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Additional Details: Aetna - CHI Health
by Tara Johnson 06 Dec '24

06 Dec '24

Hello - I have had a lot of questions about the situation with CHI and SLEBC's network, Aetna Open Choice PPO. Because of the influx of calls and emails, I have summarized what I know and options you have if this disruption pertains to you. 1. Unfortunately, we do not have a date or timeline for the continued negotiations or end date. 2. While I can usually help expedite the correction of errors, I do not have a magic wand to fix this, as we are a very small group of people that are dealing with this network issue. Many, many employers and Medicare Advantage plan members are also involved. 1. Options: * Schedule a visit with an In-Network Provider (possibly for the short-term) * Pay the higher Out-of-Pocket Costs * IF you do not have an In-Network Provider within 50-miles of your home address, claims can be processed as In-Network. This is a clause we already have in our Plan Document. If you find this is your situation, please be sure to notify the care coordinators at 866-274-9478. * Doctor on Demand may be an option depending on the reason for the visit. (When you sign up use SLEBC for the employer.) You can find this information in the attached benefit guide. Additional Options you may try: * If you are looking to have a medication refill, you may want to try to message your provider and explain the situation and ask if a refill is possible with the exception that as soon as the contract is negotiated a visit will be scheduled. * You may reach out to the CHI clinic directly to see if they are willing to negotiate with Aetna. This is unlikely but may be worth asking. If they are willing, they would need to reach out to their Provider Relationship Manager. The situation is definitely hurting CHI's bottom line, as they are losing revenue by the minute. While this financial pressure is important to the overall negotiations process, it is important for you to know that the SLEBC Board is also monitoring (and personally dealing with) the same situations many of the members are in. It is a bad situation. We will review the network at our first quarter meeting and discuss possible options. IF we were to change networks, we do not have a guarantee that another network wouldn't have the same issue with their contract negotiation, as BCBS went through this same situation recently with CHI. At the end of the day, I ask for your patience and understanding that this is not a situation any one of us wants to be in. I will continue to share updates as they are shared with me. Thank you, Tara Tara Johnson This email may contain confidential and privileged information for the sole use of the intended recipient. Any review or distribution by others is strictly prohibited. If you are not the intended recipient please contact the sender and delete all copies. ________________________________ From: Tara Johnson Sent: Wednesday, November 27, 2024 12:06 PM To: stateemail(a)groups.netroopers.org <stateemail(a)groups.netroopers.org> Cc: troopb(a)groups.netroopers.org <troopb(a)groups.netroopers.org>; troopa(a)groups.netroopers.org <troopa(a)groups.netroopers.org>; troopc(a)groups.netroopers.org <troopc(a)groups.netroopers.org>; troopd(a)groups.netroopers.org <troopd(a)groups.netroopers.org>; troope(a)groups.netroopers.org <troope(a)groups.netroopers.org>; trooph(a)groups.netroopers.org <trooph(a)groups.netroopers.org>; ncoa(a)groups.netroopers.org <ncoa(a)groups.netroopers.org>; nsfma(a)groups.netroopers.org <nsfma(a)groups.netroopers.org> Subject: Aetna - CHI Health SLEBC Insured - I wanted to send a quick note as SLEBC has been notified that CHI has officially opted to not renew their contract with Aetna. This is still an ongoing situation and with many similar situations, we have seen agreements reached after the ‘deadline’. We will continue to provide updates as received on the status. Meritain has provided a list of providers who have opted to negotiate directly with CHI linked below. Members who are impacted by this negotiation should have already received notification from CHI regarding the potential to be OON. CHI Health Partners Affiliated Providers List Nov. 26, 2024.pdf<https://www.aetnacommercialbusinesses.com/Segments/2024/Providence_Network/…> If you would like to review out-of-network costs, please see page ten of the attached benefit guide. If you would like to look up in-network providers, use the Aetna Open Choice PPO network option here<https://www.aetna.com/dsepublic/#/contentPage?page=providerSearchLanding&si…>. Please let me know if you have any questions! Thank you, Tara Tara Johnson Director of Operations & Benefits State Law Enforcement Bargaining Council STAN | NCOA | NSFMA PO Box 6729 Lincoln, NE 68506 Phone: 402.489.2081 Cell Phone: 402.440.8284 Fax: 402.489.6093 This email may contain confidential and privileged information for the sole use of the intended recipient. Any review or distribution by others is strictly prohibited. If you are not the intended recipient please contact the sender and delete all copies.

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Aetna - CHI Health
by Tara Johnson 27 Nov '24

27 Nov '24

SLEBC Insured - I wanted to send a quick note as SLEBC has been notified that CHI has officially opted to not renew their contract with Aetna. This is still an ongoing situation and with many similar situations, we have seen agreements reached after the 'deadline'. We will continue to provide updates as received on the status. Meritain has provided a list of providers who have opted to negotiate directly with CHI linked below. Members who are impacted by this negotiation should have already received notification from CHI regarding the potential to be OON. CHI Health Partners Affiliated Providers List Nov. 26, 2024.pdf<https://www.aetnacommercialbusinesses.com/Segments/2024/Providence_Network/…> If you would like to review out-of-network costs, please see page ten of the attached benefit guide. If you would like to look up in-network providers, use the Aetna Open Choice PPO network option here<https://www.aetna.com/dsepublic/#/contentPage?page=providerSearchLanding&si…>. Please let me know if you have any questions! Thank you, Tara Tara Johnson Director of Operations & Benefits State Law Enforcement Bargaining Council STAN | NCOA | NSFMA PO Box 6729 Lincoln, NE 68506 Phone: 402.489.2081 Cell Phone: 402.440.8284 Fax: 402.489.6093 This email may contain confidential and privileged information for the sole use of the intended recipient. Any review or distribution by others is strictly prohibited. If you are not the intended recipient please contact the sender and delete all copies.

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2025 Retiree SLEBC Open Enrollment - Due Monday, November 25, 2024
by Tara Johnson 22 Nov '24

22 Nov '24

You are in receipt of this email as a previously SLEBC covered employee of the State of Nebraska and are currently enrolled in the SLEBC Retiree Plan. SLEBC Open Enrollment for the 2025 plan year will be held from November 17th to November 25th, 2024. Elected changes will become effective January 1st, 2025. If you wish to make changes, please submit the necessary forms for Medical, Dental, and Vision coverage - if you do not have changes, you do NOT need to submit forms. The SLEBC Board is happy to report that we have been able to maintain the same coverages we are accustomed to with an addition of a few items. We are thankful that we do not have any major plan design changes to our medical, dental or vision plans. You will find slight increases in the medical rates due to the increasing costs seen with current inflation along with plan usage. As a self-funded health plan, this is a direct reflection of you being mindful of your utilization and using the tools available to make good healthcare decisions. We encourage you (and your family) to check in with your primary care provider for your annual preventative visit and continue to work toward being the healthiest you! Please 🙂 watch a 30-minute review of your benefits here<https://drive.google.com/file/d/173YC9l738b3xZnBX01ho2G9dqo6JAL3n/view?usp=…> <https://drive.google.com/file/d/173YC9l738b3xZnBX01ho2G9dqo6JAL3n/view?usp=…> - you will learn something, I promise! 2025 SLEBC Benefit Changes • Prescription Benefit Management in 2025 will be ServeYouRx and the formulary should cause very little disruption (less than 10 scripts). • Nutrition Counseling is now available in-network for a $15 copay with a licensed dietitian or nutritionist. • Out-of-Network Hearing Aid benefit will mirror In-Network benefits. • GLP-1 option for weight loss is available at a discounted rate through a reputable pharmacy - this is funded by the member directly. • There are no changes for dental or vision. There is an increase in your medical premium. Attachment Review: * 2025 Enrollment Documents - Fillable with optional digital signatures. * 2025 SLEBC Benefit Guide * SLEBC 2025 SBC * 2025 SLEBC Open Enrollment Presentation Deck * 2025 Medical, Dental, Vision Rates (rates are also found in the SLEBC Benefit Guide) * Life Services Toolkit (information to prepare a will, power of attorney, bill of sales, etc.) * GLP-1 Information * ServeYouRx Mail Order Information ID Cards: NEW Card - Apta Health (Medical/Rx) Utilize Current Card - Delta Dental (Dental) No ID Card - VSP (Vision) Providers use your DOB and/or the last four of your social security number. If you have a new mailing address and have not notified me, please respond to this email with your address immediately so that we can ensure your insurance documents are sent to the correct address. (Reminder: The state will NOT share this information with us.) Please always check your bank account for accuracy. If you find a discrepancy, please let me know. As always, if you would like to meet with me to discuss any benefits or have open enrollment questions, please let me know - I am more than happy to schedule a time to meet with you. Be safe, Tara Tara Johnson Director of Operations & Benefits State Law Enforcement Bargaining Council STAN | NCOA | NSFMA PO Box 6729 Lincoln, NE 68506 Phone: 402.489.2081 Cell Phone: 402.440.8284 Fax: 402.500.3666 This email may contain confidential and privileged information for the sole use of the intended recipient. Any review or distribution by others is strictly prohibited. If you are not the intended recipient, please contact the sender and delete all copies.

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SLEBC Updates, Plan Notices, and Benefit Guide
by Tara Johnson 09 Sep '24

09 Sep '24

Happy Monday! If you are part of the SLEBC Medical plan, I have a few items to update you on. Please forward this email to anyone who is on the plan that may have interest, i.e. spouse, adult children, etc.. * We have a NEW URL to access your claims and plan information: SLEBC.myaptahealth.com<http://www.SLEBC.myaptahealth.com> * Secondly, you may have received mail from Magellan RX Management. Magellan RX Management has merged with Prime Therapeutics. Additional details regarding upcoming changes are listed below. New names for your PBM and pharmacy coming this fall: Magellan Rx Management, your current pharmacy benefit manager (PBM), merged with Prime Therapeutics in late 2022. Effective Oct. 1, Magellan Rx Management will become “Prime Therapeutics Management” and on Sept. 16 Magellan Rx Pharmacy will become “Prime Therapeutics Pharmacy.” You will receive additional information from their pharmacy if you currently use its services. * What this means for you: * On Sept. 16, the new website will be primetherapeutics.com. At that time, you will be able to access your new member portal by visiting wprimetherapeutics.com/member<http://www.primetherapeutics.com/member> and using the same login that you use today. Feel free to bookmark these websites for future use. * Please note that if your plan references magellanrx.com in its Summary of Benefits or other plan documents, starting on Sept. 16 you should instead go to your new member portal at primetherapeutics.com/member. * All current mail order medications should continue to be serviced with no disruption. * The phone number on your ID card remains the same. * I have attached both our SLEBC SBC and Benefit Guide for the 2024 calendar year. You'll find important information and required notices in these that you may want to reference throughout the year. I understand that this change may raise questions, and we want to assure you that we are committed to providing a seamless experience for you. Please feel free to reach out to me or the care coordinators or Magellan RX/Prime Therapeutics for additional assistance. Thank you, Tara Tara Johnson Director of Operations & Benefits State Law Enforcement Bargaining Council STAN | NCOA | NSFMA PO Box 6729 Lincoln, NE 68506 Phone: 402.489.2081 Cell Phone: 402.440.8284 Fax: 402.500.3666 This email may contain confidential and privileged information for the sole use of the intended recipient. Any review or distribution by others is strictly prohibited. If you are not the intended recipient, please contact the sender and delete all copies.

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