Please be advised that all Commercial Fully Insured Large Groups will move from the current 3 Tier Open Formulary to our Preferred Value Formulary (PVF) based on their plan year. This change excludes Minimum Premium groups, who will continue to have the option to choose between 3 Tier Open Formulary or PVF.
Why are we making this change?
We believe this change will help manage rising costs and provide the best financial value for our Large Group customers. It will also help mitigate impacts of the frozen formulary state mandate and any additional state/federal mandates.
Will members need new ID cards?
ID cards (view sample) will be updated to include the 4-digit formulary ID (5578) which is also posted on our UniveraHealthcare.com website. ID cards will be distributed based on the group’s plan year.
For example, if a group’s renewal date is March 2024, and their plan year is March 2024, we will reissue new ID cards prior to their renewal date. If a group’s renewal is March 2024, but their plan year is January 2024, we will reissue new ID cards prior to January 2024.
How are we communicating this change to groups and members?
For members currently taking a medication that will no longer be covered under the PVF, they will be notified via letter at least 90 days prior to when the formulary change takes place. NOTE: We also will send communications to providers.
To access the formularies on our Univera Healthcare website, go to:
Please share this information with your fully insured large groups and contact your account manager with any questions.
(5578) 2024 Preferred Value State Mandate Formulary (PDF)
