ChamberCare Medical & Rx Offerings
The medical and pharmacy benefit offerings that are available through the MEWA trust are equitable and cost-effective. These plans provide competitive and comprehensive benefit options that allow employees to choose benefits that meet their individual needs and provide long-term financial security.
Medical & Rx
The ChamberCare plan designs were developed to closely align with the previous two-tier plans many employers are already familiar with.
View Plan SBCs below.
The ChamberCare program offers a MEWA arrangement with no downside risk or rate volatility. This is especially important for groups with 2-50 employees to have the protection of being part of a larger pool, backed by shared stop loss coverage. ChamberCare has always offered significant benefits over ACA and level-funded solutions, including more stability, much higher persistency in renewals each year, and the ability to participate in a larger pool.
Please note: The following plans' prescription drug coverage do not meet Medicare Part D creditable coverage standards. Because these plans are not considered creditable, members who enroll in Medicare Part D at a later date may be subject to a late enrollment penalty.
- 0044: ICC $7,500/$8,000 HSA
- 0046: ICC $6,000/$6,200 HSA
- 0048: ICC $5,000/$6,500 HSA Rx PV
- 0049: ICC $5,000/$6,500 HSA
- 0054: ICC: $3,500/$6,000 HSA
Deductible and Out-of-Pocket Max
What if members have already met the deductible or out-of-pocket maximum this year with Anthem? Will that transfer to SIHO?
Yes! Members may email their most recent Explanation of Benefits (EOBs) to eob@chambercare.org or contact ChamberCare Member Services at (844) 644-3004 for assistance.
Please note: deductible credits will be applied 7-10 business days from the date that SIHO receives the EOB.
Important Pharmacy Information Related to CVS Caremark.
- Beginning 10/1, members will need to provide their pharmacy with the new SIHO/CVS Caremark ID card.
- Members currently taking a mail order or specialty medication, will need to request a new prescription from their provider.
- Members currently utilizing a retail pharmacy for medication refills, do not need a new prescription, but should ensure the pharmacy has a copy of the new ID card.
- Members currently taking a prescription that required prior authorization and/or step therapy, will need to obtain prior authorization from their provider again. The pharmacy will initiate this at the time of refill by reaching out to the provider. However, we strongly encourage members to proactively initiate the prior authorization process before time of refill by calling CVS Caremark Customer Care at 866.475.0056.
- Members can check prescription coverage, cost, prior authorization and step therapy requirements, by registering for a CVS Caremark account. Registering for an account can be done simply by visiting caremark.com and providing the member’s name, DOB and phone number – an ID number is not required to register for an account.
Guidance on Medicare Coordination
We have received questions asking how Medicare coordination will be handled within the SIHO arrangement. Under the Medicare Secondary Payer (MSP) rules, Medicare serves as a secondary payer to a group health plan for employees and spouses with dual coverage (coverage under the group health plan and Medicare) However, an employer with fewer than 20 employees that participates in the ChamberCare MEWA may opt out of application of Medicare as secondary payer, meaning that Medicare will pay primary for working employees and spouses who have attained age 65 and are also enrolled in Medicare. Please complete this form if you wish to opt out of the MSP rules.