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Board adds UnitedHealthcare national Medicare Advantage PPO to retiree options, asks staff to explore RFP next year
Summary
After questions about provider access, formulary exceptions and risk scoring, the Health Services Board voted to offer UnitedHealthcare's Medicare Advantage national PPO as an optional plan for Medicare retirees; the board added a friendly amendment to explore a competitive RFP process next year.
The Health Services Board voted to add UnitedHealthcare’s Medicare Advantage National PPO (MAPD) as an additional optional plan for Medicare A/B retirees, with final rates to be presented at the June retiree plan meeting and a board directive to study an RFP for similar plans next year.
UnitedHealthcare account manager Jean Ferron Jones described the vendor’s annual formulary filing process and a list of identified "high‑risk" medications (based on the American Geriatrics Society). She said recent data re‑analysis showed 1,069 unique members were taking one or more drugs on that list, up from 905 in prior analyses, and explained the plan’s exception…
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