ProCare will continue as the pharmacy benefit manager.
Non-Preferred Pharmacy Providers include the following pharmacies at which you will pay a higher copayment: CVS, Walgreens, Rite-Aid, Wal-Mart, Target, and SAM’S.
Chancy Drugs is the Health Plan’s preferred pharmacy.
Participation in the Diabetic Management Program is required for all diabetics covered by the health plan. Medication co-pays are reduced for program participants. Participants who opt out of the program will be assessed an additional premium of $40.00 per month. Please contact TLC Benefit Solutions at 229-249-0940 for additional information.
There will be no changes to the dental benefits. Remember the annual maximum is now $1,500.
Out of Pocket Expense will remain $6,850 (Single); $13,700 (Family) which breaks down to ($1,325 – single and $2,650 – family) for pharmacy expense and ($5,525 – single and $11,050 – family) for medical expense.
Centers of Excellence – The following facilities are reimbursed at 90% coinsurance and qualify for hotel reimbursements of no more than $100.00 per night in connection with surgery at these centers.
Wellness Programs – The Langdale Company Wellness Program has following components: (1) tobacco cessation, (2) a diabetes management program, and (3) a (chronic) disease management program. Lower medication copays, educational opportunities and care management are a few of the benefits offered.
Preferred Lab - Labcorp and Quest/Solstas are the preferred Network provider for all lab services.
Telehealth - Telehealth visits with Primary Care Providers and Behavioral Health/Substance Use Disorder Counseling have a $15 copayment per visit. This benefit applies when seeking care outside of the Telehealth Mobile Unit.
Chiropractic Services: Atlas Orthogonal Technique - Atlas orthogonal technique was added to in 2020. Members pay $25 copayment per visit with annual limits on the number of visits. (This is an in-network benefit. Confirm the provider is in your network before you proceed)
Chiropractic Services: Physical Therapy treatment - Physical Therapy treatments provided by Chiropractors are now a covered benefit.
Sleep Apnea Program – Provides home sleep testing, treatment, supplies, and care management support at no cost to you. Annual participation fees are $200 for the initial year, and $100 a year, thereafter. Visit https://www.sleepcharge.com/langdale/ for a free evaluation. NEW SleepCharge members must average 70% compliance to qualify for annual renewal. If your compliance is below 70% within 90 days of your renewal date, you will be required to meet with a technician prior to the renewal.
The Telehealth Clinic operated at Langboard MDF in Willacoochee since July 2019 is now mobile. A schedule of clinic times and locations will be posted at each facility. The clinic is a partnership between The Langdale Company, Miller County Hospital, Chancy Drugs, Clinch Memorial Hospital, and the Global Partnership for Telehealth (GPT). Benefits include, but are not limited to:
Reminder: Adult children who turn 26 will be covered under the Plan until the end of the month in which they turn 26.
There will be no changes to the Health Insurance Premiums for Calendar Year 2021.
Electronic copies of Health and Dental Summary Plan Descriptions (SPDs) are available on the TLC Benefit Solutions’ website: http://www.tlcbenefitsolutions.net/new/forms.html.
The Langdale Company Health Portal - The Portal allows you to assess your health information, track your online health history, use calculators and trackers, identify drug interactions, and communicate with the Health Advocate http://tlcbenefitsolutions.net/diamanagement.html.
Log in to the Member Portal to access:
Please Note: Flexible Spending Accounts and Vision Insurance are not administered by TLC.