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Administered by Allegiance Benefit Plan Management, Inc. providing the Cigna Open Access Network
and CVS CareMark Pharmacy Services
Williamson County
Diabetes Care Plan Member Guide
Williamson County Diabetes Care Plan (DCP)
Williamson County understands that diabetes is a major health problem and if not managed
properly, can lead to serious health complications. Williamson County offers additional
resources, support, and enhanced medical and prescription drug benefits through a Diabetes
Care Plan. Enrolling in the DCP is the first step to better health. Please use this guide to learn
more about the many services and benefits available to enrollees of the DCP.
Diabetes Care Plan benefits include: Three free diabetes-related doctor visits Select free diabetes-related prescription drugs and supplies Wellness education to help you understand your condition Free dilated retinal eye exam Reminders for essential screenings and exams Case Management
Value you can appreciate
The DCP offers superior value with enhanced medical and prescription drug benefits to
provide support to participants. When you enroll, you’ll receive up to three diabetes-related
doctor visits, as well as select prescription drugs and supplies at no cost—a potential savings
of hundreds of dollars each plan year.
Welcome
Eligible participants (age 18 or older) must be enrolled in one of the Williamson
County Medical Plans and diagnosed with diabetes or pre-diabetes.
Enroll in the DCP by completing and submitting the DCP enrollment form.
Enrollment in the DCP can occur anytime during the plan year and you will be
able to use your existing ID card to start receiving the enhanced benefits.
Complete all required Health Actions by October 31st of each plan year in order
to remain enrolled in the DCP. Claims history may be reviewed to ensure you have
met the requirements. In some circumstances you may be asked to submit
documentation to report completion of required health actions.
Fill your diabetes-related prescription drugs and supplies at any retail or mail
order pharmacy contracted with the CVS CareMark Network. Included in this
packet is a list of the prescription drugs that are available to you at no cost. Your
pharmacy plan will be updated so you can use your existing ID card.
Visit your Cigna Open Access Network doctor for three free diabetes-related
visits. Your medical plan will be updated so you can use your existing ID card to
receive enhanced coverage.
Remember to always use a Cigna Open Access Network doctor.
Take advantage of the opportunity to talk with your StarPoint Case Manager. Your
personal case manager will be providing educational material by mail and
reaching out to you by phone to review outstanding required Health Actions and
discuss any questions or concerns you may have about the program.
Always take great care to manage your health and improve your education!
Important Program Information How the DCP works
Health Action Requirements Listed below are the minimum care requirements to stay enrolled in the DCP.
If your required Health Actions have not been completed by October 31st , you will
automatically be removed from the DCP. For Example, if you do not complete the required
Health Actions during November 1, 2012– October 31, 2013, you will be ineligible for the
DCP effective November 1, 2013. If you complete a Health Action requirement that the
claims administrator does not have record of, you will need to complete a Health Actions
notification form and submit documentation of the completed Health Action(s). Doctor visits, screenings and frequencies required for enrollment in the DCP may be different from the
care plan designed by you and your doctor. The DCP Health Plan actions should not replace the care plan
designed by you and your doctor.
Health Actions must be completed between 11/1 through 10/31 of each Plan Year
Medical and Pharmacy Benefits Being diligent about taking your diabetes prescriptions and monitoring your blood sugar
can be critical to maintaining your health. That’s why Williamson County is making many
diabetes-related prescription drugs and supplies, as well as doctor visits, available at no cost
to you when you enroll in the DCP and follow the required Health Actions.
To see the current list of the prescription drugs and supplies visit www.askallegiance.com/
wilco and review the DCP prescription drug list contained under the Pharmacy Icon. For
your convenience, a list is included at the end of this brochure, but please note this may be
subject to change throughout the year and you should review the website for current
information.
The list includes insulin (oral and injectable) blood glucose testing supplies and certain
prescription drugs that treat cholesterol, high blood pressure and depression. If your
medication is not listed, you may want to discuss other options with your doctor so you can
benefit from this program.
The Cigna Open Access Network will be your source for
contracted medical providers. Click the ”Find a Doctor“ link on
your dedicated website at www.askallegiance.com/wilco.
You can fill your prescriptions at any retail or mail order
pharmacy contracted with the CVS CareMark Network.
For more information on the Pharmacy network, visit
www.caremark.com.
Diabetes Care Plan
Primary Care or Specialist
Doctor Visits No cost to you for three diabetes-related visits per year
Pharmacy Retail
(31-day Supply) No cost to you for select prescriptions and supplies
Pharmacy Mail Order
(90-day Supply) No cost to you for select prescriptions and supplies
Note: The above table reflects your in-network costs for diabetes-related care. Be sure to fill
your prescriptions at any CVS CareMark Network pharmacy. Standard benefits apply for all
other non diabetes-related care except those listed on the DCP prescription drug list.
CVS CareMark Diabetic Meter Program
Regular blood glucose testing is essential for people with diabetes. The CVS CareMark
Diabetic Meter Program can provide you with a free Meter and test strips to monitor your
blood glucose levels .
DCP members can call the CVS CareMark Diabetic Meter Team toll-free on weekdays
between 8 am to 6 pm for assistance with their free meter kit. A Customer Care
representative can help you choose one of five available meters. For added convenience, a
representative can contact your physician to request and process prescriptions.
Meter kits will be shipped directly from the manufacturer to members within 7 to 10 days of
the order. Test strips and lancets can be shipped from CVS CareMark within 10 to 14 days.
Members may receive no more than one meter kit as part of their pharmacy benefits every
plan year. Meters are provided by Roche (ACCU-CHEK) and LifeScan (OneTouch).
ACCU-CHEK® or OneTouch® blood glucose meter kit, which includes a starter supply of test
strips and lancets, at no cost, is part of CVS CareMark Mail Service Pharmacy benefits.
Vision Care
Managing diabetes and pre-diabetes also involves protecting your eyes. Diabetes can
damage the blood vessels in the retina. This damage is called diabetic retinopathy, which can
lead to blindness and other eye problems. Finding and treating retinopathy early may
prevent vision loss.
Retinopathy often does not cause symptoms that you can notice in the early stage so,
regular eye exams are important. The DCP addresses this concern by providing you with a
benefit to see an ophthalmologist or optometrist (eye doctor) who cares for people with
diabetes.
Protect your Eyes Have a dilated eye exam at least once a year with the provider of
your choice. Call your eye doctor right away if you have any
vision changes.
Call Toll-Free 1-800-588-4456 for assistance with ordering your free meter
How to Enroll
If you, or any of your dependents who are over 18 years old, have received a diagnosis of
diabetes or pre-diabetes, complete the DCP enrollment form and submit to the Human
Resources Department. You can be enrolled in the DCP anytime throughout the benefit year.
The DCP benefits will be effective upon completing and submitting an enrollment form. You will
retain your current medical plan election in addition to receiving the DCP enhancements. A
new ID card will not be required.
Support you can count on–
Case Management
Williamson County Human Resources Department
301 S/E Inner Loop, Suite 108
Georgetown, Texas 78626
Phone 512-943-1533
Email [email protected]
Perhaps the most valuable resource available to
you under the DCP is access to, and outreach
from, a Case Manager who will be assigned to
you through StarPoint Medical Group. Your Case
Manager will reach out to you upon your
enrollment and will be available to discuss the
benefits and requirements of the DCP, as well as
assist with questions you may have regarding
your condition.
Your Case Manager will initiate follow up calls to
remind you of outstanding required Health
Actions and keep you up-to-date with diabetes-
related news and information through quarterly
mailings. Your Case Manager will provide you
with their contact information so you can get in
touch anytime you have questions or concerns.
StarPoint : 1-877-792-7827
How will I receive my free diabetes-related prescription drugs and supplies? You can fill your free prescriptions at any retail pharmacy that contracts with CVS CareMark or use CVS
CareMark mail order pharmacy. Your pharmacy plan will be updated automatically so you can use your
existing ID card to receive the enhanced pharmacy coverage. For more information on the CVS
CareMark network pharmacies visit www.caremark.com.
How will I receive three no cost diabetes-related visits to my doctor? As part of the DCP, you will automatically have three free diabetes-related visits if your claim is coded
as related to diabetes or pre-diabetes. Simply present your ID card at your doctor visit and feel free to
let them know you have three no cost diabetes-related visits as part of your DCP.
Which medications are free under the DCP? You will have the benefit of free select prescription drugs used to treat diabetes, pre-diabetes, and
other related conditions. This includes insulin's (oral and injectable), blood glucose testing supplies
and certain medications that treat cholesterol, high blood pressure and depression. All other
medications will be covered at the standard benefit level for retail and mail order. A list has been
included in this brochure which may be subject to change. Please review the current information on
the www.askallegiance.com/wilco website by selecting the pharmacy icon.
How are the DCP required Health Actions determined? Health actions are based on recommendations by the American Diabetes Association for treating
diabetes and pre-diabetes. They are also based on guidelines from the American Cancer Society.
How are my required Health Actions tracked?
The Claims Administrator will review claims history to track your required Health Actions. The Case
Manager assigned to you will review this information and reach out to discuss your progress. In some
instances, such as with screenings that may not be required yearly, you will need to complete a Health
Actions notification form and submit documentation of the completed Health Action(s).
How do I reach a Case Manager?
After your initial diagnosis of diabetes or pre-diabetes, or enrollment in the DCP, a Case Manager will
call you twice by telephone and if they can not reach you, they will send you a letter at your home
address with their contact information. The Case Manager serves as a valuable resource for
information and will help you benchmark your progress with the Health Action requirements.
What happens if I don’t complete my Health Actions in the compliance period?
Not completing your required Health Actions during the benefit period which starts on November 1st
and ends the following October 31st will make you ineligible for continued participation in the DCP for
future years.
Frequently Asked Questions
Enrollment
Benefit questions
Williamson County Human Resources
301 S/E Inner Loop, Suite 108
Georgetown, Texas 78626
Phone: 512-943-1533
8am to 5pm, Monday through Friday
Email [email protected]
Allegiance Benefit Plan Management, Inc.
1-855-333-1009
7am to 7pm, Monday through Friday
Website: www.askallegiance.com/wilco
Contact Information
For more information on the Diabetes Care Plan, please contact the following resources:
DCP Prescription Drug List
Free diabetes related prescription drugs and supplies list is subject to change
Diabetes Care Plan (DCP) Enrollment Form
SECTION I :
Employee ID Number:
Employee First Name: Employee Last Name:
Employee Address:
City: State: Zip Code:
Employee Phone Number: Employee Email:
SECTION II :
I am the Employee (Skip to Section III & IV) I am a dependent, age 18 or older (Complete Section II, III, & IV)
DCP Enrollee Social Security Number:
DCP Enrollee Date of Birth: DCP Enrollee Gender: Female Male
DCP Enrollee First Name: DCP Enrollee Last Name:
DCP Enrollee Address:
City: State: Zip Code:
DCP Enrollee Phone Number: DCP Enrollee Email:
SECTION III :
Eligible participants (age 18 or older) must be enrolled in one of the Williamson County Medical Plans and
diagnosed with diabetes or pre-diabetes.
I certify I meet the eligibility requirements for DCP Enrollment and understand I must complete all required
Health Actions by October 31st of each plan year in order to remain enrolled in the DCP.
I am enrolled in one of the Williamson County Medical Plans OR
I understand my DCP enrollment is contingent upon enrolling one of the Williamson County Medical Plans
SECTION IV:
Employee Signature: Date:
DCP Enrollee Signature: Date:
Submit your DCP enrollment form to the Human Resources Department:
Email: [email protected] • Fax: (512) 943-1535
301 S/E Inner Loop, Suite 108 • Georgetown, TX 78626