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SUMMER 2011
BULLETIN
Serving plan members who reside outside Alberta
To ensure efficient service to plan bill Alberta Blue Cross directly for your reminder notice along with an
members who reside outside of out-of-province employees’ eligible out-of-province provider direct-bill
the province, Alberta Blue Cross claims. The service provider is then reference card for plan members to
has arrangements with pharmacies paid directly for the claim and the plan present to providers when they have
and dental offices across Canada to member only needs to pay for any a prescription filled or when receiving
enable them to submit claims directly portion of the claim not covered by dental services. Alberta Blue Cross
to Alberta Blue Cross at the time the plan. is sending this reminder notice
of service through our pay-direct and provider reference card to all
To support plan members who reside
electronic claim adjudication network. plan members located outside of
outside of Alberta whose benefit
If your benefit plan provides direct- the province. The information will
plans provide direct-bill prescription
bill prescription drug benefits and/or inform them how to work with
drug benefits and/or dental coverage,
dental coverage, these providers can providers to ensure a smooth direct
Alberta Blue Cross has developed a
bill claim process.
Alberta Blue Cross plan members who
reside outside Alberta are encouraged
to make the pharmacy or dental office
aware of the pay-direct billing features
of their plan by presenting the
provider card along with their Alberta
Blue Cross identification card.
Plan members will be encouraged to
present both cards whenever they
visit a pharmacy or dental office.
If the pharmacy or dental office is not
already connected to Alberta Blue
Cross, it’s easy for them to connect to
us. To accommodate the pay-direct
billing of claims to Alberta Blue Cross,
pharmacies or dental offices simply
contact Alberta Blue Cross to activate
an electronic billing connection.
Presentation of the provider
reference card provides the
pharmacy or dental office with the
information they need to facilitate
pay-direct billing of eligible claims.
in • Top 12 drug lists • Confirming over-age dependents
this • Advantages of preauthorized debit • Convenience of direct billing
issue: • Travel plans updated • Focus on Scott Builders
TOP DRUGS
For your information, here is a list of the products most TOP 12 DRUGS FOR 2010
prescribed in 2010 to Alberta Blue Cross employer group
plan members and a list of those products that carried
(BASED ON AMOUNT PAID)
the highest cost to group benefit plans. These lists are 1. REMICADE 100 MG/VIAL INJECTION
based on a representative sample of our group book of 2. BLOOD GLUCOSE TEST STRIPS
business, profiling the claims experience of the largest 3. HUMIRA 40 MG/ 0.8 ML INJECTION SYRINGE
employer groups with direct-bill drug benefit plans
4. NEXIUM 40 MG DELAYED RELEASE TABLET
across the province.
5. CRESTOR 10 MG TABLET
6. ENBREL 50 MG/ML INJECTION SYRINGE
7. COPAXONE 20 MG/ML INJECTION SYRINGE
8. SYMBICORT 200 TURBUHALER METERED
INH POWDER
TOP 12 DRUGS FOR 2010 9. APO-LANSOPRAZOLE 30 MG DELAYED
RELEASE CAPSULE
(BASED ON NUMBER OF CLAIM LINES)
10. CYMBALTA 60 MG DELAYED RELEASE
1. BLOOD GLUCOSE TEST STRIPS
CAPSULE
2. CRESTOR 10 MG TABLET
11. LIPITOR 20 MG TABLET
3. VENTOLIN HFA 100 MCG/DOSE METERED DOSE
12. SINGULAIR 10 MG TABLET
AEROSOL
4. TYLENOL NO. 3 WITH CODEINE TABLET
5. NASONEX 50 MCG/DOSE AQUEOUS NASAL SPRAY
6. MISCELLANEOUS COMPOUND PRESCRIPTION
7. NOVAMOXIN 500 MG CAPSULE
8. RATIO-LENOLTEC NO. 3 TABLET
9. APO-LANSOPRAZOLE 30 MG DELAYED RELEASE
CAPSULE
10. SYMBICORT 200 TURBUHALER METERED INH
POWDER
11. NEXIUM 40 MG DELAYED RELEASE TABLET
12. APO-HYDRO 25 MG TABLET
Overview of top drugs
APO-HYDRO 25 MG TABLET
Used in the treatment of high blood pressure.
Travel plans
APO-LANSOPRAZOLE 30 MG DELAYED RELEASE CAPSULE
Used for the treatment of acid reflux (heartburn). updated
BLOOD GLUCOSE TEST STRIP Alberta Blue Cross group
A chemically treated strip to which a drop of blood is applied. It is used in blood glucose monitoring benefit plans are constantly
with a special device to test the sugar level. Used by diabetics for home monitoring of sugar levels. evolving along with the needs
COPAXONE 20 MG/ML INJECTION SYRINGE of Alberta businesses. Based on
Used in the treatment of relapsing-remitting multiple sclerosis. member feedback, Alberta Blue
Cross standard group travel
CRESTOR 10 MG TABLET
Used in the treatment of high cholesterol and lipid levels.
plans have been updated.
CYMBALTA 60 MG DELAYED RELEASE CAPSULE Later this summer the new
Used for the treatment of depression, as well as the treatment of neuropathic pain (nerve pain). updates will automatically be
applied to all standard group
ENBREL 50 MG/ML INJECTION SYRINGE
An injection used to treat certain joint conditions (rheumatoid arthritis, psoriatic arthritis, and travel plans.
ankylosing spondylitis) as well as skin conditions (plaque psoriasis), and Crohn’s disease. An Important Notice will be
HUMIRA 40 MG/ 0.8 ML INJECTION SYRINGE sent in June to all group
An injection used to treat certain joint conditions (rheumatoid arthritis, psoriatic arthritis, and plan sponsors with standard
ankylosing spondylitis) as well as skin conditions (plaque psoriasis), and Crohn’s disease. group travel plans outlining
LIPITOR 20 MG TABLET the updates. Until a formal
Used in the treatment of high cholesterol and lipid levels. contract update is issued,
MISCELLANEOUS COMPOUND PRESCRIPTION the notice will serve as a
Compounds are mixtures of ingredients prepared by pharmacists. Dermatologists often order contract amendment to each
compounds, such as creams, ointments or lotions, to meet the specific needs of an individual patient. Alberta Blue Cross group policy
contract.
NASONEX 50 MCG/DOSE AQUEOUS NASAL SPRAY
Used to treat the symptoms of allergies, specifically the runny nose that accompanies this condition.
It may also be used along with antibiotics for sinus infections.
NEXIUM 40 MG DELAYED RELEASE TABLET
Used for the treatment of acid reflux (heartburn).
NOVAMOXIN 500 MG CAPSULE
Antibiotic used for the treatment of various infections including infections of the chest, urinary tract
and skin.
RATIO-LENOLTEC NO. 3 TABLET
Keep it
legible
For the relief of moderate pain in a wide variety of conditions, e.g. dental pain, headaches, pain
following operative procedures.
REMICADE 100 MG/VIAL INJECTION
An injection used to treat certain joint conditions (rheumatoid arthritis and ankylosing spondylitis), When faxing forms or documents
and inflammatory bowel disease (ulcerative colitis and Crohn’s disease). to Alberta Blue Cross, please
ensure the information you send
SINGULAIR 10 MG TABLET
Used for the treatment of asthma and nasal allergies. It is taken daily to prevent the symptoms of these
is readable. Unfortunately, many
conditions. faxes we receive are not legible
and require us to call individuals
SYMBICORT 200 TURBUHALER METERED INH POWDER
to decipher and confirm the
A dry powder inhalation device used to treat asthma in adults and children 12 years and older. Reduces
and prevents inflammation in the airways of the lung and widens the airways. information. Ensuring that your
faxes are legible and easily
TYLENOL NO. 3 WITH CODEINE TABLET readable will prevent unnecessary
For the relief of moderate pain in a wide variety of conditions, e.g. dental pain, headaches, pain
delays in processing.
following operative procedures. There are a number of products available with the same ingredients. In
the competitive market place, pricing of the “brand name” product is comparable to other alternatives.
VENTOLIN HFA 100 MCG/DOSE METERED DOSE AEROSOL
Used for the treatment of asthma and COPD. Relaxes the airways to reduce wheezing and chest
tightness.
Customer profile
Benefit plans to support flexibility…
and service to support easy plan administration
When Red Deer-based Scott Builders Alberta Blue Cross customer, however, a good benefit plan they can tailor to
took its group benefits to market in 2008, Scott Builders was also able to introduce their family needs and their life situation.”
its intent was to support its positioning a “flex arrangement” with three different
Formed in 1971, Scott Builders currently
in the upper quartile of companies benefit modules to meet the differing
operates out of six full-service branches
that offer great benefit programs to interests and priorities of its employees.
across Alberta and Ontario—and keeps
their employees. This employee-owned
“Our employees make Scott Builders more than 100 employees busy. In 2010,
company is a leader in commercial,
what it is,” says Rhonda Hall, controller thanks to providing an outstanding place
industrial and institutional low-rise
and accounting manager at Scott to work and its great support of many
construction markets and has always
Builders. “So it is important for us to have local charities, Scott Builders was named
had a benefit plan. Upon becoming an
Red Deer Business of the Year.
In addition to helping Scott Builders
design and implement a flexible benefit
plan that includes drug, health, dental,
life and disability coverage and a health
spending account, Alberta Blue Cross
supports Rhonda as she administers
these benefits for her company’s
employees. She has seven-day-a-week
access to web-based services that
allow her to submit employee eligibility
information, check the status of recent
updates to employee files, order new
Alberta Blue Cross identification cards,
view her plan’s invoices and more. At the
same time, our secure online services
for plan members allow Scott Builders’
employees to find quick answers to their
questions about their coverage or claims.
“Alberta Blue Cross provides excellent
service to Scott Builders,” states Rhonda.
“I use the plan administrators’ web site
a lot because it is very easy to use and
provides all the information I need. On
top of that, I always know if I encounter
a problem, the team at the Alberta Blue
Cross Red Deer office is there to help me.”
“Our employees make Scott Builders what
it is, so it is important for us to have a good
benefit plan they can tailor to their family
If you would be willing to be featured in
needs and their life situation.” an upcoming issue of the Connection
Bulletin, please let us know by e-mail to
Rhonda Hall, connection@ab.bluecross.ca, by fax to
controller and accounting 780-498-8096, or via mail to Corporate
manager at Scott Builders Communications, Alberta Blue Cross,
10009-108 Street, Edmonton, AB T5J 3C5.
Enjoy the convenience of Included with
this issue of the
provider direct billing
Today, nearly 90 per cent of claims pay or deductible amounts. This service
Connection Bulletin…
processed by Alberta Blue Cross are is available at no cost to all Alberta Blue Included with this issue of the
submitted electronically by providers at Cross plan members and providers across Connection Bulletin is a copy of
the time of service. This provides a level of Alberta. the For Your Benefit newsletter for
convenience unparalleled in the benefits group plan
After Coordination of Benefits, if a plan members. We
industry.
member has a Health Spending Account encourage
Online claims submission allows (HSA), any eligible amount remaining will you to
providers to submit vision, chiropractic automatically flow to the HSA. photocopy
and physiotherapy claims online at the and
A paperless age
time of service through an easy-to-use distribute this
secure web site created and maintained Alberta Blue Cross is at the forefront of
developing and applying technology newsletter
by Alberta Blue Cross. The secure web to your
site allows providers to check patient in support of health benefit program
administration. employees.
coverage and determine the amount
Alberta Blue Cross will pay to their office The names of optical, chiropractic and The For
on the plan member’s behalf, as well as physiotherapy providers participating Your Benefit
the amount—if any—their office needs to in online claims submission are listed on newsletter
collect from the plan member. Processing our web site at www.ab.bluecross.ca and provides
is completed and results are displayed are also available through our Customer helpful information to group plan
immediately. Services department. members—to help your employees
make the most of their benefits.
Alberta Blue Cross also provides direct We are currently in the process of setting Copies of the For Your Benefit are
billing capabilities to pharmacies, up electronic direct billing capabilities for also available on the Alberta Blue
dental offices and ambulance service massage therapy services, which we expect Cross web site in PDF format, in case
providers. to introduce later you would rather download a PDF
7
Less out-of-pocket this year. version to forward by e-mail to your
This means plan members no longer employees.
need to pay out-of-pocket for the portion We welcome your comments about
covered by their plan. Plan members are For Your Benefit, as well as your
still responsible for payment of any co- suggestions of topics for future
issues. Please send your feedback to
connectionbulletin@ab.bluecross.ca.
www.ab.bluecross.ca
Experience the advantages of preauthorized debit
Make your work easier by enjoying bank to pay bills. receive a statement each month.
the convenience of a preauthorized
To enjoy this convenience, simply If preauthorized debit doesn’t suit your
debit plan. With the convenience of
complete the Preauthorized Debit needs, there are a number of other easy
preauthorized debit, your monthly
Agreement application available on the and convenient ways you can pay your
Alberta Blue Cross payments can be
Alberta Blue Cross web site at bill including online banking, electronic
drawn automatically from your bank
www.ab.bluecross.ca/pdfs/80415.pdf funds transfer, telephone banking and by
account the first working day of every
(also available from Alberta Blue Cross cheque.
month. This eliminates the need to
Group Administration) and return it with
write cheques each month for your For more information about payment
a void cheque to Alberta Blue Cross. We
Alberta Blue Cross group benefit options, please contact Alberta Blue
will send you a letter confirming the
plan payments—as well as no longer Cross Group Administration at
agreement before we begin to deduct
having to remember due dates, submit 1-866-498-5925 (toll free).
your payment and you will continue to
payments by mail or stand in line at the
Confirming over-age
dependents
Each July, Alberta Blue Cross must clarify whether over-age
dependents are still eligible to remain covered under family plans.
Thousands of over-age dependent documents are sent out to plan
administrators each summer asking for confirmation that over-age
dependents are either still going to school or medically qualify to
remain covered dependents. If they are no longer an eligible over-
age dependent, they will be terminated from the plan.
pic of 18-20 year
Don’t photocopy
When you receive your over-age dependent notice this summer, old
please do not photocopy the notice and distribute it to your
employees. All of the contact numbers and information on the
notice are for plan administrators’ use only, not for plan members.
Confirming coverage
Please have your employees inform you of the status of over-age
dependent eligibility and you in turn can update your files. If you
have any questions you may call the Alberta Blue Cross Group
Administration department at 1-866-498-5925 (toll free) or e-mail
groupeligibility@ab.bluecross.ca.
Be aware of specific numbers
Please be aware that the phone number listed on the back of the
over-age dependent declaration form regarding privacy is not
to be called if you have questions about over-age dependent
eligibility. The privacy number is only to be used if you have
questions or concerns about privacy matters. Calling this number
will not direct you to someone who can answer your questions and
will only slow down your request.
If you have any questions, call the New cards for new adults
Alberta Blue Cross Group Administration When dependents approach the age of 18, new Alberta Blue
Cross ID cards are sent out. This is an automatic process that
department at 1-866-498-5925 (toll free) occurs as the dependent reaches the age of majority. It does
or e-mail groupeligibility@ab.bluecross.ca. not mean there are any changes in benefits or alterations to
family coverage.
We value your feedback
The Connection Bulletin is published to communicate with
For more information about topics in
Alberta Blue Cross employer group plan sponsors on a variety of Connection Bulletin, please call your Alberta
topics relating to your plan.
We appreciate your feedback regarding the Connection Bulletin,
Blue Cross group sales or service representative.
and welcome any comments you may have about the newsletter
or suggestions of topics for upcoming issues. Please send your
feedback via e-mail to connection@ab.bluecross.ca, by fax to
780-498-8096, or via mail to Corporate Communications,
Alberta Blue Cross, 10009-108 Street, Edmonton, AB T5J 3C5.
Back issues of the Connection Bulletin may be found on the
Alberta Blue Cross web site at www.ab.bluecross.ca
www.ab.bluecross.ca/gp_grpadm.html.
®The Blue Cross symbol and name are registered marks of the Canadian Association of Blue Cross
Plans, an association of independent Blue Cross plans. Licensed to ABC Benefits Corporation for
use in operating the Alberta Blue Cross Plan. ABC 82847 (2011/05)
