Express Scripts Announces New National

Winter 2013
Chicago Regional Council of Carpenters Welfare and Pension Funds
From the Trustees
Happy holidays to everyone! We hope this edition of on the LEVEL finds you and your
families enjoying good health and prosperity and looking forward to the promise of 2014!
Express Scripts Announces New National Preferred Formulary
The Chicago Regional Council of Carpenters Welfare Fund covers prescription drugs on the Express Scripts National Preferred Formulary —
a list of preferred generic and brand-name medications approved by the Food and Drug Administration (FDA). Express Scripts has recently
announced that effective April 1, 2014, it will exclude certain drugs from its Formulary. On or before this date, Plan participants will
have to switch to an alternate medication or pay the full retail price to receive an excluded drug. A list of the prescription drugs
that will be excluded from the Formulary appears below.
DRUG
TREATMENT FOR
DRUG
ADVAIR DISKUS
ASTHMA
KADIAN
ADVAIR HFA
ASTHMA
KAZANO
ALVESCO
ASTHMA
MAXAIR AUTOHALER
TREATMENT FOR
DRUG
TREATMENT FOR
PAIN
PEG-INTRON
HEPATITIS
DIABETES
PEG-INTRON REDIPEN
HEPATITIS
ASTHMA
PROVENTIL HFA
ASTHMA
RHINOCORT AQUA
ALLERGIES
APIDRA
DIABETES
MICARDIS
HIGH BLOOD PRESS/
HEART DISEASE
APIDRA SOLOSTAR
DIABETES
MICARDIS HCT
HIGH BLOOD PRESS/
HEART DISEASE
SAIZEN
GROWTH DEFICIENCY
AUVI-Q
ANAPHYLAXIS
NESINA
DIABETES
SIMPONI
INFLAMMATORY CONDITIONS
AVINZA
PAIN
NOVOLIN 70-30
DIABETES
STAXYN
IMPOTENCE
BECONASE AQ
ALLERGIES
NOVOLIN 70-30 INNOLET
DIABETES
STELARA
SKIN CONDITIONS
BETASERON
MULTIPLE SCLEROSIS
NOVOLIN N
DIABETES
TESTIM
HORMONAL SUPPLEMENTATION
BRAVELLE
INFERTILITY
NOVOLIN N INNOLET
DIABETES
TEVETEN HCT
HIGH BLOOD PRESS/
HEART DISEASE
BREO ELLIPTA
ASTHMA
NOVOLIN R
DIABETES
TEV-TROPIN
GROWTH DEFICIENCY
CIMZIA
INFLAMMATORY CONDITIONS
NOVOLIN R INNOLET
DIABETES
TRADJENTA
DIABETES
EDARBI
HIGH BLOOD PRESS/
HEART DISEASE
NOVOLOG
DIABETES
VERAMYST
ALLERGIES
EDARBYCLOR
HIGH BLOOD PRESS/
HEART DISEASE
NOVOLOG FLEXPEN
DIABETES
VICTOZA
DIABETES
EXALGO
PAIN
NOVOLOG MIX 70-30
DIABETES
XELJANZ
PAIN AND INFLAMMATION
FLOVENT DISKUS
ASTHMA
NUTROPIN
GROWTH DEFICIENCY
XOPENEX HFA
ASTHMA
FLOVENT HFA
ASTHMA
NUTROPIN AQ
GROWTH DEFICIENCY
ZETONNA
ALLERGIES
FOLLISTIM AQ
INFERTILITY
NUTROPIN AQ NUSPIN
GROWTH DEFICIENCY
ZIOPTAN
GLAUCOMA
FORTESTA
HORMONAL SUPPLEMENTATION
OMNARIS
ALLERGIES
JENTADUETO
DIABETES
OMNITROPE
GROWTH DEFICIENCY
Union Trustees Frank T. Libby Jeffrey Isaacson Gary Perinar, Jr. Keith Jutkins Bruce Werning Joseph Pastorino
Employer Trustees J. David Pepper Benjamin A. Johnston Paul R. Hellermann Gerald W. Thiel, Jr. Todd H. Harris Mike Forest
New National Preferred Formulary continued
Although this change in Formulary will affect some of our Plan participants, all of
the excluded drugs have a recommended replacement — either generic or brand
name — that is included in the revised Formulary. Any of the recommended
replacement medications are considered to be clinically appropriate and are
designed to meet your needs as well as the drug(s) they are replacing. And, this
change in the Formulary will have a huge impact on the significantly higher costs
associated with these brand-name medications. It will mean cost savings for you,
your families and the Plan in 2014.
If you are not using one of the drugs that will be excluded, you do not
have to take any action.
If you do take one of the excluded drugs, you will receive or may already have
received a letter from Express Scripts about the change in Formulary and the
drugs being recommended as alternatives. Contact your doctor as soon as
possible to discuss which of the covered alternatives may be appropriate for
you. If your doctor believes there will be no negative effect on your treatment
by switching to a covered alternative drug, he will provide you with a new
prescription.
In some situations, your doctor may feel it is medically necessary for you to
remain on a medication that is on the excluded list. If this is the case, on or
after April 1, 2014, your physician should contact Express Scripts to request a
Formulary Exception. If the request is approved, your doctor will be notified that
you may continue to obtain the excluded drug by paying the appropriate co-pay.
Your physician may request a clinical exception
from Express Scripts for certain conditions.
This exception process is not available until April 1, 2014.
If you have any questions about these changes, please contact
Express Scripts at 800-939-2089 for more information.
FREE Physical for You and Your Spouse
As an eligible participant, you and your spouse can receive a
FREE physical exam with a health evaluation each year!
See the current provider listing at www.crccbenefits.org
under News and Announcements, click on “Health Dynamics
Provider Listing.” To schedule your free physical, simply
call the provider directly to make an appointment.
Don’t forget to mention that you are with the
Chicago Carpenters Welfare Fund and you are
calling for a “Health Dynamics” physical. If you
have questions about the program, call Health
Dynamics at 414-443-0200.
FREE Counseling Sessions
Holiday blues? Life getting you down? Through your Member Assistance
Program (MAP), you and your dependents are eligible for five FREE counseling
sessions per person, per issue, per year. Call ComPsych at 888-860-1566 or visit
www.guidanceresources.com. First time users, use the password “CRCC.”
Generic Cymbalta Coming Soon!
Cymbalta is making its generic debut in
December. If you use Cymbalta, you may want
to talk to your doctor about switching to the
generic version. This simple change could save
you big bucks — if you decide to continue
taking Cymbalta once the generic is released,
your copay will increase to 35% of the cost.
Switch to generic and you’ll pay just a $5 copay.
Legally Married Same-Sex Spouses
Eligible for Plan Coverage in 2014
Starting June 1, 2014, the Welfare Fund
will allow legally married same-sex
spouses to participate in the Plan. We will
be hosting a special enrollment period in
the spring to allow legally married samesex couples the opportunity to enroll in
the Plan.
The enrollment period will take place from
April 1 through May 15, 2014. The appropriate
documents will need to be provided to the Fund
by May 15 for a June 1 effective date. To be
eligible, same-sex couples will need to provide
their original certified marriage certificate
issued by a state that legally recognizes same-sex
marriage.
For those same sex couples who marry after
June 1, 2014, enrollments will begin the first
of the month following the receipt of the
appropriate documents. For example, if you
submit the original certified marriage certificate
on June 8th, the effective date of coverage will
be July 1st.
If you have questions, please contact the Health
Benefits Department at 312-787-9455, Menu
Option 3.
Participant Services
Health Benefits:
Phone: 312-787-9455/Option 3 Fax: 312-951-1515
Pension Benefits:
Phone: 312-787-9455/Option 4 Fax: 312-951-3986
Contributions & Collections: Phone: 312-787-9455/Option 5 Fax: 312-787-3212
Administration:Phone: 312-787-9455/Option 7 Fax: 312-951-2996
Website:
www.crccbenefits.org
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The information provided in on the LEVEL is of a general nature only and does not replace or alter the official rules and policies contained in the official plan
documents that legally govern the terms and operation of the Welfare Fund. If this newsletter differs in any way from the official plan documents, the official
plan documents always govern. Receipt of this newsletter does not guarantee eligibility for benefits. The Trustees have the right to modify benefits at any time.