Ph: (229)249-0940 • Fax: (229)249-9840 • Toll Free: (877)949-0940
The Health Plan designated ProCare Pharmacy Care (PPC) as the no-cost at-home COVID-19 test kit distributor for the Health Plan Participants.
There is a limit of 8 tests per 30-day period (or per calendar month) per family member enrolled into the Health Plan. Participants do not need physician orders to obtain these tests.
There are a few ways to order and receive your no-cost at-home test kits:
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. All patients must fill their medications through the FiveStar Telehealth Clinic. Medications are at no charge 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.
There will be no changes to the vision benefits.
Out of Pocket Expense will increase to $7,100 (Single); $14,200 (Family) which breaks down to ($1,325 – single and $2,650 – family) for pharmacy expense and ($5,775 – single and $11,550 – 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.
*Mayo Clinic is reimbursed at 80% coinsurance
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 and (4) annual health assessments (when offered). Lower medication copays, educational opportunities and care management are a few of the benefits offered.
Preferred Lab - Labcorp and Quest Diagnostics are the preferred Network provider for all lab services.
Bariatric Surgery, Limited to Gastric Sleeve - Treatment of severe obesity with surgical weight loss tools, limited to gastric sleeve, is now a covered benefit. The program offering gastric sleeve procedure must require pre-surgery diet and lifestyle changes. The procedure must be approved in advance by Utilization Management.
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)
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 is now available to all employees and their dependents over 12 years of age at all Company facilities. 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, 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 change to single or family premiums.
The Health Plan SPD will be reprinted and mailed in December 2022.
Updated Health Insurance Cards will be mailed in December 2022.
Electronic copies of Health and Dental Summary Plan Descriptions (SPDs) are available on the TLC Benefit Solutions’ website: http://www.tlcbenefitsolutions.net/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.