HighMark Pilot Program for Kaleida Health Members

After months of discussions with Kaleida Health leadership and HighMark BCBS we are happy to announce progress towards resolving some of the many problems that seem to plague our members when it comes to their health and prescription drug insurance coverages. HighMark has committed to a plan of action to provide a proper experience for our members. Their commitment is scheduled to go live in early March 2024, this will include:

1.Creating the HighMark Navigator Pilot Program

• This will offer a live customer service supervisor on site in our facilities to assist members with escalated questions, understanding benefits etc.
• A representative will be on site 8-12 hours per week rotating between primary Kaleida Health locations.
• Members can schedule a brief 15–30-minute appointment for their discussion.
• A schedule outlining days, times, and locations has yet to be finalized but once it is, Kaleida Health and the unions will readily distribute the information.

2.Creating a dedicated Kaleida Health Customer Service Team

• Highmark has committed to designate 20-25 Customer Service Representatives to service a dedicated Kaleida Health medical claim phone line. When a Kaleida Health employee calls the customer service center and one of these agents is available, our calls will go directly to them for dedicated assistance to our plans.
• Highmark will provide this new team with targeting in-depth training on the Kaleida Health plan, with increased system prompts and more detailed plan information. This will improve consistency of plan knowledge and information relayed to plan members and reduce the need for claim escalation.
• This will also include improved training regarding pharmacy plan specifics during weekday business hours. After hours and weekend calls will be transitioned to the Express Scripts pharmacy customer service team. It will continue to be best practice to call regarding prescription issues during normal business hours as Highmark will handle these questions in house in a concierge type manner. After normal hours, these calls will automatically go outside of HighMark to Express Scripts’ national help line.

3.HighMark Consideration for Employees

• Proposal to provide a “wellness debit card” to all active employees covered under Kaleida Health medical plans. The card would be valid through the end of 2024 and can be used in a variety of ways to help offset costs such as gym memberships, health food stores such as GNC and Vitamin World or for food subscription services.

4.MyHighMark Mobile Application Update

• Updates to the mobile app related to the Align plan that is administered have been requested. This request has been issued by the New York HighMark team and remains in process while Kaleida continues to push for a resolution.Currently the HighMark member website does accurately reflect all the plan benefits including for the Align program.