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YOUR BOEING PRESCRIPTION DRUG PROGRAM EFFECTIVE JANUARY 1, 2021 This is a Boeing Total Rewards Partner
FOR THE FOLLOWING INDIVIDUALS COVERED BY BOEING-SPONSORED MEDICAL PLANS: • Employees and their spouses and dependents • Retirees and their spouses and dependents not eligible for Medicare WHAT’S INSIDE: Introducing Prime Therapeutics 3 Getting Started 4 What to Expect Next 8 Support During this Change 9 Frequently Asked Questions 10 Online Resources: myprime.com/boeing
INTRODUCING
PRIME THERAPEUTICS
Prime Therapeutics LLC (Prime)1 has been selected by Boeing
as your new pharmacy benefit administrator. We are pleased
to be entrusted with your care and are committed to providing
outstanding service, pharmacy expertise and convenience for
you and your eligible family members. Prime will replace Express
Scripts,® and this change will take effect on January 1, 2021.
Prime is collectively owned by several Blue Cross and Blue Shield plans,
subsidiaries or affiliates of those plans, including the main administrator of
Boeing-sponsored medical plans — Blue Cross and Blue Shield of Illinois
(BCBSIL). Today, Prime provides pharmacy benefit management services for
over 30 million members across many medical plans.
For Boeing, we’ll provide pharmacy benefit management services for these
Boeing-sponsored plans: all medical plans administered by BCBSIL, plus
Cigna HMO and Aetna HMOs (except the Aetna HMO in Kansas).
We’ll offer you services and features that are similar to those you have
had with Express Scripts — a large national network of retail pharmacies,
a home delivery (mail order) and specialty pharmacy and a drug list that’s
comparable to your current list. Plus, you’ll find new features like the
opportunity to get up to a 90-day supply of medications at over 54,000
retail pharmacies.
3GETTING STARTED
This section describes our prescription drug list, how to fill your prescriptions and more.
It also includes tips on how to make the transition easier.
PRESCRIPTION DRUG LIST FILLING YOUR PRESCRIPTIONS
The prescription drug list is a list of medications covered • Retail Pharmacies — The Prime network of retail
by your Boeing-sponsored prescription drug program. pharmacies has over 55,000 independent and
Same as today, the list will be split into three categories, chain pharmacies, or over 99% of those used by
called tiers — generics, preferred brand drugs and non- Boeing employees and retirees today. As with the
preferred brand drugs — and the amount you pay for current Express Scripts pharmacy network, local
medications in each tier in 2020 stays the same Walgreens pharmacies will not be part of the Prime
in 2021. retail pharmacy network. To find a network pharmacy,
Effective January 1, 2021, some drugs will change visit myprime.com/boeing and click on Find a
coverage tiers, with some going to a higher cost tier, Pharmacy. In most cases, we’ll send you a letter in late
and some will no longer be covered. Overall, about November if you’re using a pharmacy that’s not in the
97% of drugs on the current list remain on the new list, network. The letter will show you nearby participating
and about 95% of drugs that continue to be covered pharmacies you can use.
will remain in their current coverage tier. These kinds • Home Delivery Service — Your new Home Delivery
of adjustments also occurred from time to time under (mail order) pharmacy will be AllianceRx Walgreens
Express Scripts. Prime. This service allows you to get up to a 90-day
To check coverage for any drug you’re taking now, please supply of medications that you take on a regular basis,
visit myprime.com/boeing, click on Find Medicines, mailed to your home.
answer a few questions to identify your medical plan and Most prescriptions currently on file with Express Scripts
simply enter the name of the drug. In most cases, we’ll Home Delivery will be transferred automatically to
send you a letter in late November if you’re taking a drug AllianceRx Walgreens Prime, as long as there are refills
where coverage may be changing. The letter will let you on file that extend beyond January 1, 2021. We’ll
know the impacted drug(s) and your next steps. send you a letter in late November about the transfer
In some plans, certain drugs are classified as preventive process. The letter will also explain when and what
drugs and may be available at lower costs. The list steps you will need to take to set up a new account.
of these drugs will be available early November at Prescriptions for compound medications or controlled
myprime.com/boeing and will be changed somewhat substances cannot be transferred and will require a
for 2021. new prescription. If that’s your situation, you’ll also get
a letter in late November that explains what you need
to do.
• Transition Tip — If you’re not using Express Scripts
Home Delivery today and want to get started after
January 1, 2021, visit myprime.com/boeing on or
after that date and click on home delivery sign up. Or,
you can call Member Service Center. See the Support
During this Change section on page 9 for details.
4• Retail Pharmacies that Fill a 90-Day Supply of • Specialty Pharmacy — Specialty medications are
Medications — For added convenience and cost used to treat chronic and complex conditions such as
savings to you, over 54,000 or nearly 98% of the retail multiple sclerosis, hepatitis C or rheumatoid arthritis.
pharmacies in the network will allow you to get up to a As is the case today, most specialty medications
90-day supply of maintenance medications (other than need to be filled by your plan’s specialty pharmacy to
specialty medications) for the same copay you would be covered. Starting January 1, 2021, the specialty
pay if you used the home delivery service. These retail pharmacy will be AllianceRx Walgreens Prime. You can
pharmacies can fill either short-term prescriptions find out if a drug is considered a specialty medication
or prescriptions of up to 90-days. To find these retail by going to myprime.com/boeing, clicking on Find
pharmacies, visit myprime.com/boeing and click on Medicines, answering a few questions to identify your
Find a Pharmacy. A pharmacy that provides this service medical plan and entering the name of a drug to see if
will show a “90-day” designation in its listing. it has a specialty indicator. This list changes from time
• Transition Tip — If you want to start getting a to time. If you’re taking one of the drugs that will be
90-day supply of a medication at a retail added to the list for 2021, we will send you a letter
pharmacy after January 1, 2021, ask your in November.
doctor to prescribe up to a 90-day supply of your • Transition Tip — If you’re having a specialty
maintenance medication. You or the doctor can medication filled today at Accredo, the specialty
submit that prescription to the pharmacy. pharmacy affiliated with Express Scripts, Accredo will
transfer your prescription to AllianceRx Walgreens
Prime, as long as you have refills on your prescription
that extend beyond January 1, 2021.
If this applies to you, we will send you a letter in late
November. Given the special handling or protocols
that specialty medications sometimes require, we’ll
invite you to call us then, or we’ll try to call you,
to help you with this transition and make sure you’re
comfortable with how the specialty process works.
5GETTING STARTED CONTINUED
PHARMACY BENEFIT
REVIEW PROGRAMS
As was the case with Express Scripts, there are programs Go to myprime.com/boeing, click on Find Medicines and
designed to encourage safe, cost-effective and answer a few questions to identify your medical plan to
appropriate use of medications. The programs described see what drugs may be subject to these special programs.
below will not take effect on January 1, 2021 for
prescriptions that you take now but may affect new
prescriptions after that date.
PROGRAM WHAT IT IS WHAT YOU NEED TO KNOW OR DO
Prior Authorization (PA) Some drugs may need to be approved • If you’re currently taking a drug that
by the program before they are covered. has a Prior Authorization on file with
This is so the program can best guide Express Scripts, and it extends beyond
appropriate use of these drugs. Your December 31, 2020, we’ll get that
doctor can help you with this process. information from Express Scripts and
honor the authorization through the date
it has been approved but no later than
December 31, 2021. Then, we’ll ask your
doctor to provide updated information.
• If your Prior Authorization expires soon
after January 1, 2021, you’ll want to talk
to your doctor now about your options
and be ready to submit information to us
shortly after January 1, 2021.
Step Therapy (ST) A “step” approach is required to receive This program will only apply to certain
coverage for certain high-cost drugs. This drugs that you begin taking for the first
means a drug will not be covered unless time on or after January 1, 2021.
you try some other lower-cost drug that
works just as well first.
Dispensing Limits (QL) These limits (also called quantity limits) This program will only apply to certain
may be applied on select drugs. Limits drugs that you begin taking for the first
may involve how much covered medicine time on or after January 1, 2021.
may be filled per prescription or in a given
time span. If your doctor prescribes an
amount that is more than the dispensing
limit, you can still get the drug. But, you
may have to pay for the full cost of the
prescription beyond what your coverage
allows. In most cases, these limits apply
for safety reasons.
6EXPLORE MYPRIME.COM/BOEING,
THE MEMBER WEBSITE
You can now visit the website to view a preview of the:
• Prescription drug list of covered medications
• Estimated prescription drug costs
• Drugs included in pharmacy benefit review programs
• In-network pharmacies
Starting January 1, 2021, you can register on the
website and get the information shown above plus:
• AllianceRx Walgreens Prime specialty pharmacy and
home delivery service general information
• More precise cost estimates for different drugs
• Your prescription drug claims history
• Submit requests for home delivery refills or specialty
pharmacy services online
You can access the website from your smartphone,
tablet or computer. Even though an app is not
available, the website is optimized for mobile devices.
That makes it very easy to use. If you participate in
a Boeing-sponsored medical plan administered by
BCBSIL, you can go to your account on the Prime
website — without having to sign in — when you log in
to your Blue Access for Members (BAM ) account.
SM SM
7WHAT TO EXPECT NEXT
1 November 3 – 24
Boeing annual enrollment
2 Early November
You will receive a letter in early November if you are having a specialty
medication filled today at Accredo. Due to the special handling or protocols
that specialty medications sometimes require, we’ll invite you to call us, or
we’ll try to call you, to make sure you are ready to go beginning January 1.
3 Late November
You may receive a letter that lets you and your doctor know what you need
to do on or after January 1, 2021, if you:
• Are taking a drug that may have a coverage change,
• Are using a pharmacy that will no longer be in network,
• Are using the Express Scripts Home Delivery Service, or
• Have a Prior Authorization on file with Express Scripts.
4 Late December
If you’re enrolled in a Boeing-sponsored medical plan administered by
BCBSIL, you will get a new Member ID card by the end of 2020. This ID card
will replace the separate medical and prescription drug ID cards that you
have today. You should use your new ID card for all medical providers and
when filling your prescriptions starting January 1, 2021.
If you’re enrolled in a Cigna HMO or Aetna HMO (except Kansas)
medical plan, you will get a new medical ID card from your medical plan.
Your new prescription drug ID card will be mailed separately by the end of
2020. Be sure to use your new prescription drug ID card when filling your
prescriptions on or after January 1, 2021.
5 January 1, 2021
• Your 2021 prescription drug benefits go into effect.
• You can go to myprime.com/boeing to set up your personal account.
• If needed, you can use this site to access AllianceRx Walgreens Prime and
complete setting up your account.
8SUPPORT DURING THIS CHANGE
We understand that you may need help or more information during this transition,
so we’ve set up a dedicated website and member service center. We can answer
your questions and help you with the resources you need:
MEMBER SERVICE CENTER ONLINE RESOURCE
BCBSIL Members myprime.com/boeing
888.802.8776
Go online anytime using any device to view
Aetna HMO/Cigna HMO Members the prescription drug list, find retail pharmacies
800.421.6022 near you and more.
Member Service Representatives are available
Monday-Friday, 8 a.m. to 8 p.m., Eastern time.
9FREQUENTLY ASKED QUESTIONS
Q: Why is Walgreens not in the local retail network? Q: If my doctor wants to request some type of
A: By not including Walgreens local retail pharmacies, exception, whom would they contact?
Prime is able to deliver a more cost-effective A: If your doctor wants to ask Prime for an exception, a
arrangement for Boeing. The retail network has coverage determination or to make an appeal, your
broad geographic coverage without Walgreens. doctor can call the Member Service Center phone
Walgreens local retail pharmacies were also excluded number on your ID card after January 1, 2021 to
from the network through Express Scripts prior to ask for a review. Prime will help guide your doctor
January 1, 2021. through the next steps, including filling out any forms.
If the coverage request is denied, Prime Therapeutics
Q: If I have a Health Care Flexible Spending Account
will let you and your doctor know why it was denied.
(FSA) or a Health Savings Account (HSA), will
I still be able to use my debit card to pay for Q: Why will some drugs no longer be covered or
prescription drug expenses? change to a higher-cost tier?
A: Yes. The debit card from either the Health Care FSA A: These changes can happen for a variety of reasons:
or HSA can be used at network retail pharmacies as there may be over-the-counter (OTC) alternatives,
well as the AllianceRx Walgreens Prime home delivery or there may be lower-cost alternatives that clinical
and specialty pharmacy. experts consider to be equally effective. If a drug
you’re taking is in the small percentage that will
no longer be covered, the letter we send in late
November will let you know, in most cases, about
other covered drugs that treat the same condition.
These kinds of adjustments also occurred from time
to time under Express Scripts.
10Q: Are the terms “preferred brand” and “non-
preferred drug” new?
A: The term “preferred brand” is now being used to refer
to the tier that had been called “formulary brand.”
The term “non-preferred drug” replaces the previous
term “non-formulary brand.”
Q: Are there any programs to help us learn how to
save money on our prescription drug expenses?
A: Toward the end of 2020 or in early 2021, we’ll send
you information about Rx Savings Solutions (RxSS).2
This is a confidential and optional service that gives
personalized prescription guidance at no cost to
help you save money. The service can send you a text
or email if you ever pay too much for a prescription.
RxSS finds other ways to get the same treatment
for less money. You can pre-register for this service
before January 1. You can find the link to register
at myprime.com/boeing.
11As always, treatment decisions are between you and your
doctor. Coverage is based on the terms and limits of your
Boeing-sponsored Medical Plan.
1
Prime Therapeutics LLC is an independent company providing
pharmacy benefit management services for Boeing health
plan members. Prime Therapeutics has an ownership interest
in AllianceRx Walgreens Prime, a central specialty pharmacy
and mail service company. Myprime.com/boeing
is an online resource offered by Prime Therapeutics LLC.
2
Rx Savings Solutions (RxSS) is an independent company that
contracts directly with Prime to provide Rx consultations.
RxSS does not offer other health plan products or services
and is solely responsible for the products and services that
it provides. There are no endorsements, representations or
warranties made regarding third-party vendors. Members
should contact the vendor directly with questions about the
products or services offered by third parties.
7049-A BOE © Prime Therapeutics LLC 09/20
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