The Future of COVID-19 With vaccines against COVID-19 now becoming more readily available, we highly recommend encouraging your teams to get vaccinated. As COVID-19 becomes a largely preventable disease, beginning May 1, TML Health will no longer provide 100% coverage of COVID-19 related treatment, but will cover these expenses as normal medical claims subject to the same pre-authorization requirements as other medical conditions.  If your employees are struggling to find available vaccination shots, we recommend going to Texas' official vaccine page to find the latest information on the different vaccines available and where they can be found locally. If we all work together, we can reduce the spread of COVID-19 and bring back the Texas we know and love!

TML Health’s Annual Regional Meetings TML Health is seeing some incredible changes in 2021 and we want to keep you and your teams up to date on everything they have access to! From incentive-based wellness programs to an exciting new partnership with Blue Cross and Blue Shield of Texas, our 2021 initiatives are already expanding your coverage options and saving the pool thousands of dollars, which will in turn save our members on benefit costs. This year, we’ll specifically be covering: • Our Service to Member Groups • Update to TML Health Strategic Plan • 2021 – 2022 Benefits Plan Updates • Power of the Pool with Blue Cross and Blue Shield – A Winning Combination • TML Well • Your Service Team • Financial Outlook • Our Commitment to You

Use the links below to sign up for the ZOOM events for member groups OR brokers and invite any member of your staff involved with the management of your benefits package. See you there!

Member Events Member Group Webinar #1 Monday, May 17 at 1PM CST Register Member Group Webinar #2 Tuesday, May 18 at 1PM CST Register Member Group Webinar #3 Wednesday, May 19 at 10AM CST Register  Member Group Webinar #4 Thursday, May 20 at 10AM CST Register

Broker Events Broker Webinar #1 Monday, May 10 at 10AM CST Register  Broker Webinar #2 Monday, May 10 at 1PM CST Register

TML Health Online is Almost Here! While we are incredibly excited about upgrading to our new TML Health Online system, these updates mean the online enrollment system will be down as of Saturday, May 1. This “lockout” will take place May 1 – 15 to ensure an accurate migration of all election data. While we can’t wait to provide you with easier enrollment and better customer care, we appreciate your patience should this update cause you any inconvenience. If you need to make enrollment changes during this period, please submit your enrollment forms to bemail@tmlhb.org or reach out to one of our Billing & Eligibility Representatives for support at (800) 537-9898. We will be hosting a series of webinars on May 13 and 14 to introduce the new TML Health Online system and what changes have occurred once everything is up and running. Benefits and Billing Coordinators can sign up to attend either day below:

Thursday, May 13 at 1:00 PM

Friday, May 14 at 10:00 AM

Updates on COBRA TML Health will no longer be offering COBRA to groups under 20 members. If you have any questions, here are the recommended FAQs and updates the US Department of Labor posted on their website to help employers comply with the new federal COBRA premium subsidy put in place by the American Rescue Plan Act (ARPA).

Navitus Transition Letters are On the Way! All of the transition letters from Navitus have been mailed out. This will be affecting any of your members that either were previously taking medications under OptumRx that are no longer covered by Navitus OR are changing to a higher copay tier. These letters will be providing the effective dates (4/1/21 for members that moved to Navitus on 10/1/20; 7/1 for members that moved on 1/1/21) and a list of covered, lower-cost alternatives that the members can discuss with their doctors.  If your employees have questions about the changes, please ask them to call (866) 333-2757. Navitus Customer Care is ready to help any members have questions about the changes or would like information about lower cost alternatives.

Raise Wellness Awareness Need help boosting enrollment in the Wellness Programs and raising awareness on the incentive checks? We’ve designed a flyer and poster you can use for emails, handouts, and hanging around the office! Feel free to print either out yourself, but TML Health can also print the posters for you. Email TMLWell@tmlhb.org by April 28, 2021 with the following information and we will mail the posters out the week of May 10. Group Name: _____________ # of Posters Requested: ____________ Attention: _______________

INCENTIVE FLYER

INCENTIVE POSTER

Friendly Reminder: The Appeal Deadline Is Changing We are just reminding you that TML Health is making a change to the benefit plan language regarding appeal timelines. This change is necessary to prepare for our upcoming transition to Blue Cross and Blue Shield of Texas (BCBSTX); it will ensure that TML Health can finalize any appeals that occur under the UnitedHealthcare (UHC) network prior to the termination of our contract with UHC. A copy of this notice will be provided to all covered employees in a separate email. The information will also be included on the front of future Explanation of Benefits (EOB) documents and on the plan booklet for members.

NOTICE: Effective Tuesday, June 1, 2021 TML Health is amending the appeal deadline for all denials from twelve (12) months to 180 days When a claim is denied, it will be reflected on the Explanation of Benefits (EOB) document.

The EOB form will:  - Explain the reasons for the denial.  - Explain the steps you may take to submit the claim for appeal (review).  The process for proceeding with an Appeal is outlined in the TML Health Medical Plan Booklet which is available for each member on the TML Health Portal. Login at: tmlhealthbenefits.org. At the menu bar select: LOGIN > Login as a Member.    Members who have received a denial of claims prior to June 1, 2021 will have twelve (12) months to appeal. Claims that are denied on June 1, 2021 and thereafter will have 180 days to appeal.

If you have questions or concerns, please contact our Customer Care team at 1-800-282-5385 Monday-Friday 7:00am - 6:00pm Central Time.

TML Health | tmlhealthbenefits.org

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