Information on the Renewal Verification Form, Group SEP guidelines, and an important update on the Rx Savings Solutions program.
Renewal Verification Form
Health Options will be utilizing a new Renewal Verification Form to help determine whether a renewing group belongs in the small or large group market segment, issued 75 – 90 days before the renewal date to give the employer and/or broker ample opportunity to complete and return it. While this form is not needed in all situations, we are asking brokers to submit it when they believe an employer’s enrollment has changed enough to impact its market segment.
Please share this document with your agency’s office support staff. For more information, contact Business Development at (207) 402-3353. We thank you in advance for your cooperation as we implement this new process.
Group SEP Guidelines Reference Sheet
We created the attached grid to help demystify group Special Enrollment Period (SEP) guidelines, approval requirements, and the paperwork needed for processing. It provides at a glance information about approved SEPs, notification timelines, documentation required, and effective dates. To further simplify the process, we are accepting signatures on the documents from the employee/employer or broker for ease of submission.
Important Notice Regarding Rx Savings Solutions
Health Options partnered with Rx Savings Solutions to provide a savings alert program for our Members to help them obtain the best pricing on their prescription medications. Due to low participation we are discontinuing the program as of January 1, 2020. We do recognize the value of this type of service, so we are bringing it in-house. Going forward, our dedicated Pharmacy and Care Management teams will advise our Members about meaningful opportunities to saving on medication costs. Members who are registered with Rx Savings Solutions will be notified directly about this change.
Detailed information on Behavioral Health Prior Authorization, Utilization Management and Appeals Process changes, Payment Electronic Delivery, Narcan and Naloxone, 2020 Drug Formulary changes, Pharmacy updates, Member Rights & Responsibilities and our Claims Services Associates Team.