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Open Enrollment sneak peek: A new deadline and change of pharmacy benefit manager for UC PPO plans

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Open Enrollment is approaching, and you’ll have more help than ever this year in choosing the right benefits for you and your family. In the meantime, we want to give you a heads up about a couple of important changes.

New Open Enrollment deadline this year

This year’s open enrollment period will start Thursday, Oct. 28, at 8 a.m. and end Friday, Nov. 19, at 5 p.m. For those of you who have been here a while, that’s a change from our usual Open Enrollment deadline of the Tuesday before Thanksgiving. You’ll still have more than three weeks to make your benefits choices and our benefits professionals will have some needed extra time to ensure UC’s systems are up to date for 2022.

New pharmacy benefit manager

Navitus Health Solutions (Navitus) is replacing Anthem IngenioRx as the administrator of prescription drug benefits for the following plans: CORE, UC Care, UC Health Savings Plan, UC High Option Supplement to Medicare and UC Medicare PPO. As the pharmacy benefit manager, Navitus sets clinical policy and guidelines for medications and for the processing of pharmacy-related claims.

UC regularly reviews the administrators of our health and welfare plans to ensure members receive the highest levels of service at the most competitive prices. After a thorough process, a committee representing faculty, staff and retirees determined that Navitus would offer significant advantages as the pharmacy benefit manager for these UC plans.

Continued focus on member service and convenience

Navitus offers convenient options for filling prescription drugs that members are accustomed to, including participating University of California Health pharmacies, a large retail network (Costco, CVS, Walgreens, Walmart, and Safeway/Vons), mail order delivery through Costco and access to specialty medications through Lumicera and participating UC specialty pharmacies.

Navitus will also provide robust support to help you better understand and manage your prescription drug benefit, including:

  • 24/7 customer care
  • A pre-enrollment website (coming in October) with tools for finding participating pharmacies, checking drug prices at the pharmacy of your choice, and looking up drugs included in the formulary (the list of drugs that are covered by the plan)
  • A mobile app (for non-Medicare members) and member portal, for easy access to all your prescription medication information

There are no changes to the standard cost-sharing amounts (copayments or coinsurance) for prescription drugs due to the transition to Navitus. However, every pharmacy benefit manager uses its own formulary. While the Anthem IngenioRx and Navitus formularies are similar, there are some differences, which could affect your individual medication costs.

More detailed information about the new prescription drug plan will be sent to you near the beginning of Open Enrollment. You will also receive information from UC later in the fall about any specific impacts to you or your medications because of the change.

Stay tuned for more Open Enrollment updates!

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