Nippon Life Benefits is committed to assisting all members who have been displaced by the California Wildfire Declared State of Emergency
Nippon Life Benefits will provide an insured person who has been displaced by the Wildfire State of Emergency, as declared by the Governor, access to medically necessary health care services. This includes:
- Relaxing time limits for prior authorization or precertification.
- Extending filing deadlines for claims.
- Suspending prescription refill limitations and allowing an impacted insured person to refill his or her prescriptions at an out-of-network pharmacy, even if the prescription is not due for refill.
- Authorizing an insured person to replace medical equipment or supplies.
- Allowing an insured person to access an appropriate out-of-network provider if an in-network provider is unavailable due to the state of emergency or if the insured is out of the area due to displacement.
- Providing continuity of care for insured persons participating in a care management program.
- Provision for mental health care for displaced persons for mental health concerns resulting from the disaster.
- Billing leniency for insured persons within the designated disaster area before any action is taken for nonpayment of premium on a health insurance policy.
Nippon Life Benefits and CVS Caremark are also dedicated to assisting all members who may need assistance with pharmacy benefits and services. The below is a listing of what members need to know:
- Relaxing limitations on waiting periods between refills so that insureds can maintain at least a 30-day supply of medication on hand, while managing, in collaboration with pharmacists and providers, patient safety risk associated with early refills for certain drug classes, such as opioids, benzodiazepines, and stimulants.
- Permitting conversion of 30-day prescriptions with multiple refills into one larger prescription, so that, for example, a prescription written as a 30-day supply with 3 refills may be filled as a single 90-day supply.
- Relaxing insurer-imposed fill or refill supply limits where the provider has indicated that a larger fill or refill amount is appropriate for the patient.
- Waiving delivery charges for home delivery of prescription medications.
- Assuring access by streamlining processes for requesting prior authorization, step therapy exceptions, and exceptions for obtaining off-formulary drugs when a drug is unavailable due to supply chain disruptions or similar issues.
- Providing access to retail pharmacies, including non-network pharmacies, to fill prescriptions ordinarily filled by mail order when timely delivery by mail cannot be assured, or when mailing poses a risk of deterioration due to the combination of transportation delay and the extreme heat event.
- Monitoring of timeliness of pharmaceutical delivery to assure the adequacy of the network in delivering medications timely.
- Utilizing carriers other than the U.S. Postal Service if necessary to assure timely delivery.
Affected Members can call for answers to questions on the items described above, about the loss of health insurance identification cards, or how to access health care, whether it be general or specific types of care. Please see contact information below:
- Nippon Life Benefits
- 800-374-1835 (English/Spanish)
- 800-971-0638 (Japanese)
- 877-827-8713 (Korean)
- CVS Caremark RX claims number: 866-644-7527
- ActiveHealth Prior Authorization Review (if the PPO on your ID card is not Aetna Signature Administrators): 877-518- 0770
- Health Review (if the PPO on your ID card is not Aetna Signature Administrators) 1-855-326-9054.