WellCare Health Plans (Medicaid) As previously communicated, effective January 1, 2016, CVS/caremark began to administer the prescription benefits for WellCare Health Plans. Beginning January 28, 2016, claims submitted with an incorrect RXPCN will reject with the following or similar message: Reject 85 : <Claim Not Processed> <Submit RxPCN MCAIDADV> To minimize disruption, please update member profiles with this RXPCN. RXBIN: 004336 RXPCN: MCAIDADV RXGRP: Varies by plan/state. Use the information printed on the member’s ID card or see table below.

RXBIN: 004336 RXPCN: MCAIDADV RXGRP: RX8894 Member ID Format: 8 digits Person Code: 2 digits Effective January 1, 2016, CVS/caremark will begin to administer the prescription benefits for WellCare of South Carolina, a Care Management Organization in the South Carolina Medicaid Program. Healthy Connections members will be transitioned to a network with CVS/caremark that continues to meet member access requirements, but may offer fewer providers.

RXBIN: 004336 RXPCN: MCAIDADV RXGRP: RX8896 Member ID Format: 7 numeric + 1 alpha Person Code: 2 digits Effective January 1, 2016, CVS/caremark will begin to administer the prescription benefits for WellCare of Iowa, a Care Management Organization, in the Iowa Medicaid Program. WellCare of Iowa members will be transitioned to a network with CVS/caremark that continues to meet member access requirements, but may offer fewer Providers.

RXBIN: 004336 RXPCN: MCAIDADV RXGRP: RX8893 Member ID Format: 8 digits Person Code: 2 digits Effective January 1, 2016, CVS/caremark will begin to administer the prescription benefits for WellCare of Kentucky, a Care Management Organization, in the Kentucky Medicaid Program. WellCare of Kentucky members will be transitioned to a network with CVS/caremark that continues to meet member access requirements, but may offer fewer Providers.

RXBIN: 004336 RXPCN: MCAIDADV RXGRP: RX8895 Member ID Format: 8 digits Person Code: 2 digits Effective January 1, 2016, CVS/caremark will begin to administer the prescription benefits for WellCare of New Jersey, a Care Management Organization, in the New Jersey Medicaid Program. WellCare of New Jersey members will be transitioned to a network with CVS/caremark that continues to meet member access requirements, but may offer fewer Providers.