulators, such as deductible and annual out-of-pocket maximums.
The coupon accumulator adjustment program will be implemented for plans with Specialty Select as follows:
Fully insured and QHP plans with Specialty Select:
Self-funded plans with Specialty Select:
We'll soon send letters to members who have used a coupon when filling a medication at ARxWP in the past four months so they can prepare for any impact to their 2020 prescription costs.
Please read the Producer FAQ for more detailed information.
If you have any questions about these programs, please contact your Asuris representative.