(sample letter to employers and brokers)<\/p>\n
May 1, 2011<\/p>\n
<Name><\/p>\n
<Address1><\/p>\n
<City, State Zip><\/p>\n
RE: Semi-Annual Notice of Changes<\/p>\n
Dear Employers and Brokers:<\/p>\n
As part of our commitment to provide affordable access to high quality health care, we continually review the benefits and services offered to our members. As a result, from time to time we update the coverage we provide and change the way that coverage is administered. We then notify our subscribers and their employers, our brokers, and our contracted providers of these changes.<\/p>\n
We have attached a copy of an amendment to the HNE Explanation of Coverage. We will send this amendment to HNE subscribers with the next edition of our member newsletter,\u00a0Living Well<\/em>. If you have any questions, please call me at 413-233-3396.<\/p>\n Sincerely,<\/p>\n June Gardner<\/p>\n Sales Director<\/p>\n ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<\/p>\n AMENDMENT 04-2011<\/strong><\/p>\n This is an Amendment to your Health New England, Inc. Explanation of Coverage (EOC). Please keep this Amendment with your EOC as it changes the terms of that EOC. Any language in the EOC that is inconsistent with the terms of this Amendment no longer applies. This Amendment is effective as of July 1, 2011, unless noted below.<\/p>\n The EOC is amended as follows:<\/p>\n This service requires Prior Approval.<\/td>\n<\/tr>\n (sample letter to employers and brokers) May 1, 2011 <Name> <Address1> <City, State Zip> RE: Semi-Annual Notice of Changes Dear Employers and Brokers: As part of our commitment to provide affordable access to high quality health care, we continually review the benefits and services offered to our members. As a result, from time to time […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-270","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZOS-4m","_links":{"self":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/posts\/270","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/comments?post=270"}],"version-history":[{"count":0,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/posts\/270\/revisions"}],"wp:attachment":[{"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/media?parent=270"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/categories?post=270"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hnetalk.com\/broker\/wp-json\/wp\/v2\/tags?post=270"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n\n
\n Benefit, Program or Requirement<\/strong><\/td>\n Description<\/strong><\/td>\n<\/tr>\n<\/thead>\n\n \n Human Organ Transplants and Bone Marrow Transplants. <\/strong><\/td>\n The sentence in italics is added to the description below.HNE covers:Human leukocyte antigen testing or histocompatibility locus antigen testing for a Member when necessary to establish such Member\u2019s bone marrow transplant donor suitability. HNE covers the costs of testing for A, B, or DR antigens, or any combination thereof. Coverage is limited to one test per member per lifetime.<\/em><\/p>\n \n Services and Procedures that Require Prior Approval <\/strong>\u00a0<\/strong><\/td>\n The following item is added to the Prior Approval List.<\/p>\n \n
\n Behavioral Health Services (Mental Health and Substance Abuse)<\/strong><\/td>\n HNE requires Prior Approval for the following services:<\/p>\n \n
\n Termination<\/strong><\/td>\n The bulleted item below (in italics) is added to the section of your EOC titled Termination<\/em><\/strong>:How This Agreement May EndHNE may cancel your coverage or refuse to renew your coverage\u2026<\/p>\n \n
\n\n
\n Prescription Drug Coverage <\/em><\/strong>\u00a0<\/strong>Note: Tier 1 \u2013 lowest copay; Tier 2 \u2013 mid copay level; Tier 3 \u2013 highest copay level <\/em><\/strong><\/td>\n<\/tr>\n<\/thead>\n\n \n Tier Assignments<\/strong>The following Prescription Items are changing Copay Tier Assignment <\/strong><\/td>\n<\/tr>\n \n Item<\/td>\n Tier on or before 6\/30\/11<\/td>\n Tier on or after 7\/1\/11<\/td>\n<\/tr>\n \n FreeStyle\u00ae and Precision Xtra\u00ae test strips<\/td>\n Tier 3<\/td>\n Tier 2<\/td>\n<\/tr>\n \n HNE will provide new blood glucose meters \u2013 free of charge \u2013 to affected members before 7\/1\/11. This change brings our members the benefits of up-to-date technology provided by FreeStyle\u00ae<\/sup> and Precision Xtra\u00ae<\/sup> Blood Glucose Monitoring Systems.On or after 7\/1\/11 all other brands of test strips will require Prior Approval. If approved, the member will pay a Tier 3 copayment. Other brands include Accucheck\u00ae, Breeze\u00ae, Nova Max\u00ae, and One-Touch\u00ae among others.NOTE: This change does not apply to members who currently use an insulin pump.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"