&= nbsp; IMPORTANT INFORMATION

PLEASE READ

CAREFULLY

New Cigna Pharmacy Benefit Manager

Your current health insurance plan prescription benefit manager is Cigna Pharmacy Management. Present thi= s card to each provider of them on your next visit to ensure your claims are prope= rly processed.

Please acquaint yourself with the Cigna pharmacy program through the several websites listed below:

Performance Preferred Dr= ug lists- this list replaces the Express Scripts “formulary” list. Go to www.prior= authRX.ihcgroup.com. There are some prescription d= rugs no longer considered “formulary”, such as Crestor and Prevacid. If your drug is not on the Performance Preferred Drug list, consult with your physician to see if he can prescribe a drug on the l= ist to reduce you’re out of pocket costs for drugs.
Prior-authorization list- these drugs may not be eligible for benefits under your benefit plan.<= span style=3D'mso-spacerun:yes'> To help you determine coverag= e, please call 602-906-6253, if you are prescribed a drug on this list. T= hose drugs marked with an asterisk, (*) refer to a Step Therapy program that your plan does not participate in and those drugs can be ignored.=
Specialty Pharmacy Netwo= rk- drugs requiring special handling, such as self injectable (does not include insulin), and very expensive oral medications require use of t= he Cigna Specialty Pharmacy network.&nbs= p; Please refer to the website: www.priorauthRX.ihcgroup= .com for identification of those drugs and instructions for ordering.<= /o:p>
Cigna Home Delivery Pharmacy- this replaces ExpressScripts Mail Delivery pharmacy. You only need to register at = www.myCIGNAforhealth.com= , if you plan to enroll for this service.&= nbsp; Please refer to the attached “How to enroll and utilize t= he Cigna Home Delivery Pharmacy” attachment.
Pharmacies in the Cigna Pharmacy program- go to w= ww.myCignaforhealth.com and go to “Register Now”.= After registering, you will have access to a list of pharmacies, cost of drugs, and other tools to enable you to manage your health care costs.

To receive prescription benefits, without utilizing the mail-order program, re= member to show your new Prescription/Medical ID card at your pharmacy. For more information, or if you have trouble using your new prescription benefits ca= rd, call the Cigna Pharmacy dedicated toll-free number (800) 325-1404.

Please note: Your medical PPO network, will remain the same; you still have access to the same network of physicians, facilities and other providers.

Precertification Requirements=

You= r new ID card contains information about when to contact us prior to receiving medical services and supplies. While it is your responsibility to call us to pre-certify certain medical services or predetermine certain classes of prescription drugs, most often your health care provider will perform this service for you.

Please present this card to each of your health = care providers upon your next visit and inform them that it includes new instructions for notifying us about certain medical services and supplies. =

We = ask that you contact us prior to seven days for the following:

To pre-certify non-emerg= ency inpatient stays, in a hospital or skilled nursing facility<= /span>

To pre-certify emergency inpatient stays the next day

Before scheduling outpat= ient imaging diagnostic testing (MRIs, CT scans, PET scans)

Prior to starting chemotherapy treatment

Prior to obtaining durab= le medical equipment that cost over $1,000 Upon learning that you have be= come pregnant

Prior to outpatient surg= ical and diagnostic procedures done outside of a doctors office<= /span>

To predetermine drugs on= the specialty drugs or prior authorization list (priorauthRX.com)

For Benefit/Claim questions, please call the number listed on the b= ack of your ID card.

We look forward to continuing to se= rve you.