Bulletins

Effective July 1, 2025, Aetna will no longer cover Zepbound, a GLP-1 medication used for weight management. Both Wegovy and Saxenda will continue to be covered. The change is estimated to create year-over-year client savings of 10 to 15 percent within this medication classification.

Gravie members receiving coverage for GLP-1 medication, used to treat type 2 diabetes and prescribed for weight loss, will be subject to new requirements effective July 15, 2025.

Allstate recently emailed plan sponsors requesting data needed to comply with the Prescription Drug Data Collection (RxDC) reporting requirement. To comply with the Consolidated Appropriations Act (CAA), passed in December 2021, insurance companies and employer-based plans must submit information...

Blue Cross and Blue Shield of Kansas City (Blue KC) emailed plan sponsors today requesting data needed to comply with the Prescription Drug Data Collection (RxDC) reporting requirement. Groups that do not have an email address on file, or whose email address bounced, will be mailed a letter. To...

Blue Cross and Blue Shield of Kansas (BCBSKS) recently mailed letters to plan sponsors requesting data needed to comply with the Prescription Drug Data Collection (RxDC) reporting requirement. To comply with the Consolidated Appropriations Act (CAA), passed in December 2021, insurance companies and...

UnitedHealthcare (UHC) plan sponsors have until March 31 to provide data needed to complete the annual Prescription Drug Data Collection (RxDC) reporting. To comply with the Consolidated Appropriations Act (CAA), passed in December 2021, insurance carriers and employer-based plans must submit...

Aetna recently emailed employer groups that had Aetna coverage for any period in 2024, requesting data needed to comply with the Prescription Drug Data Collection (RxDC) reporting requirement. To comply with the Consolidated Appropriations Act (CAA) passed in December 2021, insurance companies and...

Effective July 1, 2024, Blue Cross and Blue Shield of Kansas City (Blue KC) will update prescription drug lists (PDLs) for small (ACA and non-ACA) and large employer groups. Blue KC’s Medical Pharmacy Management Committee regularly reviews and updates PDLs for “drug safety, effectiveness, clinical...

Starting April 29, 2024, members enrolled in the Cigna Open Access Plus network no longer have access to providers and hospitals in the Kansas City area’s Prime Healthcare System. Cigna said the decision stems from the inability to negotiate lower costs with the health system, resulting in inflated...

Starting in June, Cigna members will have access to a Humira biosimilar used to treat a range of inflammatory conditions for $0 out of pocket. The biosimilar costs nearly 85% less than Humira and will lower patient costs by approximately $3,500 annually.