Contract Update – Qualified Health Plan (QHP)
A regulatory change requires those offering Qualified Health Plans (QHPs) to update contract language to note that, in addition to federal regulators, State Exchanges also have audit rights related to QHPs. To implement the change, we are giving notice that each Select Health Agent/Agency agreement is revised to substitute the attached Exhibit D for the Qualified Health Plan Exhibit previously in place. The revised language is included in Section 3.
EXHIBIT D: Qualified Health Plan
$0 Copay for Chronic Conditions Medications
Beginning in 2023, we will offer a new benefit (excluding grandmothered or Association plans) for members with certain chronic conditions enrolled on Individual and Small Employer Plans—both Traditional and High Deductible Health Plans (HDHPs). Medication for chronic conditions including asthma, diabetes, and COPD will be available for a $0 copay. Visit selecthealth.org/blog/2022/09/prescription-benefits-for-chronic-conditions to view a medication list.
Select Health still covers certain medications, devices, and tests with a waived deductible for HDHPs. Refer to the Deductible Waived Drugs & Devices Flyer on Select Health Link, under Agent Resources for more information.
Here’s a simple way to understand this coverage and how the two different lists work.
Pre-Deductible Drug List for High Deductible Health Plans (HDHP)
- This list has been in place for a few years and only applies to HDHP plans. Drugs and devices on this list are covered at the normal cost share or copays, but the deductible is waived.
- There are items on this list that are NOT on the new Chronic Condition list. The new Chronic Condition Drug List DOES NOT replace this list.
- This coverage also applies to Associations plans.
- It does not apply to grandmothered plans.
NEW Chronic Condition Drug List
- Drugs on this list have a $0 copay.
- ALL Drugs on this list are also included on the Pre-Deductible drug list for HDHP referenced above. This means drugs on this list are covered at no cost before the deductible on HDHP plans as well as on Traditional plans.
- This coverage is effective January 1, 2023 regardless of when the member’s policy or group renews.
- This coverage is not available to Association or grandmothered plans.
Individual Sales Open Enrollment Hours
As a reminder, Individual Sales has extended hours during Open Enrollment. Currently hours are Monday through Friday, 8:00 a.m. to 9:00 p.m. and Saturday, 9:00 a.m. to 3:00 p.m. MST. You can reach them at 800-442-5306, option 2. We’re here to help!
2023 Sales materials, including translated versions, are available in Link. They are located below the Agent Tools heading, under Agent Resources. The filters in the left-hand column can be used to navigate the product line. We offer downloadable and shareable versions in addition to physical copies. There is no login required for the recipient when sharing a link to a specific brochure. This option minimizes the size of an attachment when using email.
Link Agent Portal Helpful Hints
- Remember to bookmark the URL page in Link only after you’ve fully logged in, including 2-step verification to avoid the “Forbidden” error.
- To access the agent portal, go to selecthealth.org/link/manage. If you have a new phone and need to set up PingID again, contact our help desk at 801-442-7979, option 2 for assistance.
- Forgot your Link username? Contact Conner.Midgley@selecthealth.org or 801-442-1126.
- Want more training on the Link system? Contact Darrin.Reed@selecthealth.org or 801-442-1121.