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Update for Cost Plus Customers: Per-Claim Fee for OTC COVID-19 Testing Program

February 23, 2022

Applies to ASO and Cost Plus Groups

As you’re aware, we’re supporting the federal government’s over-the-counter (OTC) COVID-19 test coverage requirement for employers that have Prime Therapeutics® coverage through Blue Cross and Blue Shield of Texas.

What this means to you: We previously let you know that we would bill our self-insured customers who have carved-in pharmacy benefits through Prime an administrative fee of $2.50 per OTC test claim. This fee also applies to our Cost Plus customers.

The Feb. 2 article includes the details about the fee.

We will notify Cost Plus groups by email this week. If you have questions, please contact your account representative.

This information applies to members and groups with prescription drug benefits administered through Blue Cross and Blue Shield of Texas (BCBSTX).

BCBSTX contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. In addition, contracting pharmacies are contracted through Prime Therapeutics. The relationship between BCBSTX and contracting pharmacies is that of independent contractors. BCBSTX, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.