Open Enrollment for Active Employees

Yes. Express Scripts will mail new prescription ID cards. Watch for a welcome letter with your cards in June. Be sure to start using your new card starting July 1, 2026 —whether filling a prescription for yourself or a covered family member. Starting July 1, 2026, you can also access your digital prescription ID card online at www.express-scripts.com and on the Express Scripts ^® mobile app. You can download the Express Scripts mobile app for free from your device's app store.

Beginning April 22 at 8:00 a.m., you may call the Express Scripts ^® Member Services toll-free number for UNM at 800.743.1720. Express Scripts representatives will be available 24 hours a day, 365 days a year.

UNM’s current prescription drug benefits, such as copays or coinsurance, are not changing. However, the Express Scripts formulary may differ slightly from the current CVS Caremark formulary, which means your medication may be at a different formulary tier or excluded on Express Scripts’ formulary. Beginning April 22, you can calculate the estimated cost of your current medication(s) using the Price A Medication tool available on UNM’s open enrollment site. On the site, you can also check the formulary status of a medication and view preferred alternatives and excluded medications.

Yes. UNM’s list of preferred medications – also known as a Formulary – is changing effective July 1, 2026. This means your medication may be at a different formulary tier or excluded. You can view Express Scripts Standard National Preferred Formulary List and Standard National Preferred Formulary Exclusion List with Preferred Alternatives.

To confirm if your medication will be considered a preferred medication, log on to express-scripts.com on or after July 1 to verify coverage, price medications, and find covered alternatives. If you are taking a preferred brand-name drug that will become non-preferred, consider talking to your doctor about a lower-cost option.

Starting July 1, UNM’s plan will use the Express Scripts Standard National Preferred Formulary List. An online Price A Medication calculator tool will be available on April 22 to provide you with real-time cost estimates at different pharmacies by zip code.

Express Scripts© National Preferred Formulary is a list of preferred medications covered under your plan. Your formulary offers a wide selection of generic and brand-name prescription medications chosen to help keep prescription medication costs down. Log in to express-scripts.com on or after July 1, 2026, to find coverage and pricing details, and to see whether your medication has a generic equivalent. If you prefer, beginning April 22, you can also call the Express Scripts dedicated UNM customer service line at 800.743.1720 to speak with an Express Scripts representative for assistance.

Yes. Prior to July 1, Express Scripts will send a notification letter to individuals taking a medication that will be impacted, and their current medication will be a higher tier or excluded from the National Preferred Formulary. The notification will include alternative medications that are on a lower tier on the formulary to help you save money.

After July 1, Express Scripts will mail a notification letter to you if your drug changes formulary status.

Yes. Generic drugs have the same active ingredients as their brand-name counterparts and must meet the same FDA standards for quality, purity, safety, and effectiveness. The inactive ingredients may be different, which can impact a drug’s shape, color, size, or taste. But the drug’s strength and dosage will be the same as the brand-name drug.

Generic and preferred brand-name drugs are effective and can help you save money. For example, generic drugs are chemical copies of the brand-name drugs but cost you less under your Plan.

If you’re taking a non-preferred brand-name drug, ask your doctor whether a lower-cost preferred alternative would be right for you. If you request a brand-name medication when a generic is available, you will pay the brand-name drug price PLUS the difference in cost between the generic and brand-name medication. Of course, if there’s a medical reason that you need to take the brand-name drug, your provider can complete a prior authorization for approval. If approved, you won’t have to pay the penalty.

Beginning July 1, you may have your physician contact Express Scripts to request a medical review or prior authorization for your new prescription. Your physician can visit the Express Scripts ^® Pharmacy Benefit Services online portal at esrx.com/PA or call Express Scripts at 800.417.1764 to request a review.

You can view the National Preferred Formulary Exclusion List with Preferred Alternatives. Starting July 1, 2026, log in to express-scripts.com and use the Price a Medication feature, available under Manage Prescriptions. Look up your medication’s name and click View Coverage Notes for details. If you prefer, beginning April 22, you can also call the Express Scripts dedicated UNM customer service line at 800.743.1720 to speak with an Express Scripts representative for assistance.

Medications excluded from your formulary will require prior authorization for coverage. Prior authorization is a program that monitors certain prescription medications and their costs to determine whether your use of certain medications meets your plan’s conditions of coverage. It works much like healthcare plans that approve certain medical procedures before they’re done, to make sure you’re getting tests you need. If you’re prescribed certain medication, it may need a prior authorization. A prior authorization makes sure you’re getting a cost-effective prescription medication that works for you.

Beginning July 1, if your prescription requires prior authorization, you may have your physician contact Express Scripts to request a medical review or prior authorization for your new prescription. Your physician can visit the Express Scripts ^® Pharmacy Benefit Services online portal at esrx.com/PA or call Express Scripts at 800.417.1764 to request a review.

If you are on a medication that received prior authorization in 2025, that prior authorization will be transitioned to Express Scripts. You will receive a notification in the Express Scripts portal 60 days before your prior authorization expires so you may re-initiate it with your physician.

No, you can go to any pharmacy in the Express Scripts pharmacy network, as well as UNM Pharmacies. Beginning April 22, use the Express Scripts ^®Pharmacy Locator to check for your pharmacy, or call the Express Scripts dedicated UNM customer service line at 800.743.1720 to speak with an Express Scripts representative.

Most major drugstores participate in the Express Scripts retail pharmacy network. If yours is in network, your retail prescriptions will stay as they are, and you can keep using your preferred pharmacy. The only change is you’ll need to show your new Express Scripts ID card the first time you fill prescriptions starting July 1, 2026.

Starting July 1, simply log in to express-scripts.com, and you can search for nearby pharmacies in your prescription plan’s network using the Find a Pharmacy tool under Prescriptions in the main menu. You can search for nearby network pharmacies by ZIP code or city and state. You can also find a list of the services available at each pharmacy.

Through Express Scripts Pharmacy Home Delivery, you can get a 90-day supply of your medications shipped right to your door—saving you time and money. You can even set up automatic refills, so you never have to worry about running out. Log in to express-scripts.com starting July 1 to manage your prescriptions.

Yes. We want your transition to Express Scripts to be a smooth one. So, in most cases, if you used CVS Caremark home delivery previously, your active prescriptions will transfer to Express Scripts Home Delivery for you. You won’t have to do a thing. Starting July 1, 2026, you’ll see your active prescriptions when you register and log in to your Express Scripts account—online or on the mobile app.

Starting July 1, visit express-scripts.com and click the Register button. You’ll need to provide your preferred email address, name, date of birth, and ZIP code, and create a password.

You can do everything related to managing your prescription drugs. Starting July 1, visit the website to:

• Check prescription coverage and pricing
• Find participating retail pharmacies near you
• See how much your medications will cost
• Start or refill home delivery prescriptions online
• Check your order status
• Receive timely medication alerts
• Find potential lower-cost options available under your plan
• Ask questions of a pharmacist online
• See Prior Authorizations status

Visit your mobile device’s app store and search for “Express Scripts.” From there, you can download the app and use it for free.

• Express Scripts (App Store)
• Express Scripts (Google Play)

You can use the Express Scripts mobile app to manage your prescriptions on the go. For example, the app makes it easy to:

• View and refill your medications
• Check order status
• Set reminders for when to take your medications
• Get notifications when you are running low and other personalized alerts
• Check for lower-cost prescription options available under your plan
• Show your digital member ID card at the pharmacy

No immediate action is needed if you have a current prescription at the CVS Caremark Specialty Pharmacy. Your open prescription with refills will transfer directly to Accredo Specialty Pharmacy after 7/1. Express Scripts will be sending you a notification letter with Accredo Specialty Pharmacy contact information and next steps prior to 7/1. Beginning July 1, you can reach Accredo Specialty at 800-870-4498, or you can visit them online at https://www.accredo.com.

If you have a new prescription, ask your doctor to send it electronically to Accredo. Once it's ready, a patient care advocate will call you to schedule delivery.

You can choose to utilize Accredo Specialty Pharmacy for specialty prescriptions or fill your specialty medication at any participating network specialty pharmacy.

Yes. The University of New Mexico has partnered with SaveonSP to provide a specialty pharmacy copay assistance program. A select group of approximately 400 specialty medications in 20 therapy classes are part of the SaveonSP program. Starting July 1, you may visit saveonsp.com/unm to see the latest list of medications under this program.

If you are currently taking a specialty medication that is part of the SaveonSP program, you will receive a letter in June with more details. As part of this benefit, medications included in SaveonSP will be subject to a 30% coinsurance; however, you could pay as little as $0 for them.

If you submit a new specialty prescription, an Accredo representative will reach out to you prior to processing the prescription and assist you with enrolling in the program by engaging you with a SaveonSP representative.

No. Accredo is part of your prescription drug benefit.

No. Accredo manages specialty medications only.

Yes. Biosimilars are medicines made to be very similar to existing biologic drugs (Humira, Enbrel, or Remicade, for example). The FDA requires biosimilars to show no meaningful differences in safety or effectiveness compared to the original biologic. While generic drugs are the exact same chemical copies of the brand-name drugs, biosimilars are highly similar because biologics are made from living cells, which are naturally more complex.

Health premiums rise when the overall cost of providing care goes up. This includes higher prices for medical services, increased use of healthcare, and rising prescription drug costs. UNM’s premium increases are consistent with local and national trends of increasing healthcare costs.

To help manage long term costs and minimize premium increases for all employees, UNM will discontinue coverage of GLP 1 medications when prescribed for weight management, effective July 1. This decision follows an extensive review of utilization trends, benchmarking data, long term cost projections, and broad stakeholder engagement throughout the year. Coverage for GLP 1 medications used to treat other conditions, including diabetes, will not change.

UNM's self-insured model ensures that approximately 94% of the premiums paid by employees and UNM directly fund healthcare services, such as doctor visits, hospital stays, and prescriptions. While we partner with insurance companies like BCBS and Presbyterian for administrative services, including claims processing and customer service, our self-insured approach enables us to manage costs effectively. By self-insuring, we can prioritize providing comprehensive coverage to our employees while saving costs that would otherwise go towards profit margins. This year, for the prescription drug component, UNM conducted a competitive bid for our prescription drug plan to secure better pricing and help manage costs more effectively. Click here for more details.

UNM collaborates with external benefits consultants to assess the funding required to cover healthcare claims and administrative costs for the upcoming fiscal year. This analysis considers factors such as the previous year's costs, national and local healthcare trends, and projected needs. The increase in premiums reflects the necessary adjustments to ensure adequate funding for healthcare services and support continued access to quality care for our employees.

Calculating your estimated premium contributions is made easy with our Benefits Calculator. Simply visit UNM Benefits Calculator and input your relevant information to receive a breakdown of your estimated premium contributions for the upcoming Plan Year. This tool will help you make informed decisions about your benefits coverage and understand any changes in your premium contributions based on your salary level and coverage choices.

• There are no plan design changes to our medical plan; copays, deductibles, and out-of-pocket maximums remain the same.
• July 1, UNM is transitioning from CVS Caremark ^® to Express Scripts ^® Pharmacy Benefit Services to administer our prescription drug plan. Click here for more details.
• July 1, UNM will discontinue coverage of GLP-1 medications when prescribed for weight management. Click here for more information about this change.
• You can continue to access the same comprehensive medical, prescription drug, dental, and vision coverage options offered by UNM.

During the Open Enrollment period, you will receive detailed instructions on how to review and make changes to your current benefits elections. This typically involves accessing the online enrollment portal or submitting paper forms provided by Human Resources. We'll ensure you receive all necessary information to make informed decisions about your benefits.

Yes, Open Enrollment provides an opportunity to review and update your dependent coverage. You can add or remove dependents from your health insurance plan as needed. Please ensure you review the eligibility criteria and any documentation requirements outlined in the enrollment materials provided.

UNM offers a wide array of resources to support your wellness journey. We encourage you to subscribe to the UNM LoboWell Newsletter, a monthly email delivering practical, health enhancing tips straight to your inbox. Each issue features curated content on nutrition, fitness, emotional well being, and financial wellness—designed to help you thrive and achieve a healthier work life balance.

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Please visit the Employee Wellness website to explore upcoming events and featured resources. Learn more about ongoing online workout classes designed for all fitness levels, as well as one-on-one consultations to support your physical, mental, and financial well-being. You’ll also find a variety of educational courses, financial wellness presentations, and special programs focused on stress management, healthy habits, and work-life balance.