For members affected by the storm, the APWU Health Plan alters our benefits for Health Plan members in both the High Option and Consumer Driven Option Plan in the affected areas. Altered benefits include relaxed precertification requirements for all types of care (medical and mental health) and we will make payment at the higher PPO rate to any provider of service regardless of their non-network status for a designated period of time. Below are some other accommodations:

• APWUHP members have telehealth options available to them for medical and mental health issues through our designated telehealth vendors.
• For all of the affected areas, UnitedHealthcare remains committed to supporting its customers and their employees’ emotional well-being in times of tragedy.
• Resources and support are available to help individuals directly and indirectly impacted by the storm. UHC has opened a public support line for the next two (2) calendar weeks considering this event at 866-447-3573.
• Another resource is Optumwellbeing.com, a public website where employees can access resources to help them navigate difficult situations. The Critical Support Center section of the website includes a library of content for individuals to access during a critical event, grouped by topic (trauma, natural disasters, etc.).

We also have extensive prescription drug provisions with Express Scripts (High Option members) and OptumRx (Consumer Driven Option and the Medicare Advantage Plan members) to allow for refill too soon edits to be bypassed in order for members to obtain their prescription drugs if they have been damaged or lost.

Prescription Drug Coverage – Effective date of 9/26/2024 through 10/27/2024 for High Option Members:

• Health Plan members who reside in the affected areas, with the designated zip codes will be able to obtain a 30-day supply of their prescription drugs at a network retail pharmacy – at retail copay/coinsurance during the designated timeframes. Additionally, the pharmacists have the ability to override the “refill too soon” edits for members who indicate that they have lost their prescriptions.
• Paper claims submitted by members residing in the affected zip code areas for dates that fall within the designated timeframes will be identified in our data entry department prior to entry into ESD and sent hard copy to the Multiple Coverage Unit to be processed at the normal retail copay.
• Express Scripts by Mail will hold shipments of narcotics and temperature-sensitive medications into impacted areas pending member contact.
• Mail orders can be shipped to a temporary alternate address. Members should call Express Scripts customer service at 1-800-841-2734 (this number is also on the back of their ID card) and request their order be mailed to a temporary address. This applies to new orders, refills of existing prescriptions on file with Express Scripts and, in some instances, orders already placed.
• If a member is unable to receive their order by mail, Express Scripts can transfer their prescription to a retail pharmacy for dispensing. Express Scripts Pharmacy Services (1-800-922-1557) can assist the local pharmacist in processing the prescription if necessary.
• Doctor calls and drug utilization review (DUR) calls will continue and every effort will be made to complete these calls. Orders will not be cancelled and returned unfilled to the member. Express Scripts pharmacies are holding these orders in-house until the member/prescriber has been reached.

Prescription Drug Coverage -Effective date of 9/26/2024 through 10/27/2024 for Consumer Driven Option Members:

• UHC will follow the same guidelines that the High Option has set out in this letter utilizing their network, telehealth vendors, pharmacy benefit manager and benefit structure. Their EOB message for payment of out-of-network claims at the in-network benefit level will be: “In-network coinsurance applied”, since there are no copays under the Consumer Driven Option.