We want to update you on the steps we are taking to resolve issues with enrollment, ROAM, pharmacy coverage, member ID cards, and customer service response times affecting you and your customers.

As we shared in our eBulletin last week, we are capturing and addressing issues as soon as they are identified. We have dedicated teams in place to identify and understand root causes and execute solutions quickly and accurately to restore the service levels that you, our customers and members expect from us.

Working with you, we are prioritizing issue resolution according to members' access to care. Below is a list of the scenarios we know are causing the greatest impact, with information to help you support your customers. We continue to leverage all available resources to provide prompt customer service and to ensure members have access to care.

Enrollment/ROAM

• There were delays in processing January open enrollment benefit changes and member transactions.
  Due to extremely high volume, we experienced delays in processing both group benefit changes and member transactions. We no longer have a backlog for processing the group benefit changes. We have also established an enrollment task force dedicated to completing all outstanding member enrollment changes.
• Customer information is not accurately displaying in ROAM.
  We implemented an enhanced QA process and have identified situations where customers are active in our enrollment systems but are not reflecting active coverage in ROAM. The number of outstanding enrollment transactions has delayed the display of the real-time information in ROAM. Our dedicated enrollment task force is working to quickly process all outstanding inventory.
  We have a support team in place that is closely monitoring enrollment activities to identify and manage issues. We continue to monitor this closely and will keep you apprised of any emerging issues.
  As a reminder, the information that is available to view on ROAM may change depending on whether or not your customers have migrated to our new platform. Please refer the Fact Sheets and FAQs in the Broker Playbook on ROAM for more details on how account administration changes affect your customers.
• Medigap coverage is not appearing in ROAM.
  Errors in coding during Medigap enrollment set up are causing a temporary delay in coverage appearing in ROAM. We are working with our Medicare enrollment team to get the correct coverage codes to update the information as quickly as possible. Please note that benefits information is correct in our enrollment and claims systems and there should be no impact to a member's access to care. The updated benefit information is simply not yet available to view in ROAM.
  We have also resolved an issue that temporarily caused providers to be unable to verify members' Medigap coverage. This may have resulted in claims being temporarily suspended while we worked to get coverage information to providers.
• Domestic partner coverage can't be confirmed through ROAM or the employer portal.
  New business quoted through ROAM will default to "no" for domestic partner coverage unless you specifically select "yes." Only quotes where domestic partner coverage was selected will reflect this coverage on ROAM. Unless you have indicated "yes" to domestic partner coverage when you submit your quote, this selection will not display on ROAM.
• Entering PCP information for my customer through ROAM is not available.
  Migrated customers and brokers cannot make changes to PCP information on behalf of an employee through the employer portal/ROAM. However, you or your customer can still submit PCP changes through a paper form. To ensure that members who did not have a PCP assigned to them had access to care, we identified members without a PCP and provided them with instructions on how to submit their PCP selection through a specially established electronic mailbox to expedite PCP selection and ID card processing.

Pharmacy coverage
We have experienced a significant decrease in the volume of pharmacy inquires due to our ongoing communication with pharmacies and members regarding the change in BIN/PCN numbers on the ID card for our customers enrolled in the new metallic products. We are working closely with FutureScripts®, our pharmacy benefits manager, to troubleshoot and resolve issues as quickly as possible and have established a dedicated FutureScripts customer service phone number so pharmacists and members can get expedited answers to their questions.

• Some members in our small group metallic products were either not enrolled in the pharmacy system, enrolled incorrectly in pharmacy coverage or experienced issues obtaining prior authorization for their medications.
  Issues with the data transfer to our pharmacy benefits manager affected member eligibility and caused prior authorization issues at the point of sale. Process improvement teams are working diligently to implement solutions that will improve future enrollments. Where appropriate, we contacted members directly through a letter and by phone to explain the issues and to ensure they were able to obtain their medications.
• Some members in our small group metallic products were also overcharged for certain prescriptions under their pharmacy benefit.
  We experienced benefit coding errors with our PBM when implementing the new metallic products. These coding errors resulted in several issues such as discount prices not being reflected, deductibles applying incorrectly or incorrect copayments being charged. We have contacted members directly through a letter and a phone call to let them know that they will be reimbursed for any overpayment.

ID cards
We experienced errors in ID card generation for both renewing and new business in January. We completed a reconciliation of ID cards for customers in our small group metallic plans and have reissued cards to members where necessary. This included the reissue of dental plan cards for small group employers who purchased a standalone dental plan.

The enrollment processing backlog also resulted in ID cards that were incorrect or late. We established an enrollment task force and a dedicated email box to facilitate ID card questions from our members and to expedite the processing of replacement cards.

Customer service response times
We are pleased to report that customer call wait times have decreased significantly across all of our service centers. We added more staff in our service centers to ensure that questions are answered on a timely basis. We also responded to all outstanding email inquires received through the Broker Care Center to date.

In order to ensure that we are responding as quickly as possible to phone calls and emails from you, your customers, and members, we have taken the following steps:

• We created a new secure email inbox for members who need urgent access to medical or pharmacy services.
• We added more representatives to answer calls to the Broker Care Center from 8:30 a.m. to 5 p.m., Monday through Friday.
• We are working to respond to email inquiries through the Broker Care Center after hours, from 5 p.m. to 8 p.m. Monday through Friday and 8 a.m. to 4 p.m. on Saturday.

We appreciate your patience as we work to resolve these issues and acknowledge that we don't have answers to all of your questions. We are committed to identifying the root cause of open issues and will share the solutions we develop with you regularly.

If you have questions, please contact your IBC account executive or the Broker Care Center.