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Express Scripts Transition Update

Nov 03, 2009

In April 2009, Anthem Blue Cross' parent company announced the acquisition of NextRx, Anthem's affiliated pharmacy benefits manager, by Express Scripts. The agreement also includes a 10-year contract for Express Scripts to provide services to Anthem members following closing of the transaction, which is expected to occur by the end of 2009. Anthem will continue managing integrated, carve-in accounts.

Same integrated approach. Same great service.

Anthem anticipates that the Express Scripts agreement will enhance their service offering and improve the quality of health care delivered to their members. Groups and members will gain several advantages:

·   best-in-class programs from both organizations

·   the integration of their medical and pharmacy benefits from the leaders in their respective fields

·   competitive pricing

Under the terms of the agreement:

·   Anthem will continue managing benefit designs and Express Scripts will implement those offerings. Benefit designs will not change.

·   Anthem will control the formulary, data analytics, disease management and clinical pharmacy programs.

·   Anthem will continue to have one implementation team, one eligibility feed, one service contact and one reporting strategy.

·   Members will keep their existing ID card, customer service numbers, formulary and edits.

Upon close of the sale, NextRx will be owned by Express Scripts and will continue processing prescription drug claims. Express Scripts pricing will go into effect as soon as the transaction closes.

Beginning March 1, 2010, Anthem expects to start migrating groups to the Express Scripts pharmacy operating platform. Express Scripts will begin processing prescription drug claims once accounts have been migrated. The health plan will continue managing clients' prescription drug programs.

Client and member communications

Anthem is committed to making the transition as seamless as possible for groups and members. Groups will receive communications beginning October 30, 2009. Members most likely to experience a change due to the Express Scripts transition will receive the following communications:

·   Retail network disruption letters, scheduled to be mailed in early November, will be sent to members whose current retail pharmacy is not in the Express Scripts network. The letters list alternative pharmacies.

·   On November 1, letters will be sent to about 800,000 members currently using NextRx mail service pharmacy notifying them that their medication may come from a different dispensing location in the future.

The letters also notify members that due to differences between manufacturers, some generic prescriptions may appear different but have the same active ingredient, dosing, etc., as the product they've received in the past.

An Employer communication about the transition to Express Scripts is being sent this week, along with Frequently Asked Questions.

For more information

If you have questions about this transition, please contact your Beere & Purves representative.

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