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YOUR BOEINGPRESCRIPTION DRUGPROGRAMEFFECTIVE JANUARY 1, 2021This is aBoeing Total Rewards Partner
FOR THE FOLLOWING INDIVIDUALSCOVERED BY BOEING-SPONSOREDMEDICAL PLANS: Employees and their spouses and dependents Retirees and their spouses and dependentsnot eligible for MedicareWHAT’S INSIDE:Introducing Prime Therapeutics3Getting Started4What to Expect Next8Support During this Change9Frequently Asked Questions10Online Resources: myprime.com/boeing
INTRODUCINGPRIME THERAPEUTICSPrime Therapeutics LLC (Prime)1 has been selected by Boeingas your new pharmacy benefit administrator. We are pleasedto be entrusted with your care and are committed to providingoutstanding service, pharmacy expertise and convenience foryou and your eligible family members. Prime will replace ExpressScripts, 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 ofBoeing-sponsored medical plans — Blue Cross and Blue Shield of Illinois(BCBSIL). Today, Prime provides pharmacy benefit management services forover 30 million members across many medical plans.For Boeing, we’ll provide pharmacy benefit management services for theseBoeing-sponsored plans: all medical plans administered by BCBSIL, plusCigna HMO and Aetna HMOs (except the Aetna HMO in Kansas).We’ll offer you services and features that are similar to those you havehad with Express Scripts — a large national network of retail pharmacies,a home delivery (mail order) and specialty pharmacy and a drug list that’scomparable to your current list. Plus, you’ll find new features like theopportunity to get up to a 90-day supply of medications at over 54,000retail pharmacies.3
GETTING STARTEDThis 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 LISTThe prescription drug list is a list of medications coveredby your Boeing-sponsored prescription drug program.Same as today, the list will be split into three categories,called tiers — generics, preferred brand drugs and nonpreferred brand drugs — and the amount you pay formedications in each tier in 2020 stays the samein 2021.Effective January 1, 2021, some drugs will changecoverage tiers, with some going to a higher cost tier,and some will no longer be covered. Overall, about97% of drugs on the current list remain on the new list,and about 95% of drugs that continue to be coveredwill remain in their current coverage tier. These kindsof adjustments also occurred from time to time underExpress Scripts.To check coverage for any drug you’re taking now, pleasevisit myprime.com/boeing, click on Find Medicines,answer a few questions to identify your medical plan andsimply enter the name of the drug. In most cases, we’llsend you a letter in late November if you’re taking a drugwhere coverage may be changing. The letter will let youknow the impacted drug(s) and your next steps.In some plans, certain drugs are classified as preventivedrugs and may be available at lower costs. The listof these drugs will be available early November atmyprime.com/boeing and will be changed somewhatfor 2021.FILLING YOUR PRESCRIPTIONS Retail Pharmacies — The Prime network of retailpharmacies has over 55,000 independent andchain pharmacies, or over 99% of those used byBoeing employees and retirees today. As with thecurrent Express Scripts pharmacy network, localWalgreens pharmacies will not be part of the Primeretail pharmacy network. To find a network pharmacy,visit myprime.com/boeing and click on Find aPharmacy. In most cases, we’ll send you a letter in lateNovember if you’re using a pharmacy that’s not in thenetwork. The letter will show you nearby participatingpharmacies you can use. Home Delivery Service — Your new Home Delivery(mail order) pharmacy will be AllianceRx WalgreensPrime. This service allows you to get up to a 90-daysupply of medications that you take on a regular basis,mailed to your home.Most prescriptions currently on file with Express ScriptsHome Delivery will be transferred automatically toAllianceRx Walgreens Prime, as long as there are refillson file that extend beyond January 1, 2021. We’llsend you a letter in late November about the transferprocess. The letter will also explain when and whatsteps you will need to take to set up a new account.Prescriptions for compound medications or controlledsubstances cannot be transferred and will require anew prescription. If that’s your situation, you’ll also geta letter in late November that explains what you needto do. Transition Tip — If you’re not using Express ScriptsHome Delivery today and want to get started afterJanuary 1, 2021, visit myprime.com/boeing on orafter that date and click on home delivery sign up. Or,you can call Member Service Center. See the SupportDuring this Change section on page 9 for details.4
Retail Pharmacies that Fill a 90-Day Supply ofMedications — For added convenience and costsavings to you, over 54,000 or nearly 98% of the retailpharmacies in the network will allow you to get up to a90-day supply of maintenance medications (other thanspecialty medications) for the same copay you wouldpay if you used the home delivery service. These retailpharmacies can fill either short-term prescriptionsor prescriptions of up to 90-days. To find these retailpharmacies, visit myprime.com/boeing and click onFind a Pharmacy. A pharmacy that provides this servicewill show a “90-day” designation in its listing. Transition Tip — If you want to start getting a90-day supply of a medication at a retailpharmacy after January 1, 2021, ask yourdoctor to prescribe up to a 90-day supply of yourmaintenance medication. You or the doctor cansubmit that prescription to the pharmacy. Specialty Pharmacy — Specialty medications areused to treat chronic and complex conditions such asmultiple sclerosis, hepatitis C or rheumatoid arthritis.As is the case today, most specialty medicationsneed to be filled by your plan’s specialty pharmacy tobe covered. Starting January 1, 2021, the specialtypharmacy will be AllianceRx Walgreens Prime. You canfind out if a drug is considered a specialty medicationby going to myprime.com/boeing, clicking on FindMedicines, answering a few questions to identify yourmedical plan and entering the name of a drug to see ifit has a specialty indicator. This list changes from timeto time. If you’re taking one of the drugs that will beadded to the list for 2021, we will send you a letterin November. Transition Tip — If you’re having a specialtymedication filled today at Accredo, the specialtypharmacy affiliated with Express Scripts, Accredo willtransfer your prescription to AllianceRx WalgreensPrime, as long as you have refills on your prescriptionthat extend beyond January 1, 2021.If this applies to you, we will send you a letter in lateNovember. Given the special handling or protocolsthat specialty medications sometimes require, we’llinvite you to call us then, or we’ll try to call you,to help you with this transition and make sure you’recomfortable with how the specialty process works.5
GETTING STARTED CONTINUEDPHARMACY BENEFITREVIEW PROGRAMSAs was the case with Express Scripts, there are programsdesigned to encourage safe, cost-effective andappropriate use of medications. The programs describedbelow will not take effect on January 1, 2021 forprescriptions that you take now but may affect newprescriptions after that date.Go to myprime.com/boeing, click on Find Medicines andanswer a few questions to identify your medical plan tosee what drugs may be subject to these special programs.PROGRAMWHAT IT ISPrior Authorization (PA)Some drugs may need to be approvedby the program before they are covered.This is so the program can best guideappropriate use of these drugs. Yourdoctor can help you with this process.WHAT YOU NEED TO KNOW OR DO If you’re currently taking a drug thathas a Prior Authorization on file withExpress Scripts, and it extends beyondDecember 31, 2020, we’ll get thatinformation from Express Scripts andhonor the authorization through the dateit has been approved but no later thanDecember 31, 2021. Then, we’ll ask yourdoctor to provide updated information. If your Prior Authorization expires soonafter January 1, 2021, you’ll want to talkto your doctor now about your optionsand be ready to submit information to usshortly after January 1, 2021.6Step Therapy (ST)A “step” approach is required to receivecoverage for certain high-cost drugs. Thismeans a drug will not be covered unlessyou try some other lower-cost drug thatworks just as well first.This program will only apply to certaindrugs that you begin taking for the firsttime on or after January 1, 2021.Dispensing Limits (QL)These limits (also called quantity limits)may be applied on select drugs. Limitsmay involve how much covered medicinemay be filled per prescription or in a giventime span. If your doctor prescribes anamount that is more than the dispensinglimit, you can still get the drug. But, youmay have to pay for the full cost of theprescription beyond what your coverageallows. In most cases, these limits applyfor safety reasons.This program will only apply to certaindrugs that you begin taking for the firsttime on or after January 1, 2021.
EXPLORE MYPRIME.COM/BOEING,THE MEMBER WEBSITEYou 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 pharmaciesStarting January 1, 2021, you can register on thewebsite and get the information shown above plus: AllianceRx Walgreens Prime specialty pharmacy andhome delivery service general information More precise cost estimates for different drugs Your prescription drug claims history Submit requests for home delivery refills or specialtypharmacy services onlineYou can access the website from your smartphone,tablet or computer. Even though an app is notavailable, the website is optimized for mobile devices.That makes it very easy to use. If you participate ina Boeing-sponsored medical plan administered byBCBSIL, you can go to your account on the Primewebsite — without having to sign in — when you log inSMSMto your Blue Access for Members (BAM ) account.7
WHAT TO EXPECT NEXT1 November 3 – 24Boeing annual enrollment2 Early NovemberYou will receive a letter in early November if you are having a specialtymedication filled today at Accredo. Due to the special handling or protocolsthat specialty medications sometimes require, we’ll invite you to call us, orwe’ll try to call you, to make sure you are ready to go beginning January 1.3 Late NovemberYou may receive a letter that lets you and your doctor know what you needto 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 DecemberIf you’re enrolled in a Boeing-sponsored medical plan administered byBCBSIL, you will get a new Member ID card by the end of 2020. This ID cardwill replace the separate medical and prescription drug ID cards that youhave today. You should use your new ID card for all medical providers andwhen 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 of2020. Be sure to use your new prescription drug ID card when filling yourprescriptions 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 andcomplete setting up your account.8
SUPPORT DURING THIS CHANGEWe 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 answeryour questions and help you with the resources you need:MEMBER SERVICE CENTERONLINE RESOURCEBCBSIL Members888.802.8776myprime.com/boeingAetna HMO/Cigna HMO Members800.421.6022Go online anytime using any device to viewthe prescription drug list, find retail pharmaciesnear you and more.Member Service Representatives are availableMonday-Friday, 8 a.m. to 8 p.m., Eastern time.9
FREQUENTLY ASKED QUESTIONSQ: Why is Walgreens not in the local retail network?A: By not including Walgreens local retail pharmacies,Prime is able to deliver a more cost-effectivearrangement for Boeing. The retail network hasbroad geographic coverage without Walgreens.Walgreens local retail pharmacies were also excludedfrom the network through Express Scripts prior toJanuary 1, 2021.Q: If I have a Health Care Flexible Spending Account(FSA) or a Health Savings Account (HSA), willI still be able to use my debit card to pay forprescription drug expenses?A: Yes. The debit card from either the Health Care FSAor HSA can be used at network retail pharmacies aswell as the AllianceRx Walgreens Prime home deliveryand specialty pharmacy.10Q: If my doctor wants to request some type ofexception, whom would they contact?A: If your doctor wants to ask Prime for an exception, acoverage determination or to make an appeal, yourdoctor can call the Member Service Center phonenumber on your ID card after January 1, 2021 toask for a review. Prime will help guide your doctorthrough the next steps, including filling out any forms.If the coverage request is denied, Prime Therapeuticswill let you and your doctor know why it was denied.Q: Why will some drugs no longer be covered orchange to a higher-cost tier?A: These changes can happen for a variety of reasons:there may be over-the-counter (OTC) alternatives,or there may be lower-cost alternatives that clinicalexperts consider to be equally effective. If a drugyou’re taking is in the small percentage that willno longer be covered, the letter we send in lateNovember will let you know, in most cases, aboutother covered drugs that treat the same condition.These kinds of adjustments also occurred from timeto time under Express Scripts.
Q: Are the terms “preferred brand” and “nonpreferred drug” new?A: The term “preferred brand” is now being used to referto the tier that had been called “formulary brand.”The term “non-preferred drug” replaces the previousterm “non-formulary brand.”Q: Are there any programs to help us learn how tosave money on our prescription drug expenses?A: Toward the end of 2020 or in early 2021, we’ll sendyou information about Rx Savings Solutions (RxSS).2This is a confidential and optional service that givespersonalized prescription guidance at no cost tohelp you save money. The service can send you a textor email if you ever pay too much for a prescription.RxSS finds other ways to get the same treatmentfor less money. You can pre-register for this servicebefore January 1. You can find the link to registerat myprime.com/boeing.11
As always, treatment decisions are between you and yourdoctor. Coverage is based on the terms and limits of yourBoeing-sponsored Medical Plan.1Prime Therapeutics LLC is an independent company providingpharmacy benefit management services for Boeing healthplan members. Prime Therapeutics has an ownership interestin AllianceRx Walgreens Prime, a central specialty pharmacyand mail service company. Myprime.com/boeingis an online resource offered by Prime Therapeutics LLC.2Rx Savings Solutions (RxSS) is an independent company thatcontracts directly with Prime to provide Rx consultations.RxSS does not offer other health plan products or servicesand is solely responsible for the products and services thatit provides. There are no endorsements, representations orwarranties made regarding third-party vendors. Membersshould contact the vendor directly with questions about theproducts or services offered by third parties.J0346967049-A BOE Prime Therapeutics LLC 09/20
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
