Frequently Asked Questions

HSA and POS Plan FAQs

Anthem is anchored by Blue Cross Blue Shield plans across the country and provides one of the most comprehensive networks in the nation.

If you have questions about your medical benefits, claims, or eligibility, AmeriBen will be your primary customer service resource. 

AmeriBen will be the primary customer service resource for those enrolled in the HSA or POS plans. They will manage questions about your medical benefits, claims, incentives or eligibility. Anthem Blue Cross Blue Shield manages a comprehensive national provider network and establishes in-network eligibility and negotiated pricing.

In most cases, yes. Approximately 98% of current Tier 1 and Tier 2 providers will remain in network through Anthem's provider network. The Anthem network includes an extensive selection of primary care and specialty physicians throughout Georgia and across the country. Click here beginning 10/5/26 to search and verify your providers and facilities are in-network.

The change to the new provider network will be effective January 1, 2027.  If you are currently enrolled in the Aetna HSA or POS plan, you will continue seeing your providers and managing your claims with Aetna through December 31, 2026.

Anthem provides access to a broad national network of participating providers throughout the United States, giving employees and eligible family members who live outside Georgia access to care where they live.

The change to Prime Therapeutics and the new formulary will be effective January 1, 2027. If you are currently enrolled in the Aetna HSA or POS plan, you will continue using CVS/Caremark to manage your prescription benefits Aetna through December 31, 2026.

Yes. Employees will continue having access to Emory Healthcare physicians and facilities. Services received from Emory Healthcare will remain at the Tier 1 level, with the lowest cost-share for employees.

Members will continue having the flexibility to receive care outside Emory Healthcare through Anthem's broad provider network if they choose.

Yes. New member ID cards will be mailed before the new plan becomes effective on January 1, 2027.  ID cards will be used for both medical and pharmacy benefits and will list all enrolled members within the family.

Yes, you and your spouse can lower your medical costs by participating in a menu of activities. You can each earn up to $425 (a total of $850 for employee + spouse). There will also be new redemption options for wellness dollars in 2027.

Yes, AmeriBen Engage is the wellness platform that will replace Sharecare. This will become your new online benefits portal. From one convenient location, you'll be able to: 

  • Review your benefits   
  • View claims   
  • Access pharmacy information   
  • Find providers   
  • Estimate healthcare costs  
  • Access MyChart   
  • Access wellness resources   
  • Earn wellness incentives  
  • Connect with telemedicine 

Pharmacy Benefits FAQs

Prime Therapeutics helps manage pharmacy benefits when members fill a prescription. This includes covered medications, participating pharmacies, and prescription support. 

Beginning January 1, 2027, Prime Therapeutics will also manage the plan’s updated list of preferred medications. If a medication is affected, members will be notified in advance of the new plan year and supported in understanding covered options.

In most cases, yes. Members will continue having access to many familiar pharmacies, including Emory pharmacies, CVS retail pharmacies, Publix, Kroger, Amazon Pharmacy, and additional participating pharmacies. Beginning 10/5/26 find an in-network Prime Therapeutics pharmacy.

Members outside Georgia can use Prime Therapeutics’ national network of pharmacies, Amazon Pharmacy for eligible deliveries, and Accredo Specialty Pharmacy when needed for out-of-state specialty medication shipping.

Specialty medications will continue to be available through the Emory Health Plan. Emory Specialty Pharmacy will be the Emory Health Plan’s preferred specialty pharmacy.

Emory Specialty Pharmacy helps coordinate specialty medication support across providers and care teams, creating a more connected experience throughout treatment. 

This means members can receive personalized support for complex and specialty medications, expert guidance throughout treatment, assistance with medication approvals and refills, better coordination among healthcare providers and care teams, and a more connected and convenient healthcare experience.

If your specialty medication isn’t available through Emory Specialty Pharmacy, you can still access it through another participating specialty pharmacy, such as Accredo, depending on your medication and benefit requirements.

Yes. Employees enrolled in the Emory Health Plan will receive new member ID cards in December 2026 before the new plan becomes effective on January 1, 2027. Members should use the new ID card for pharmacy and medical benefits beginning January 1, 2027.

Yes. The Emory Health Plan will continue to provide coverage for select medications used for weight management and related conditions, including GLP-1 medications, for eligible members in accordance with the plan's clinical guidelines.

Beginning in 2027, certain medications in this category will be covered under a new Tier 5.

Yes. Beginning in 2027, the Emory Health Plan will introduce Tier 5 – Select for certain medications, including GLP-1 medications used for weight management and related conditions. Medications covered under Tier 5 – Select will have a 40% member coinsurance responsibility up to a maximum of $200 per 30-day supply.

While this represents a higher out-of-pocket cost for some members than they may pay today, Emory will continue providing coverage for these medications rather than eliminating coverage altogether.

This change helps balance continued access to select medications with the long-term affordability and sustainability of the health plan for all employees and their families.

GLP-1 medications for weight loss have specific pharmacy requirements, so you may not be able to fill them through your usual retail or mail-order pharmacy. If your prescription is approved for coverage, it will need to be filled through a designated pharmacy in order to receive your Plan benefit. CenterWell Pharmacy is expected to be one of the designated pharmacy options.

GLP-1 medications have become an important treatment option for many patients, but they also represent one of the fastest-growing healthcare costs nationwide. 

Emory remains committed to providing access to clinically appropriate medication and treatments while responsibly managing healthcare costs so the health plan remains affordable and sustainable for all employees and families.

FlyteHealth continues to be an important part of the Emory Health Plan's comprehensive approach to weight management and metabolic health. Employees enrolled in FlyteHealth continue to receive medication access, coaching, education, clinical support and remote monitoring as part of their overall care experience.