Date: June 26, 2009

To:  Benefit-Eligible Employees of Wright State University

There are three important changes to note:

·         Wright State University’s Prescription Benefit Management Company will change from Anthem to Express Scripts, Inc. effective July 1, 2009 for employees covered by the HMO, PPO and Traditional Health Plans.  This change will not apply to employees covered by the High Deductible Health Plan (HDHP) with a Health Savings Account.

·         All maintenance prescriptions will be filled through Express Scripts by a mail order only effective October 1, 2009.  After then, no retail pharmacy will dispense prescriptions written for greater than a 30 day supply under the HMO, PPO or Traditional Health Plans.  However, some of the larger retail companies (For example: Walmart, Meijer, Kroger) have prescription programs offering generic prescriptions as a 90 day supply for greatly reduced co-pay amounts.  These types of programs would be outside of your health plan coverage and generally have a very limited selection.  You would need to contact the pharmacies directly for more information about what type of programs are available.

·         The Department of Human Resources has been informed of the University’s decision to close the Wright State University Pharmacy effective December 31, 2009.

Why has the University made the decision to join the RX Ohio Collaborative (RxOC), which has contracted with Express Scripts for pharmacy benefit management (PBM)? 

The Rx Ohio Collaborative is a “Pharmacy Benefit Manager” which collaboratively supports employers in optimizing their pharmacy benefits.  The RxOC began with Ohio’s largest purchasers including:  Ohio Public Employees Retirement System (OPERS), State Teachers Retirement System of Ohio (STRS), School Employees Retirement System of Ohio (SERS) and The Ohio State University representing over 400,000 covered lives and one billion dollars in annual drug expenditures.   This program will improve access to pharmacy benefits for smaller employers and addresses one of Governor Strickland’s goals: cost savings through pooled purchasing among state institutions.  We estimate that Wright State University’s annual drug expenditures are approximately three million dollars.  Collaborative purchasing will save the University on the price of prescription drugs, dispensing fees, and will provide rebates from prescription drug companies.  For more information about the RxOC program go to www.rxoc.org.

Why is it necessary for Wright State University to make changes regarding the Prescription Benefit Management Company?

Prescription drugs continue to represent the fastest-rising cost in U.S. health care spending, and they represent a significant portion of the university’s health care spending.  The university reviewed its prescription drug coverage and determined this was an appropriate move to help contain prescription drug costs.  By partnering with Express Scripts, Inc., as the Pharmacy Benefit Management Company, the university is taking important steps to ensure that it can continue to provide cost-effective prescription drug coverage in the future.

Who is Express Scripts?

Express Scripts is a Pharmacy Benefit Manager founded in 1986 as a result of a joint venture between a retail chain of more than 79 pharmacies.  Express Scripts has a history of aligning its interests with those of plan sponsors and their members.

Express Scripts accomplishes lowest net cost by enabling better health and value at the consumer level. As evidence, Express Scripts’ generic dispensing rate leads the industry.

Express Scripts is headquartered in St. Louis, MO, but there are administrative, pharmacy, and customer service operations throughout the United States and Canada. Express Scripts continues to expand its services and today there are more than 11,500 employees focused on the mission to make the use of prescription drugs safer and more affordable. Express Scripts, Inc. Code of Conduct (PDF file) provides the framework for their actions as they advance this mission in every aspect of business.

Service

Express Scripts handles millions of prescriptions each year through Home Delivery and at retail pharmacies. They share a common cause with each of their clients — to help offer a healthy prescription-drug benefit today and into the future. In support of this effort, they have launched The Center for Cost-Effective Consumerism. The Center and its Advisory Board provide forward thinking and key insights to drive better health and value in the pharmacy benefit. The Advisory Board includes nationally recognized experts in the science of human behavior and decision making.

By combining insights from the Center with Express Scripts' proven ability to develop, test, and implement industry-leading programs, Express Scripts’ provide the greatest opportunity to encourage smarter prescription-drug choices and achieve the lowest total plan cost. 

In September 2008, JD Powers & Associates ranked Express Scripts Home Delivery Pharmacy second among the nations PBM’s.  Express Scripts ranks its Customer Service Satisfaction rate via phone, fax, and email at 95% as of May 2009.  Find out more by visiting their web-site at: www.express-scripts.com. 

Wright State University’s commitment to you

The Department of Human Resources and Advanced Benefit Planning (937-294-4525) will make every effort to support and assist those employees impacted by this transition. 

Additional information about mail order and transition to Express Scripts will be sent in the mail to your home address by Express Scripts, Inc.  You can expect a packet in late June, in which will include your new ID card, instructions and an order form for mail order prescriptions.

We have created a “Frequently Asked Questions” document (with your help) to assist with any questions and or concerns you have about this transition to Express Scripts, Inc. effective July 1, 2009.  If you have any additional questions not referenced in FAQ’s, please feel free to email these to HR_benefits@wright.edu.   

Frequently Asked Questions

1.     Why is Wright State University changing to Express Scripts as Pharmacy Benefit Manager (PBM)?
The university has chosen Express Scripts as its Pharmacy Benefit Manager as a means to make our prescription benefits more cost effective while keeping the provisions of this benefit substantially the same.  Express Scripts offers high quality and cost effective pharmacy services.
 

2.     Will I get a new member ID card?
Yes. With the change to Express Scripts, your local pharmacy needs a few identification numbers that are listed on your card. These numbers show that your pharmacy is part of the Express Scripts pharmacy network. Without these identification numbers your prescriptions cannot be processed. These numbers are located on your ID card as RXBIN, RXPCN, RXGRP. It is important that you show your local pharmacy the new ID card when you fill a prescription starting July 1, 2009.  Also included with your ID card is a mail order form to help you get started using the ESI mail order service. 

3.     How can I get a replacement member ID card?
Call Express Scripts Customer Service at (877) 783-3539.  (Phone line will not be active until June 24^th, 2009)
 

4.     Will my co-pays be changing?
No. The copayments you currently pay will remain the same with Express Scripts.
 

5.     Where do I fill my prescriptions after July 1, 2009? 

• For most pharmacies, you may continue to fill your prescriptions at your current network pharmacy near your home. If you are using a retail pharmacy, you do not need to get a new prescription.
• You can also get your prescriptions through mail order service. Starting July 1, 2009, you must send your mail order prescriptions to Express Scripts mail pharmacy. 

6.     Can I still fill a 90 day prescription at the Wright State University pharmacy?
Maintenance medication prescriptions for a 90 day supply will be available through September 30, 2009 at the Wright State University pharmacy.  After that time only a 30 day supply will be allowed and members will need to utilize ESI mail order for 90 day fills.  If you would like to get started using Express Scripts mail pharmacy for 90 day prescriptions, fill out the mail order form included in your ID card packet, enclose the prescription along with payment, and mail it to the Express Scripts mail order pharmacy. Your first prescription will be filled in 14 days of Express Scripts receiving your order. Refills at mail are shipped within an average of three business days of the refill request.
 

7.     Where is the Express Scripts mail pharmacy located?
The pharmacy is located in Bensalem, Pennsylvania.
 

8.     If I choose to use Express Scripts mail order pharmacy, will my prescription require a signature when it is delivered?
In most circumstances, your prescription will not require signature. If you are filling a class two medication or a narcotic, a signature may be required. For more information, call Express Scripts at (877) 783-3539.
 

9.     Can I have my prescription from Express Scripts, Inc. delivered to a campus address?
According to Wright Way Policy, Shipping and Receiving Policy #5408, states “The practice of having personal items delivered through the university’s receiving department is strongly discouraged.”   www.wright.edu/wrightway/5408.html.  Wright State University cannot be held responsible for any personal medications shipped to a campus address.
 

10.  What if my prescription needs refrigeration?
ESI keeps prescriptions needing refrigeration in a refrigerated compartment in the pharmacy, removing them only for dispensing, packaging, and shipping.  The prescriptions are shipped in insulated containers with frozen gel blocks for sufficient cooling during the transportation process.  A label on the package includes storage warnings such as “Refrigerate upon Arrival” and “Do Not Freeze.”
 

11.  Do I need to ask my doctor for a new prescription to use the Express Scripts mail order service?
Yes.  If you have never used the current mail order service, contact your doctor for a new prescription for a three-month supply with refills for up to one year and send to Express Scripts starting July 1, 2009.

Effective September 30, 2009, the Wright State University pharmacy will no longer be offering a 90 day supply. To continue receiving medication in a 90 day supply, you’ll need to send a new prescription for a three-month supply with refills up to one year to Express Scripts.

12.  I currently fill my prescription with Express Scripts. Do I need to get a new prescription?
No. If you currently are using the Express Scripts Mail Order pharmacy, you do not need to get a new prescription unless your prescription is expired or out of refills. Simply call the number on the back of your card, and Express Scripts can help you obtain your refill.
 

13.   How do I obtain a Prior Authorization for a medication?
Your doctor can submit a request for a new PA to Express Scripts via phone, fax or letter:

§  Phone – doctor can call Express Scripts PA Dept for clinical PA at 800-417-8164

§  Fax – doctor can fax requests for clinical PA to Express Scripts PA Dept fax # 800-357-9577

• Letter – doctor can send letter requesting a clinical PA to:

Express Scripts Inc, Prior Authorization Department,
Mail Route BL 0390
6625 West 78th Street
Bloomington, MN 55439 

14.  Can my local pharmacist request a Prior Authorization on my behalf?
Yes, your local pharmacist can call the Express Scripts Pharmacy Help Desk # printed on your member ID card. Express Scripts Pharmacy Help Desk #: 800-417-8164.
 

15.  When can I send my new prescription order to Express Scripts?
Express Scripts will begin processing scripts on July 1, 2009. Express Scripts will accept and hold new scripts received at least two weeks prior to implementation date (i.e. two weeks prior to July 1, 2009). If Express Scripts receives any scripts more than two weeks prior to July 1, 2009, Express Scripts will return the prescriptions to you. 
 

16.  How do I order my prescription with Express Scripts?
Wright State University is sending you an Express Scripts mail order form with a notification letter and new member ID card in June. 

§  To use the Express Scripts mail order pharmacy beginning July 1, 2009, complete the Express Scripts mail order form enclosed with the notification letter that you received from Wright State University in June.

§  If you are ordering a new prescription you will need to contact your doctor to request a prescription for a three-month supply with refills for up to one year.

• By law, refills for controlled drugs and compounded medications cannot be automatically transferred. Please contact your doctor for a new prescription if your medication is a controlled substance or compounded medication. Examples of controlled substance drugs include Vicodin^Ò (Hydrocodone w/Acetaminophen), Ativan^Ò (Lorazepam), Restoril (Temazepam), Ambien, Codeine containing products such as Acetaminophen with Codeine, Xanax (Alprazalam), MS Contin (Morphine), Oxycontin, Duragesic.

§  Mail your completed Express Scripts mail order form, new prescription refill slip along with your payment to Express Scripts by using the pre-printed return envelope provided with the Express Scripts mail order form.

17.  How do I pay for my mail order with Express Scripts?
You may send a check or money order with your prescription order to Express Scripts. You may also use a credit card by filling out the credit card information on the mail order form or making a payment on the Express Scripts website at www.express-scripts.com . Express Scripts accepts Mastercard, Visa, Discover and American Express credit cards.
 

18.  How long will it take to receive my order from Express Scripts?
For new prescriptions, you will receive your prescriptions within 14 days from the date Express Scripts receives your request. Please include payment (check, money order or credit card information) to avoid delays.  Refills are shipped within an average of three business days of the refill request.
 

19.  If my medication is not covered, will Express Scripts notify me?
Yes. If your medication is not covered, Express Scripts will send you a letter to notify you that your medication could not be filled.
 

20.  Can I still get a 90 day supply through Express Scripts mail pharmacy?
Yes, a three-month supply is the maximum days supply for your mail order benefit.
 

21.  Can I fill my local prescriptions with a pharmacy that is not in the Express Scripts pharmacy network?
No, local prescriptions need to be filled with a pharmacy that is part of the Express Scripts network.
 

22.  How does my local pharmacy join the Express Scripts pharmacy network?
The pharmacy will need to call the Express Scripts Pharmacy Help Desk at (800) 824-0898.
 

23.  My local pharmacy is having trouble filling my medication. Can you help?
Yes, your local pharmacist can call the Express Scripts Pharmacy Help Desk for assistance. Please see the Express Scripts Pharmacy Help Desk # printed on your member ID card. (Express Scripts Pharmacy Help Desk #): (800) 824-0898)
 

24.  How do I register for the website?
Log on at www.express-scripts.com. Select “For Members” and follow instructions to register. Members cannot register at www.express-scripts.com before the effective date of July 1, 2009.
 

25.  Does each family member need their own user ID and password for the website?
No. Currently, the ESI standard is the subscriber (i.e., cardholder) login. The subscriber (i.e. cardholder) can then view and complete all on-line transactions for all covered members.
   

26.  Do I pay for shipping if my medication requires overnight method?
Express Scripts pays for overnight shipping on orders that require expedited delivery such as temperature sensitive medications. However, if you request special handling on your order for personal reasons, Express Scripts will charge you for the expedited shipping method unless there is a delay due to service issues at Express Scripts.

27.  I cannot open child proof caps on medication bottles. Can I get a regular cap?
Yes, you can request a regular cap by contacting Express Scripts Customer Service – (877) 783-3539 (After June 24^th, 2009).
 

28.  I am getting divorced (or I am divorced). I am still covered under my spouse’s plan. I don’t want to put my credit card number on my spouse’s account. How do I pay for my medication?
You can pay by check or money order.
 

29.  What is the number to Express Scripts Customer Service and their hours of operation?
Express Scripts Customer Service - (877) 783-3539 (After June 24^th, 2009) (TDD for Hearing Impaired 1-800-899-2114) - 24 hours a day, 7 days a week.

human_resources@wright.edu