RESOURCE CENTER

Sample Letters
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12.12.2012
MLR 2011 state refund
Sample notice sent to members regarding AHNJ's MLR for small employer groups with SEH HMO plans being under the 80% required by state law. As such, AHNJ will provide refunds to small employer groups that offered SEH HMO in 2011.
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12.04.2012
Sample letter for formulary list changes effective January 1st, 2013
Letter to sent to AHDE members advising of the formulary list changes as of January 1st, 2013
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11.21.2012
Sample Nexavar letter
Sample member letter to be sent to those who recently folled a Nexavar prescription. As of 11/30/12, manufacturer is only offering through select pharmacies (Accredo or CuraScript), so members must take steps to assure no interuption in service.
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11.21.2012
Sample Humatrope change letter
Sample member letter to be sent to members who have a script or pre-auth for Humatrope, advising that 1/1/13 it will be a non-formulary/tier 3 drug.
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10.25.2012
Sample Member letter for Adderall XR coverage
Sample member letter to be sent to all fully insured and self-insured members who may be taking Adderall XR. Due to low supply of generic equivalent of Adderall, AHNJ is allow the brand drug to remain at tier 1 from 11/1/12 through 12/31/13.
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10.22.2012
Sample Employer letter for 2013 Creditable Coverage Notice
Sample employer letter regarding the Creditable coverage certification. Employers who offer Rx, must advise all employees of Rx creditable status by 10/15.
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10.05.2012
Sample Member letter for New ID card for DE residing members
Sample member letter to be sent to employers with members who reside in DE. New ID cards will be issued that show the member's PCP office, rather than actual PCP. ID cards will be distributed throughout October.
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10.05.2012
Sample Employer letter for New ID card for DE residing members
Sample employer letter to be sent to employers with members who reside in DE. New ID cards will be issued that show the member's PCP office, rather than actual PCP. ID cards will be distributed throughout October.
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09.11.2012
Sample letter for formulary list changes effective October 1st, 2012
Letter to sent to AHNJ members advising of the formulary list changes as of October 1st, 2012
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05.21.2012
Sample member letter for Injectible Rx error
Sample letter to members, to be sent by AHNJ, to inform members of operational error with injectible drugs. Members should obtain injectible drugs at doctor's office, not pharmacies.
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05.21.2012
Sample employer letter for Injectible Rx error
Sample letter to employers, to be sent by AHNJ, to inform group leaders of operational error with injectible drugs. Members should obtain injectible drugs at doctor's office, not pharmacies.
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03.01.2012
Sample letter for formulary list changes effective April 1st, 2012
Letter to sent to AHNJ members advising of the formulary list changes as of April 1st, 2012
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01.17.2012
Sample employer letter for MLR Compliance notice
Sample letter to employers, to be sent by AHNJ during week of 1/16, to collect needed employer information for their MLR calculations. Employer response is required by 2/20/12.
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12.13.2011
Sample member letter for specialty Rx change to ICORE
Letter to be sent to AHNJ members who currently have specialty pharmacy scripts through Acro Pharmaceuticals (current partner). Effective 2/1/12, AHNJ will partner with ICORE. Current scripts should transfer seamlessly.
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11.28.2011
Sample Member letter for Progesterone in Oil change
Sample letter to members who currently take Progesterone in Oil. This injectible, effective 1/1/12, will be covered under the medical benefit as are all standard injectibles. Only self-injectibles are covered under the pharmacy benefit.
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