Dear Valued Provider,

Participating Pharmacies may be experiencing claim rejections when trying to process claims for Covered Persons of Florida Blue.

Action Required:

Eligibility for these Covered Persons is currently being updated and expected to be corrected by November 16, 2016. If you have a Covered Person with an urgent claim to be processed, please advise the Covered Person to call the Customer Service number on the back of their Florida Blue ID card.

Please communicate this information to your pharmacies to prevent further disruption of service for these Covered Persons.

Sincerely,

Pharmacy Network Management

Prime Therapeutics LLC

Effective January 1, 2017, CVS Caremark® will begin to administer the prescription benefits for Samsung (SRA). Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

RXBIN: 004336

RXPCN: ADV

RXGRP: RX0439

Member ID Format: 11 digits, alphanumeric

Person Code : 2 digits, required

*Please see attached PDF for more information.

Effective January 1, 2017, CVS Caremark® will begin to administer the prescription benefits for Troon Golf. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

RXBIN: 004336
RXPCN: ADV
RXGRP: RX0435
Member ID Format: 11 digits, alpha only
Person Code : 2 digits, required

Card images are not available at this time.

Patient Pay Amount
Please rely on the claims system to determine the correct amount to collect from the plan member, if applicable.

Effective January 1, 2017, CVS Caremark® will begin to administer the prescription benefits for Flynn Restaurant Group. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

RXBIN: 004336

RXPCN: ADV

RXGRP: RX0386

Member ID Format: 12 digits, alphanumeric

Person Code : 2 digits, required

Card images are not available at this time.

Patient Pay Amount

Please rely on the claims system to determine the correct amount to collect from the plan member, if applicable.

Effective January 1, 2017, CVS Caremark® will begin to administer the prescription benefits for Cabela’s. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

RXBIN: 004336

RXPCN: ADV

RXGRP: RX0420

Member ID Format: 11 digits