ORDER NO. 31579 KERR COUNTY EMPLOYEE PRESCRIPTION DRUG AND INSURANCE HEALTH PLANS Came to be heard this the 28th day of December, 2009, with a motion made by Commissioner Baldwin, seconded by Commissioner Williams, the Court unanimously approved by a vote of 3-0-0 to: Approve the recommended modifications to the Kerr County Employees Prescription and Insurance Health Plans for 2010, as presented. ~ ~ ~ 3~~~9 COMMISSIONERS' COURT AGENDA REQUEST PLEASE FURNISH ONE ORIGINAL AND TEN (10) COPIES OF THIS REOUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT MADE BY: Eva Hyde MEETING DATE: December 28, 2009 OFFICE: Human Resources TIME PREFERRED: SUBJECT: Consider, discuss and take appropriate actions on amendments/modifications to Kerr County Employees prescription drug and insurance health plans. EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON) NAME OF PERSON ADDRESSING THE COURT: Eva Hyde ESTIMATED LENGTH OF PRESENTATION: IF PERSONNEL MATTER - NAME OF EMPLOYEE: Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter 551 and 552, Government Code, is as follows: Meeting scheduled for Mondays: THIS REQUEST RECEIVED BY: THIS RQUEST RECEIVED ON: 5:00 PM previous Tuesday @ .M. All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be appreciated and contribute towards your request being addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners' Court. Page 1 of 2 Jody Grinstead From: Eva Hyde [ehyde@co.kerr.Uc.us] Sent: Wednesday, December 23, 2009 10:06 AM To: ptinley@co.kerr.tx.us; bwilliams@co.kerr.Uc.us; Jody Grinstead Cc: 'Eva Hyde'; 'Malek, Carey'; Gary Looney Subject: Commissioners Court Agenda Item Information re: Scripts Attachments: SCL Diabetic Program Letter 2009.pdf; 2010 Scriptcare Changes.doc Good Morning, Jody, please use both attachments as back up info for the Court review books. This is the information regarding the agenda item for our Prescription Drug plan and my recommendations for modifying the plan. OTC (add these~ Omeprazole Prevacid OTC Nicotine Replacement Patches Tobacco Cessation Plan Limit to $500.00 Bi-Annual with a Lifetime Maximum Benefit of $2000.00 which includes OTC $0.00 Co-pay Items. (Bi-Annual = every other year) SCL Diabetic Program (Change to SCL) Mandatory Program - currently have 19 diabetics acquiring medication for diabetes yet only 9 acquired supplies. (See attachment "SCL Diabetic Program Letter") Co-Pay Structure (Change Plan) Current Plan New Plan Retail (30-Day Supply) $10.00 Generic $5.00 $20.00 Formulary $25.00 $35.00 Non-formulary $40.00 $0.00 Alternative $55.00 Current Plan New Plan Mail (90-Day Supply) $20.00 Generic $20.00 (reduced to $10.00 x 2=$20) $25.00 Formulary $50.00 $40.00 Non-formulary $80.00 $0.00 Alternative $110.00 NOTE: Mail Plan is set up to be 2 retail copays for a 90 day supply. If the retail copay is $10.00, $10 x 2=$20; $25 x2=$50etc Current Plan New Plan National Diabetic Pharmacy NDP $5.00 Generic SCL Pharmacy $0.00 $5.00 Formulary $5.00 $35.00 Non-formulary $35.00 Current Plan New Plan Specialty $20.00 Generic $10.00 $40.00 Formulary $45.00 $70.00 Non-formulary $75.00 Alternative Tier Medications ~ 55.00 (Retail) OR Alternative $5.00 Generic Alternative Tier Medications Therapeutic Alternatives Aci hex ome razole, anto razole, lanso razole Celebrex meloxicam, nonsteroidal anti-inflammatory a ents 12/23/2009 Page 2 of 2 Crestor simvastatin, ravastatin, lovastatin Ka idex ome razole, anto razole, lanso razole Li itor simvastatin, ravastatin, lovastatin Nexium ome razole, anto razole, lanso razole V torin simvastatin, ravastatin, lovastatin Over The Counter (OTCI Zero CoAayment Meds Current Prilosec OTC (20mg) Pepcid AC OTC ( l Omg and 20mg) Pepcid Complete OTC (lOmg) Zantac OTC (75mg and 150mg) Tagament HB (200mg) Axid AR (75mg) Claritin OTC (lOmg) Alavert OTC (lOmg) Loratidine OTC (lOmg) Zyrtec OTGCetrizine OTC (effective 3/12/2008) New Prilosec OTC (20mg) Pepcid AC OTC (lOmg and 20mg) Pepcid Complete OTC (lOmg) Zantac OTC (75mg and 150mg) Tagament HB (200mg) Axid AR (75mg) Claritin OTC (lOmg) Alavert OTC (lOmg) Loratidine OTC ( l Omg) Zyrtec OTGCetrizine OTC (effective 3/12/2008) Omeprazole **"NEW""' Prevacid OTC "*"NEW*"* Nicotine Replacement Patches "**NEW*"* I hope this is pretty clear, I will be asking Jody to ensure this is in the Court Notes.... Eva M. Hyde Kerr County H.R. Director ei~+ilcii`co.kerr.t~.us $3t)-89G-9(}?3 o~1'lice ;33p-2;7-4227 1ax Confidentiality Notice: Protected Health Information Enclosed: Protected Health Information (PH) is personal and sensitive Individually-identifiable information related to a person's health care. It is being faxed/emailed to you after appropriate authorization from the individual or under circumstances that do not require authorization. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Re-disclosure without authorization or as permitted by law is prohibited. Unauthorized re-disclosure or failure to maintain confidentiality could subject you to penalties described in federal and state law. IMPORTANT WARNING: This message is intended for the use of the person or entity to which it is addressed. If you are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any disclosure, copying or distribution of this information is strictly prohibited. Please notify the sender immediately to arrange for the return or destruction of these misdirected documents. 12/23/2009 We understand that living with diabetes can be a challenge. Research shows keeping your blood sugar close to your target range lowers your risk of diabetes complications. It is important to check your blood sugar every day, using an accurate blood glucose monitoring system. Use of these results allows you and your health care team to take the right steps to maximize your glucose control. The SCL Diabetic Program is offered as part of your prescription drug program administered by Script Care and offers tremendous savings on products and services. This program will allow you to take a giant step toward better and affordable diabetes care. Here are some answers to key questions you may have: What does this mean to me? The SCL Diabetic Program is available for you to order your diabetes medications, equipment, and supplies. Additionally, the SCL Diabetic Program will ship your order right to your door. Best of all, the SCL Diabetic Program will call you when it is time to reorder. No more running out of test strips! What do you mean by diabetes medications, equipment, and supplies? • All refrigerated and non-refrigerated diabetic drugs • Home Blood Glucose Monitor - Free of Charge* • Blood Glucose Test Strips • Lancets • Spring-Powered Device for Lancets • Syringes • AlcoholPads • Insulin (not required to be purchased through the SCL Diabetic Program) You may not need all the items listed above. Your physician will determine what is required for your care. What if I already have a home blood glucose monitor? You can continue to use it or the SCL Diabetic Program can provide you with a new monitor that may offer additional features. A 90- day shipment of supplies will be sent with the new monitor. What if I am unsure how to use my new monitor? You will receive directions with your shipment. You can also call the SCL Diabetic Program to receive instructions over the phone, in English or Spanish. How do I get started? Simply call the SCL Diabetic Program at 1-866-561-8047. The SCL Diabetic Program will then verify your benefits for diabetes supplies and what, if any, copays apply. What should I do when it is time to reorder my supplies? An SCL Diabetic Program representative will call you at home once every 90 days to inventory your supplies and replenish them accordingly. They will verify your order and health coverage before mailing your next shipment. If you have moved, or your phone number has changed, please notify the SCL Diabetic Program promptly so they can continue the reorder service uninterrupted. If you have questions concerning your diabetes medications, equipment, or testing supplies, please feel free to contact the SCL Diabetic Program at 1-866-561-8047 for more information. SCL Diabetic Program P.O. Box 12607 Beaumont, TX 77726-2607 Customer Service Hours Monday - Friday 7:00 a.m. to 6:00 p.m. (CST) Telephone: (866) 561-8047 Fax: (409) 866-1317 www.scriptcare.com * Accu-Chek and Life Scan honae blood glucose monitors are anailable free of charge. Benefits sa~bject to estab/ished plan provisions and copay aniounts. The SCL Diabetic Program MUST be used to obtain diabetic drugs and supplies. Recommended Modifications to the Prescription Plan for 2010 Commissioners Court 12-28-09 OTC (add thesel Omeprazole Prevacid OTC Nicotine Replacement Patches Tobacco Cessation Plan Limit to $500.00 Bi-Annual with a Lifetime Maximum Benefit of $2000.00 which includes OTC $0.00 Co- pay Items. (Bi-Annual = every other year) SCL Diabetic Proqram (Change to SCL) Mandatory Program - currently have 19 diabetics acquiring medication for diabetes yet only 9 acquired supplies. (See attachment "SCL Diabetic Program Letter") Co-Pav Structure (Change Plan) Retail (30-Day Supply) Current Plan $10.00 Generic $20.00 Formulary $35.00 Non-formulary $0.00 Alternative Current Plan Mail (90-Day Supply) $20.00 Generic $25.00 Formulary $40.00 Non-formulary $0.00 Alternative NOTE: Mail Plan is set up to be 2 retail copays for a 90 day supply $25 x 2 = $50 etc Current Plan Natl Diabetic PharmacyNDP $5.00 Generic $5.00 Formulary $35.00 Non-formulary Current Plan Specialty $20.00 Generic $40.00 Formulary $70.00 Non-formulary New Plan $5.00 $25.00 $40.00 $55.00 New Plan $20.00 (reduced $10.00 x 2 = $20) $50.00 $80.00 $110.00 If the retail copay is $10.00, $10 x 2=$20; New Plan SCL Pharmacy $0.00 $5.00 $35.00 New Plan $10.00 $45.00 $75.00 Eva Hyde Page 1 12/23/2009 Alternative Tier Medicatians (~ $55 00 (Retail) OR Alternative $5 00 Generic Alternative Tier Medications Therapeutic Alternatives Aciphex omeprazole, pantoprazole, lanso razole Celebrex . meloxicam, nonsteroidal anti- inflammatory agents Crestor simvastatin, ravastatin, lovastatin Kapidex omeprazole, pantoprazole, lansoprazole Li itor simvastatin, pravastatin, lovastatin Nexium omeprazole, pantoprazole, lanso razole V torin simvastatin, pravastatin, lovastatin Over The Counter (OTCI Zero Copavment Meds Current Prilosec OTC (20mg) Pepcid AC OTC (lOmg and 20mg) Pepcid Complete OTC (1 Omg) Zantac OTC (75mg and 150mg) Tagament HB (200mg) Axid AR (75mg) New Prilosec OTC (20mg) Pepcid AC OTC ( l Omg and 20mg) Pepcid Complete OTC (lOmg) Zantac OTC (75mg and 150mg) Tagament HB (200mg) Axid AR (75mg) Claritin OTC (lOmg) Alavert OTC (lOmg) Loratidine OTC (lOmg) Zyrtec OTC/Cetrizine OTC (effective 3/12/2008) Claritin OTC (lOmg) Alavert OTC (1 Omg) Loratidine OTC ( l Omg) Zyrtec OTC/Cetrizine OTC (effective 3/12/2008) Omeprazole *'`"NEW"** Prevacid OTC '`**NEW*** Nicotine Replacement Patches ``*NEW*** Eva Hyde Page 2 12/23/2009 Recommended Modifications to the Prescription Plan for 2010 Commissioners Court 12-28-09 OTC (add thesel Omeprazole Prevacid OTC Nicotine Replacement Patches Tobacco Cessation Plan Limit to $500.00 Bi-Annual with a Lifetime Maximum Benefit of $2000.00 which includes OTC $0.00 Co- pay Items. (Bi-Annual = every other year) SCL Diabetic Proctram (Change to SCL) Mandatory Program - currently have 19 diabetics acquiring medication for diabetes yet only 9 acquired supplies. (See attachment "SCL Diabetic Program Letter") Co-Pav Structure (Change Plan) Retail (30-Day Supply) Current Plan $10.00 Generic $20.00 Formulary $35.00 Non-formulary $0.00 Alternative Current Plan Mail (90-Day Supply) $20.00 Generic $25.00 Formulary $40.00 Non-formulary $0.00 Alternative NOTE: Mail Plan is set up to be 2 retail copays for a 90 day supply $25 x 2 = $50 etc Current Plan Natl Diabetic PharmacyNDP $5.00 Generic $5.00 Formulary $35.00 Non-formulary Current Plan Specialty $20.00 Generic $40.00 Formulary $70.00 Non-formulary New Plan $5.00 $25.00 $40.00 $55.00 N~w Plan S , o $29:00 (reduced $46.00 x 2 = $~6) $ 50.00 $80.00 $110.00 If the retail copay is $10.00, $10 x 2=$20; New Plan SCL Pharmacy $0.00 $5.00 $35.00 New Plan $10.00 $45.00 $75.00 Eva Hyde Page 1 12/28/2009 \ Alternative Tier Medications Ca~ $55.00 (Retail) OR Alternative $5.00 Generic Alternative Tier Medications Therapeutic Alternatives Aciphex omeprazole, pantoprazole, lanso razole Celebrex meloxicam, nonsteroidal anti- inflammatory agents Crestor simvastatin, ravastatin, lovastatin Kapidex omeprazole, pantoprazole, lanso razole Li itor simvastatin, ravastatin, lovastatin Nexium omeprazole, pantoprazole, lanso razole V torin simvastatin, ravastatin, lovastatin Over The Counter (OTC) Zero Copavment Meds Current Prilosec OTC (20mg) Pepcid AC OTC (lOmg and 20mg) Pepcid Complete OTC (lOmg) Zantac OTC (75mg and 150mg) Tagament HB (200mg) Axid AR (75mg) Claritin OTC (lOmg) Alavert OTC ( l Omg) Loratidine OTC ( l Omg) Zyrtec OTGCetrizine OTC (effective 3/12/2008) New Prilosec OTC (20mg) Pepcid AC OTC ( l Omg and 20mg) Pepcid Complete OTC (lOmg) Zantac OTC (75mg and 150mg) Tagament HB (200mg) Axid AR (75mg) Claritin OTC (lOmg) Alavert OTC (lOmg) Loratidine OTC ( l Omg) Zyrtec OTC/Cetrizine OTC (effective 3/12/2008) Omeprazole `*"NEW*** Prevacid OTC "*"NEW*** Nicotine Replacement Patches '"'NEW*"" Eva Hyde Page 2 12/28/2009 We understand that living with diabetes can be a challenge. Research shows keeping your blood sugar close to your target range lowers your risk of diabetes complications. It is important to check your blood sugar every day, using an accurate blood glucose monitoring system. Use of these results allows you and your health care team to take the right steps to maximize your glucose control. The SCL Diabetic Program is offered as part of your prescription drug program administered by Script Care and offers tremendous savings on products and services. This program will allow you to take a giant step toward better and affordable diabetes care. Here are some answers to key questions you may have: What does this mean to me? The SCL Diabetic Program is available for you to order your diabetes medications, equipment, and supplies. Additionally, the SCL Diabetic Program will ship your order right to your door. Best of all, the SCL Diabetic Program will call you when it is time to reorder. No more running out of test strips! What do you mean by diabetes medications, equipment, and supplies? • All refrigerated and non-refrigerated diabetic drugs • Home Blood Glucose Monitor - Free of Charge* • Blood Glucose Test Strips • Lancets • Spring-Powered Device for Lancets • Syringes • AlcoholPads • Insulin (not required to be purchased through the SCL Diabetic Program) You may not need all the items listed above. Your physician will determine what is required for your care What if I already have a home blood glucose monitor? You can continue to use it or the SCL Diabetic Program can provide you with a new monitor that may offer additional features. A 90- day shipment of supplies will be sent with the new monitor. What if I am unsure how to use my new monitor? You will receive directions with your shipment. You can also call the SCL Diabetic Program to receive instructions over the phone, in English or Spanish. How do I get started? Simply call the SCL Diabetic Program at 1-866-561-8047. The SCL Diabetic Program will then verify your benefits for diabetes supplies and what, if any, copays apply. What should I do when it is time to reorder my supplies? An SCL Diabetic Program representative will call you at home once every 90 days to inventory your supplies and replenish them accordingly. They will verify your order and health coverage before mailing your next shipment. If you have moved, or your phone number has changed, please notify the SCL Diabetic Program promptly so they can continue the reorder service uninterrupted. If you have questions concerning your diabetes medications, equipment, or testing supplies, please feel free to contact the SCL Diabetic Program at 1-866-561-8047 for more information. SCL Diabetic Program P.O. Box 12607 Beaumont, TX 77726-2607 Customer Service Hours Monday - Friday 7:00 a.m. to 6:00 p.m. (CST) Telephone: (866) 561-8047 Fax: (409) 866-1317 www.scriptcare.com * Accu-Chek and Life Scan home blood glucose monitors are available free of charge. Benefits subject to established plan provisions and copay amountr. The SCL Diabetic Program MUST be used to obtain diabetic drugs and supplies.