Express Scripts. Here is what you need to do to have benefits in 2011:

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1 MICHIGAN UFCW UNIONS & EMPLOYERS HEALTH & WELFARE Benefit Navigator V O L U M E 2 I S S U E 3 S E P T E M B E R Express Scripts Effective October 1, 2010 the Plan s prescription drug and cost effective pharmacy services. Will the network change? INSIDE THIS ISSUE: benefits will be managed by Express Script. Why is the Health & Welfare Fund switching to Express Scripts? The Trustees of the Health What does this mean for the participant? It means that when you go to your pharmacy, effective 10/1/2010, you will no longer show them your No. You must still use a network pharmacy to have coverage for your prescription drugs. Visit our website for a list of Network Pharmacies. & Welfare Fund are constantly looking for better Caremark card. Instead, you will show them your Will I still pay the same co-pays? ways to service the Express Scripts card which Yes. Your co-pays are: participant and provider great coverage. Express will be mailed to you prior to 10/1/2010. Everything Generic $7 Brand Formulary $15 Scripts offers high quality else will stay the same. Brand Non-Formulary $ Open Enrollment Period is Underway Here is what you need to do to have benefits in 2011: 1. Review the 2011 Enrollment Guide 2. Complete and return both the Election of Healthcare Benefits Form and the Payroll Deduction Authorization Form 3. Returned both completed forms to the Fund Office You can also enroll electronically by clicking on the Login feature on the home page of our website, sign in and click the 2011 Enrollment option. Answer a few questions and click the submit button. It s easy! Didn t get your packet? You have 3 options: 1. Contact the Fund Office immediately so one can be sent to you. 2. You can find the 2011 Enrollment Guide and election forms online by visiting the Announcements page of our website Just print the forms, complete and return them to the Fund Office. 3. Enroll electronically by clicking on the Login feature on the home page of our website, sign in and click the 2011 Enrollment option. It s quick, easy and most of all convenient!

2 PAGE 2 More Q&A About Express Scripts Express Scripts Mission Statement Express Scripts makes the use of prescription drugs safer and more affordable for tens of millions of consumers through thousands of employers, government, union and health plans. How can Express Scripts help me manage my prescription drugs better? You can get instant online access to your prescription information on their website Once you register, you will find easy-to-use tools that give you the ability to: Get detailed information on your prescription medications and benefit coverage See how much your prescriptions cost and find out how you could save Locate your nearest participating pharmacy Look up drug and health information Will my prior authorization information transfer from Caremark to Express Scripts? Your prior authorizations (PA) will be entered into the Express Scripts system, unless they have recently expired. If the prior authorization is no longer valid, your doctor can submit a request for a new PA to Express Scripts via phone, fax or letter. Can my local Pharmacist request a Prior Authorization on my behalf? Yes, your local Pharmacist can call the Express Scripts Pharmacy Help Desk # printed on your member ID card. You should be receiving your Express Scripts ID card before October 1, If my medications are not covered, will Express Scripts notify me? Yes. If your medication is not covered, Express Scripts will send you a letter to notify you that your medication will not be filled. Who do I contact if my pharmacy is having trouble filling my medication? Your pharmacist can call the Express Scripts Pharmacy Help Desk # on the back of your ID card. Drug Limits on ED Medication BENEFIT NAVIGATOR

3 VOLUME 2 ISSUE 3 PAGE 3 FDA Warning About Online Drug Purchases If you are looking to save money on prescription drugs that the Plan does not cover, be very careful if you are making an online purchase. Some websites sell medicine that may not be safe to use and could put your health at risk -FDA According to the FDA, some websites that sell medicine: Are not US state-licensed pharmacies and in some cases are not pharmacies at all May give incorrect diagnosis and give you medicine that isn't right for your condition Will not protect your privacy In addition, the FDA states that the medications sold online are in some cases: Fake (counterfeit) Either too strong or weak Have dangerous ingredients Expired Not FDA approved Not made using safe standards Not safe to use with other medications or products Incorrectly labeled, stored or shipped So how can you protect yourself? The FDA suggests that you use the following 4 safety tips to determine if the website you are purchasing form is safe: 1. The website pharmacy should be located in the US and licensed by the state board pharmacy where the website is operating. 2. They should have a licensed pharmacist to answer your questions 3. The websites should require a prescription from your doctor who is licensed to prescribe the medication. 4. The website should have a way for you to talk to a person if you have problems. For more information about buying online, visit the FDA s website at Who is Express Scripts? Founded in 1986 and never owned by a drug manufacturer, Express Scripts aligns its interests with those of plan sponsors and their members. This legacy of independence means that the company s programs and original research on the pharmacy benefit serve its clients. Express Scripts drives to lowest net cost by enabling better health and value at the consumer level. As evidence, Express Scripts generic fill rate leads the industry. They call St. Louis home, but there are administrative, pharmacy, and customer service operations throughout the United States and Canada. Express Scripts continues to expand its services and today there are more than 14,000 employees focused on their mission to make the use of prescription drugs safer and more affordable. Their Code of Conduct provides the framework for their actions as they advance this mission in every aspect of their business. Express Scripts handles millions of prescriptions each year through Home Delivery and at retail pharmacies. We share a common cause with each of our clients to help offer a healthy prescription-drug benefit today and into the future. -Express Scripts

4 PAGE 4 Need copies of your EOBs? Legal Plan BENEFIT NAVIGATOR

5 VOLUME 2 ISSUE 3 PAGE 5 Crisscross Apple Crowns Directions 8 Servings Prep: 30 min. Bake: 20 min. 1-1/3 cups chopped peeled tart apples 1/3 cup chopped walnuts 1/3 cup raisins 1/2 cup sugar, divided 2 tablespoons all-purpose flour 2 teaspoons ground cinnamon, divided Dash salt 1 package (16.3 ounces) large refrigerated flaky biscuits 2 teaspoons butter, melted In a large microwave-safe bowl, combine the apples, walnuts, raisins, 3 tablespoons sugar, flour, 3/4 teaspoon cinnamon and salt. Microwave on high for 2-3 minutes or until almost tender. Flatten each biscuit into a 5-in. circle. Combine remaining sugar and cinnamon; sprinkle a rounded teaspoonful of sugar mixture over each. Top each with 1/4 cup apple mixture. Bring up edges to enclose mixture; pinch edges to seal. Place seam side down in ungreased muffin cups. Brush tops with butter; sprinkle with remaining sugar mixture. With a sharp knife, cut an X in the top of each. Bake at 350 for minutes or until golden brown. Cool for 5 minutes before removing from pan to a wire rack. Nutrition Facts: 1 serving equals 333 calories, 14 g fat (3 g saturated fat), 3 mg cholesterol, 607 mg sodium, 49 g carbohydrate, 2 g fiber, 5 g protein. Back to School Check-Ups Schools are starting to require that children have an annual school physical before the start of the new school year. The same goes for children interested in playing a sport. So why don t you take advantage of the wellness benefits available through the Plan and have your child examined. According to the University of Children s Hospital, an annual check-up for children ages 2 to 18 generally includes: Review and update of medical history A head-to-toe physical exam Measurement of height, weight, blood pressure and heart rate Urine test to screen for kidney problems Blood test for anemia Spinal check for evidence of spinal curvature (scoliosis) Test for early signs of diabetes, tuberculosis, anemia and high cholesterol if the child is at risk Even though most vaccinations are administered while the child is young, before they enter kindergarten, the Center for Disease Control (CDC) recommends that the child take the final dose of DTaP (tetanus, diphtheria and acellular petussin), IPV (inactivated poliovirus), MMR (measles, mumps and rubella) and chickenpox (varicella). Remember, your Plan includes a $500 wellness benefit so have your child examined today.

6 PAGE 6 Don t Miss Out- Enroll Online! To enroll online, visit our website at and click on the Log-in feature. You can terminate coverage for yourself or a dependent if : Your dependent no longer meets the Plan s definition of an Eligible Dependent. You or your dependent become eligible for other coverage, including Medicare. If this change results in a reduction of your weekly payroll If this is your first time logging in on our website here is how you can log in: Once you are logged in, click on the 2011 Enrollment option and answer a few simple questions. Your Username: This is the numeric portion of your employee ID or Contract number as it appears on your BlueCross BlueShield card. (Example, if your BlueCross ID# is UFX then your user ID is ) Your Password: This is your first initial and last name in capital letters. (Example, if your name is Mary Smith, your password is MSMITH) Don t forget to change your password after you log in for the first time. Click the Change Password option and enter your new password. While you are logged in, check out the rest of the neat features. View Eligibility find out if you are eligible for benefits during a specific period of time. You can view all your claims by clicking on the View Claims History or View Disability Claims and selecting a timeframe. From this menu, you can also print copies of your Explanation of Benefits that show how your claims were paid. View Participant Information such as address and phone number. Check out your Beneficiary Information and see who you designated as a beneficiary. If you do not have one, a designation form is in the Documents & Forms tab. deductions, you must request the change in coverage within 60 days Adult Dependent Children Under Age 19 of the event resulting in the loss of dependent status or eligibility for other coverage, including Medicare. BENEFIT NAVIGATOR

7 VOLUME 2 ISSUE 3 PAGE 7 Your Right to Appeal If you would like to appeal/dispute a determination that has been made regarding claims, late enrollments, or any other type of benefit under the Fund, you may do so in writing. Please provide a written explanation indicating the reason for your appeal and supporting documentation. The Administrative Manager will review your appeal to make sure the right determination was made. If it is determined that your appeal should remain denied, it will then be forwarded to the Board of Trustees for review. To appeal the determination of a denied claim you must do so within 180 days of the claim denial.

8 Michigan UFCW Unions & Employers Health & Welfare Fund 876 Horace Brown Drive P.O. Box Madison Heights, MI Phone: Toll Free: Fax: Visit us on the web! Enrollment As a quick reminder, the 2011 Open Enrollment season is right around the corner. If you had a recent address change and have not notified the Fund Office of this change, please do so immediately. It is very important that we have your address on file in order to send you important announcements and Health & Welfare materials. Open Enrollment for benefits effective January 1, 2011 will begin August 30th and end November 1st. If you do not complete and return your enrollment forms during the Open Enrollment period you will not have another opportunity to do so until the next Open Enrollment period in the Fall of Open Mandatory Open Enrollment does not need to be a hassle. Enroll online, its quick easy and paperless Enrollment is mandatory for all active participants if they wish to receive Health & Welfare benefits for the 2011 benefit year. The 2011 Open Enrollment forms and guide will be available mid August on our website at You can also complete your enrollment online by clicking on the Login button, fill out your 2011 enrollment form and click submit. For assistance with your enrollment, contact the Fund Office..