n August of 2023, the League’s Board of Trustees voted to end the Health Benefits Trust (HBT) contract with its provider, MedCost, and transition to the League’s new provider partners, Aetna and Vimly Benefits Solution, effective July 1, 2024. The League fully understands the uncertainty and questions that stem from such an important change. The decision to switch providers was not made lightly. This transition will allow League staff to have more involvement in eligibility and provide the ability to help members more directly, bringing a higher level of customer service facilitated by the League, to members. “Taking billing, eligibility, and customer service in-house doesn’t only provide cost savings to our membership in future years; it’s an investment in fostering direct relationships, enhancing accountability, and driving positive change from within. We are excited about the future of this program and what we will be able to do for our membership with these changes,” says Youssou Fall, NCLM Director of Strategic Operations. So, what does this mean for HBT members? To modernize plan options with this transition, some benefits will be altered to have a more positive impact on members’ overall experiences. Members will still receive similar great plan options. One important change is the way these plan benefits are administered to members. For example, existing members are familiar with MedCost’s provider Teladoc as a virtual, on-demand care service. Aetna offers CVS Virtual Care and CVS Virtual Primary Care as their virtual, on-demand care provider. View the full list of new program names in the chart to the right. Members can expect the same health care they are accustomed to under their current HBT plan offered by the League, including medical, dental, vision, pharmacy, life, and short-term disability benefits. Aetna’s expansive provider network will be able to offer members even more access in the 2024–2025 plan. Their provider network is a 99.6% match to providers previously offered through MedCost. The few primary care physicians not currently in Aetna’s provider network will be “grandfathered” in as in-network providers for current pool members. The bottom line is members will not have to change their primary care physician. With this greater network of new providers, members can get access to care that is conveniently located close to them, no matter where they are in North Carolina. Vimly Benefit Solutions, and its software platform named SIMON, will be the billing and eligibility vendor for all HBT plans. The SIMON software allows the League to bring eligibility in-house. I RMS UPDATE Health Benefits Trust Transition to Aetna ISABELLA MORMANDO Communications Associate 2023–2024 Programs 2024–2025 Aetna Program Name Teladoc CVS Health Virtual Care CVS Health Virtual Primary Care Teladoc Mental Health CVS Health Virtual Care— Mental Health SmartStarts Aetna Enhanced Maternity Active and Fit Direct Aetna Health Your Way—Engage Aetna member website Aetna Concierge CAM Benefits CAM Benefits Wondr Health Wondr Health Diabetes Management Program Diabetes Management Program Personal Care Management Aetna One Flex 24-Hour Nurse Line Claims Portal Aetna member website Aetna Health app Aetna Concierge Rx Benefits Aetna Pharmacy Optum Rx Aetna Pharmacy Atrium Specialty Pharmacy CVS Specialty Pharmacy Tobacco Cessation Aetna Health Your Way—ENGAGE Online digital coaching programs—Quit Tobacco. ACA Required. Smoking cessation counseling 8 visits per year. Covered same as Adult Routine Exam. Also available via MinuteClinic at select CVS Pharmacy locations. ACA Required. Eligible tobacco cessation drugs with prescription. SOUTHERN CITY Quarter 1 2024 16
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