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Volume 7 | March 2020
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Partnership News from the Exemplar Network
Exemplar andAnanda Professional have
partnered together to create away to provide your
customers the best qualityCBD.
AN EXCLUSIVE PROFESSIONAL LINE OFCANNABIDIOL (CBD) PRODUCTS CREATED FOR
PHARMACISTSAnanda Professional continues the pioneering commitmentof Ananda Hemp by bringing to market the first fullycompliant and legal CBD oil product line created specificallyfor the needs of independent pharmacies and healthcareprofessionals.We know that pharmacists and their patients want products
“We’re extremely proud and excited ofthe new partnership between AnandaProfessional and Exemplar. This putsone more high quality tool in theindependent pharmacist's toolbox. ThisFarm-to-Pharmacy approach is the keyto Ananda Professional's successful lineof products. The Ananda product line isavailable through our distributionpartner, www.ipdpharma.com"
Wesley DrakePresident
Exemplar HealthcarePartnership Organization
that are safe and effective. This exclusive professional linemeets strict safety standards and features the samepharmaceutical grade full-spectrum cannabinoids brought toyou by the creators of Ananda Hemp.For healthcare professionals, we understand that meetingpatients’ individual needs can be a challenge. That’s whywe created different forms of delivery and varying strengthsso that you can easily develop customized treatment plans.We are committed to providing you with the information youneed so that you can better serve your patients. We firmlybelieve that if we meet your needs, you can meet theirs.
So how does the partnership between Ananda Professionaland Exemplar work? As you know, Exemplar is building anetwork of independent pharmacies and primary carephysicians that will bring you more lives and betterreimbursement. Ananda CBD products will be eligible underthe Medicare Savings Account. This plan allows customersto control their allocated Medicare dollars. These MedicareSavings accounts dollars can be used at your pharmacy foritems covered including Ananda Professional CBD
To learn more about the opportunities that the Anandapartnership offered to Exemplar Network members, visitAnanda Professional.
A Texas-Sized Opportunity for the Lone Star State...and more to come!
Tired of DIR fees from PBM's? We weretoo. So we are launching ExemplarHealth PDP in 2021 in Texas. We willbe quickly adding more states to thisPDP, but we figured we'd start with oneof the biggest States first.EHBA is having great success sellingcommercial insurance plans all over thecountry that are benefiting the ExemplarNetwork. As an Exemplar Networkmember the PBM and Health PlanPAYS BACK A PORTION OF THEIRPROFITS TO THE NETWORK. Thesecommercial plans are available in moststates to companies with as few as 2unrelated employees (depending onState).
There are businesses all around yourpharmacy that NEED employee healthcoverage - why not suggest to them thecoverage that will make the ExemplarNetwork Pharmacies the preferredpharmacy, keeping those patients withyou - the local independent pharmacy?Then, when you fill their prescriptions,you will see MORE LIVES ANDBETTER REIMBURSEMENTS!!!!!
Congratulations to Jeff Dalton from
Medicine Shoppe Pharmacy, Altavista, VA-
the winner of our survey random drawing!
Exemplar Insurance Hits the Mark, Saving Money on PremiumsExemplar Insurance Hits the Mark, Saving Money on Premiums
The results are in, and the savings are SOLID. On January 1st 2020, ExemplarInsurance was launched and our agents hit the ground running. Quote afterquote, we are seeing typical premium savings of 45% with BETTERCOVERAGE. Our flagship products, Exemplar Advantage (Level Funded Planwith Reference Based Pricing option) and Advantage Essential (PPO) aretargeted at small and midsized businesses, allowing us to cover as few as 2non-related lives (depending on state) in a small business. Keeping in the spiritof the Exemplar network's primary demands of wanting more lives and betterreimbursements, Exemplar Insurance's new product launch is poised to dojust that. By being a vertically integrated product and Exemplar Insurancecontrolling the majority of the margins in the health insurance product design,rates can be as much as 45% less expensive than other major carriers. Thiswill allow our broker distribution to win more lives in the commercial spacearound all the Exemplar member network locations.
Also, through our PBM, ProRx Solutions, network members stand to earnmore money from the prescription side of the medical plan. Did you know
besides payroll, covering health insurance premiums is usually the second largest
expense a small business owner has? Now we have a potential solution to save
business owners in your community significant dollars. In return, you have the
opportunity to reach the ultimate desired out come in your pharmacy, More Lives
And Better Reimbursements. If you know of any small business owners in your local
community, or would like a quote for your own business, we can help.
For more information or to request a quote, please call 855-826-3422
or visit www.exemplarinsurance.com
Frequently Asked Questions:
Who should be tested for COVID-19?As of 3/8/2020, the Centers for Disease Control(“CDC”) recommends that anyone with symptomsof COVID-19, returning from a Centers for DiseaseControl-designated “Level 2” or “Level 3” advisoryarea, or who has been in contact with someonewho is suspected or confirmed of having thecoronavirus within the last 14 days, should betested.Any individual who suspects that they may havebeen exposed to the coronavirus or is exhibitingsymptoms should consult with their health careprovider to make the appropriate testingrecommendation, in line with CDC guidelines.
Can anyone get tested for COVID-19?The CDC has outlined clinical criteria to qualify asa candidate which may be approved by adoctor. The CDC clinical criteria for a COVID-19person under investigation (PUI) have beendeveloped based on what is known about COVID-19 and are subject to change as additionalinformation becomes available.
How can members access COVID-19 testing?Members who have concerns that they may have
Coronavirus – COVID-19 – Information andResources
At Exemplar Health Benefits Administrator(EHBA), the health and well-being of you, youremployees, and your families is our top priority. Asthe world continues to monitor the internationalcoronavirus COVID-19 outbreak, we want toensure your plan members have easy access todiagnostic testing as needed. When your Plan members seek diagnostic testingfor COVID-19, they do not needto pay anything; the provider should submit theclaim as usual, and we will work directlywith providers toensure the seamless processing andreimbursement of the following added benefits:*
· Waived member cost sharing for COVID-19diagnostic tests and related charges. o Your Plan members will not be subject todeductibles, copays, or coinsurance for diagnostictesting charges related to COVID-19. This means100%, first-dollar Plan payment for professionalservices, lab tests and facility charges (e.g. officevisit, ER visit, urgent care visit) incurred for aCOVID-19 diagnostic test. § For Members who obtain COVID-19 diagnostictests, the Plan will pay 100% of the network-contracted rate. § If a Member tests positive for COVID-19, alladditional services provided to the Member for thetreatment of and medically necessary supportivecare for COVID-19 will be subject to the Member’sdeductible, copays and coinsurance.
· Waived Penalty for Emergency RoomCOVID-19 diagnostic tests. o Since some members seeking COVID-19diagnostic tests may be directed to an emergencyroom for quarantine purposes, the standardpenalty for emergency room use for non-
been exposed to COVID-19 or may havesymptoms of COVID-19 should contact their healthcare practitioner or state Department of Health fortesting.
Is there a vaccine or treatment available?No vaccine or specific treatment forCOVID-19 is available at this time; carefor a person who tests positive for thevirus is supportive in nature.
How can I learn more about COVID-19?Here are some resources tolearn more about COVID-19:
https://www.cdc.gov/coronavirus/2019-ncov/index.htmlhttps://www.who.int/emergencies/diseases/novel-coronavirus-2019https://www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html
emergencies will NOT be applied for COVID-19diagnostic tests.
· Waived Prior Authorizationrequirements/penalties for COVID-19 testingand treatment. o There will be no prior authorizationrequirements for plan members seeking COVID-19diagnostic tests, treatment for COVID-19, ormedically necessary supportive care if testedpositive for COVID-19.
· Outpatient Prescription Drug Support.o Early refills and prescriptions for up to 90-day supplies (as prescribed) will be permitted uponrequest due to quarantine or other COVID-19hardships.For inquiries and benefit questions, membersshould call the customer service number on theback of their Medical Plan ID card. EHBA will continue to monitor the situation andprovide updates as additional treatment orprevention solutions become available. *If you do not want to apply these benefitenhancements to your group health plan, pleasecontact EHBA at 855-826-3422.
March is National Nutrition Month®
The Academy of Nutrition and Dieteticscelebrates this annually. As part of theircampaign, they invite the public to focus onthe importance of making informed foodchoices and developing sound eating andphysical activity habits.
EHBA focuses on healthcare and strives tohelp our members stay healthy. Let us helpyou help your associates develop soundeating and physical activity habits. Contactus for more information on our productsand services.
Welcome, Gem State andWelcome, Gem State andSooner State!Sooner State!
Exemplar Health BenefitsAdministrator recently expanded itsTPA state licensure to new marketsincluding the states of Idaho andOklahoma. States marked in blue arestates we are currently licensed in.More coming soon!
To learn more about EHBA click here,or follow us on LinkedIn to stay up tospeed on our news and events.
Anchor Demonstrations
Contact your Account Manager todayto schedule an Anchor demonstrationto show you the benefits of AnchorDashboard, a free tool from Exemplarto help bring more lives and betterreimbursements to your pharmacy.
STAYING CONNECTED WITH THE NETWORK TIPS FOR PHARMACY OWNERS
Exemplar is committed to helping the independent pharmacy and physician network. Hereare some tips to ensure that you thrive in today's world and remain committed to yourpatients, as well as your surrounding communities for generations to come. Have yourown tip or want to be featured in next month's newsletter? Contact us [email protected]