Dear Valued Member:

As you know, we launched OptumRx as CalPERS' new pharmacy benefit manager on January 1 to replace CVS Caremark. As with any major change within an organization the size of CalPERS, we expected a few bumps along the transition road.

However, we recognize that a number of issues have negatively impacted our members who rely on OptumRx to provide their prescription drug services. We want to assure you that we are working hard to improve customer service and your OptumRx experience.

We Have Listened To Your Concerns and Taken Some Immediate Steps to Address Them

  • OptumRx will add approximately 100 additional "Select90/Preferred90" retail pharmacies in California's rural, suburban, and urban areas in June 2017. More members in areas where a Walgreens pharmacy is not available will soon have easier access to a 90-day supply of maintenance medications in retail pharmacies.
  • OptumRx has expanded its dedicated call center staffing to reduce wait times and improve customer service.
  • CalPERS' health team provided training to OptumRx's customer service representatives to help them better understand CalPERS' benefits and how the Medicare Part D plans are administered.
  • At our request, OptumRx appointed a customer service manager to work directly with the CalPERS health senior leadership team to resolve call center and customer service issues.
  • OptumRx enhanced its Prior Authorization review process for Medicare members to increase the approval rate for prescription drugs to which members previously had access.
  • CalPERS is placing some Medicare specialty drugs in a lower cost tier.
  • The CalPERS health team continues to hold daily meetings with OptumRx staff to resolve issues, especially in the area of customer service and clinical programs.

The following resources are available should you have questions concerning your OptumRx pharmacy benefit:

OptumRx Customer Service:
Medicare/EGWP: (855) 505-8106
Basic: (855) 505-8110
TTY service: 711
BriovaRX Specialty Pharmacy: (855) 821-7217
Prior Authorization Fax: (800) 527-0531
OptumRx Website

We want to thank you for your comments, and we promise to continue to diligently work to improve the service and your experience with OptumRx.

CalPERS Health Team

View printable version of the letter.