Effective January 1, 2016, Express Scripts will administer the State Health Plan prescription drug benefits for PEBA.

Please note that a new formulary will be employed that will increase copayments for some State Health Plan members. Targeted communication to impacted members has been delayed, and some members may be unaware of this change. Letters were mailed to impacted Medicare Prescription Drug program members on December 29, 2015. Letters to affected commercial members will be mailed January 5, 2016.

January 1, 2016, Express Scripts implementedthenew NCPDP Reject Code 777 (Plan'sPrescriberDataBaseNotAbleto Verify Active State License with Prescriptive Authority for PrescriberID Submitted), in order to be more in line with NCPDP standards.

Reject 777 results when a prescriber has an invalid taxonomy(prescriptive authority)for Medicare. If the pharmacist is confident the prescriber can write prescriptions for Medicare beneficiaries, he/she shouldreprocess the claim with a submission clarification code (SCC) value of 52 to override the reject.

New Plan Information Effective January 1, 2016, Magellan Rx Management, will assume administrative operation of the Pharmacy Benefit Management (PBM) program for Yancey Bros Co. from the current administrating company, Optum. At that same time, pharmacies will submit claims for payment through the new PBM system. The new system will provide point-of-sale (POS) claims processing.

Members belonging to Teamsters and Food Employers Security Trust Fund will not have their Pharmacy Prescription Benefit Card by January 1, 2016. This will include all members whose ID# starts with "TFE". Please use the ID number that you currently have on file. NO PCN or Group is required by ProCare Rx for Broadreach Medical Resources, Inc. If your Software System/Vendor requires a PCN, please use BMR. Should you have any questions, please email network@procarerx.com. The NEW BIN number for claim submission is 018299 If you