Reminder: Pharmacy Benefit Manager Change Effective January 1, 2025

A Broker Quick Alert was sent out on November 1 to notify brokers that QualChoice will be making a change to its Pharmacy Benefit Manager (PBM) effective January 1, 2025. As of that date, Express Scripts (ESI) will be the new PBM for QualChoice members. Prior Authorizations (PAs) may be requested starting January 1, 2025, from ESI by any of the methods below. A general PA form and a copy of the 2025 Formulary is available at QualChoice.com on the Pharmacy page.

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

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. See below for the timeline of the distribution of the new ID cards:

• New ID cards for groups with renewal dates of February through November will go out the last week of November.
• December renewals must be in house and fully processed by December 5 to ensure a December 9 postmark date.
• January renewals must be in house and fully processed by December 11 to ensure a December 16 postmark date.

2025 Plan Information Now Available Online

Our 2025 Plan information is now available on our website:

• 2025 POS Group Plans Snapshot (PDF)
• 2025 PPO Group Plans Snapshot (PDF)
• 2025 Metallic Plan rates are available in QuicQuote.
• 2025 MediQ65 Plans are also available in the online application.

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

November Is Diabetes Awareness Month

The QCARE Diabetes Management Program is our special way of caring for people living with high blood sugar. Members and their dependents with high blood sugar can take part at no added cost.

• Learn more about our QCARE programs 
• Download the Diabetes Management Program overview (PDF)

NOTE: Programs vary by employer group and benefit plan. Members should check with their benefits administrator.

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.

Thanksgiving Office Closure

Our offices will be closed Thursday, November 28, and Friday, November 29, so employees can spend time with their families. We’re thankful for you, our valued broker partners, and we wish you and yours a safe and peaceful holiday!