Happy Holidays from QualChoice!

Quality Health Matters

News and Updates for Employer Groups

December 12, 2024

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As 2024 draws to a close, I have been reflecting on the past year and those who have helped shape our business. I want to take a moment to thank each of you, our valued employer and group clients, for your support and trust. It’s been quite a year for us all! I hope that this year has been just as memorable for you, your colleagues, and your loved ones.

We look forward to continuing our partnership with you in the coming year, as we continually strive to improve our offerings, quality, and services to assure our mutual success.

We wish you a very happy holiday season and a peaceful and prosperous New Year.

Tracy Matson, Sales Director

Reminder: Pharmacy Benefit Manager Change Effective January 1, 2025

On January 1, 2025, QualChoice will be changing to Express Scripts (ESI) for its Pharmacy Benefit Manager (PBM). Prior Authorizations (PAs) may be requested starting January 1, 2025, from ESI by any of the methods below.

Call 1-800-417-8164 or 1-800-753-2852
Fax 1-877-251-5896
CoverMyMeds: Express Scripts Prior Authorization Forms | CoverMyMeds

A general PA form and a copy of the 2025 Formulary is available on the QualChoice.com Pharmacy page.

Members will receive a new QualChoice ID card before January 1, 2025, and should be encouraged to share that new card with their pharmacy at their first fill of 2025 so they have the new processing information.

Be Sure to Check Out Our Great Rates for 2025!

The 2025 Plans information is now available on our website:

2025 POS Group Plans Snapshot (PDF)
2025 PPO Group Plans Snapshot (PDF)
2025 MediQ65 Plans are also available in the online application.

Contact your Sales Account Manager or Account Service Representative (PDF) for more information.

Tools to Help Members Manage Their Benefits

We want to make it easy for our members to manage their benefits wisely. The Member Handbook is a great resource for members to learn how to use their QualChoice benefits.

View and download the Member Handbook in English (PDF) or in Spanish (PDF).
Members can view full details about specific health plans and print official plan documents by signing in to My Account and selecting Your Benefit Booklet.

For additional tips and helpful information, visit our Member Learning Center on QualChoice.com.

Flu Season Reminder

QualChoice members can get the flu vaccine at any network pharmacy or provider’s office. No copayment is required. Get more facts about the flu at QualChoice.com.

Holiday Schedule

Our offices will be closed on the following days:

Tuesday, December 24
Wednesday, December 25
Tuesday, December 31 (half day)
Wednesday, January 1

We wish you all happy holidays and a healthy New Year!

Updated Forms

To make sure you are using current QualChoice forms, please download from the Employer Forms page at QualChoice.com each time you need to use one. View Employer Forms.

In the Media

QualChoice answers frequently asked questions about Medicare was recently featured in the Southwest Arkansas Today. For more health tips and information, visit QualChoice.com/news.

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