Executive Notes is designed for the employers who use our benefits programs. Brief soundbites allow you to quickly scan for what is relevant to you. If your organization doesn’t offer all of our benefits, simply skip the sections that don’t apply to you.
Regarding LTD / STD premiums
Milliman has identified that salary-based premium calculations need to be recalculated for any salaries that changed after the initial data files were received. We anticipate these updates to be made in the March billing report cycle, and will be made retroactively. The system is being updated to automatically recalculate premiums whenever salaries are updated.

Information now available on how over-the-counter Covid tests are covered or reimbursed

Please read below for a better understanding of how this is handled.

NOTE: We have sent the information covered here to members of Brethren Medical Plan to let them know about this benefit. 

Highmark will reimburse the cost of
FDA-approved COVID tests 

Members of the Brethren Medical Plan can be reimbursed for the cost up to $12 per test of over-the-counter COVID tests. By making this available to members of the Brethren Medical Plan, Highmark is complying with Federal guidelines. To receive reimbursement, members must submit a claim form through the mail or online. For instructions on how to do this and for any exclusions that may apply click here.  

Up to 8 tests 

Members can be reimbursed for up to eight OTC COVID tests per month. This coverage began on Jan. 15, 2022. 

Access without upfront cost  

Members can access OTC COVID-19 antigen tests directly from the Highmark preferred pharmacy network without any upfront cost, eliminating the need for reimbursement. Here is a list of the OTC COVID-19 antigen tests approved for emergency use by the FDA and covered by Highmark: 

  • Inteliswab COVID-19 Home Test 
  • Binaxnow COVID-19 AG Home Test 
  • Quickvue At-Home COVID-19 Test 
  • Ellume COVID-19 Home Test 
  • iHealth COVID-19 AG Home Test 
  • Flowflex COVID-19 AG Home Test 

Mail-order and other retailers 

Members can also buy OTC COVID-19 tests through mail-order, using their pharmacy coverage. Further, they will still have the ability to obtain tests from retailers outside the preferred pharmacy network but will need to submit reimbursement claims to Highmark under their pharmacy coverage only. 

How members can get a test without out-of-pocket costs 

  • Visit the pharmacy where you get your prescriptions or any in-network pharmacy (To find in-network pharmacies, visit the Highmark member website or call the number on the back of your card).
  • Look for a test that is on the above list.
  • Show your Highmark insurance card at the checkout with no out-of-pocket costs. 
  • You can also pay for the test and submit a claim form for reimbursement. 

For those who are on Medicare and have a
Medicare Supplement plan  

At this time, Medicare users can go through the government site of Covidtests.gov to obtain free COVID tests. We anticipate that within the next few months, tests will be available for you at pharmacies, where you will use your Medicare information. We will keep you posted on this.

Please see Milliman's updated billing report below:

Lynnae Rodeffer
Vice President of Products
and Services
We hope you find this update helpful, and we welcome your feedback.