UPDATES FROM FALLON HEALTH
The most wonderful time of the year
Deb Daviau
Do you remember the old Staples television ad where a very happy dad takes his not-so-happy kids back-to-school shopping while the Andy Williams classic holiday song plays in the background? I always think of that ad—and that song—as we prepare for Medicare’s Annual Election Period (AEP). It’s a lot of work, it’s very busy, but most importantly, it’s exciting. And I look forward to it every year.

As you know, we are quickly approaching the beginning of AEP on October 15, and I’m very pleased to launch our 2022 plan options. Starting on October 1, you’ll see and hear Fallon Health advertising throughout our service area on the radio, billboards, digital and transit. And your individual Medicare clients will begin to receive direct mail from us too. We are confident that our offerings will be competitive in the marketplace, and that our existing members will be very happy to retain their Fallon plans.

There has never been a better time to become a Medicare broker with Fallon. We are launching our new Broker Rewards program on October 1. With four status tiers, ranging from bronze to platinum, brokers earn rewards based on the volume of Medicare-approved applications they produce. And we’ll make it easy for you to be part of it. All of our existing Medicare brokers will be automatically enrolled in the program. But don’t worry—if you haven’t signed on to be a Medicare broker with us, there is still plenty of time.

My team and I look forward to working with you during this year’s AEP and beyond. Let’s make this the most wonderful time of our year!

Best,
Deb Daviau
VP of Medicare and Executive Director of NaviCare
Medicare brokers receive rewards
On October 1, Fallon is launching a new rewards program for all contracted agents. Brokers will receive rewards such as AHIP reimbursements, continuing education reimbursements and marketing dollars based on the number of enrollments received. Learn more about this new program or give us a call.

And it’s not too late to become a Medicare broker with Fallon. Visit our broker page on the website and you’ll be on your way!
Benefit Bank plus new OTC benefit for Orange plan members
Effective January 1, 2022, all of our Orange plan members will receive $1,000 per year to pay for dental care, eyewear, fitness memberships and hearing aids with their Benefit Bank card. Fallon preloads money onto the member’s card and they choose how to use it. They can pay a portion—or the full cost—of an item, or buy a combination of items.

We are pleased that starting January 1, 2022, Orange plan members will get an extra $25 per calendar quarter they can use to buy health care products. They can shop NationsOTC—online or by phone—to choose from thousands of over-the-counter items.

Please remember: Benefit changes, and any other information about Fallon’s 2022 product offerings, cannot be disclosed to beneficiaries until October 1, 2021.
OptumRx named Fallon’s new PBM 
Beginning on January 1, 2022, Fallon Health will transition from CVS Caremark to OptumRx, for our pharmacy benefit management services. CVS Caremark has been a good partner for many years. Based on the changing needs of our members and our business, we conducted a thorough evaluation of our PBM strategy and services, which resulted in our selection of OptumRx. For more than 30 years, OptumRx has been supporting health plans and is currently serving nearly 60 million members across a broad spectrum of lines of business. They provide PBM services in Massachusetts today, and are tailoring a pharmacy benefits program that will meet our specific needs.

Fallon members will begin to hear about this change starting in October. Fallon and OptumRx are committed to ensuring that all members have a smooth transition.
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