Third Party Administrator – Allied Benefit Systems

Effective 09-01-2025, Allied Benefit Systems is replacing HealthNow Administrative Services as Clovis Unified School District’s Third Party Administrator (TPA), offering a heightened level of customer service to our valued Health Plan members.

In addition to paying claims, Allied customer service agents will assist our members by answering questions about the CUSD Health Plan, looking up providers to make sure they are part of the Anthem Blue Cross network, printing insurance cards as well as Certificates of Coverage and assisting members with claims issues.

Allied will be offering Clovis Unified members the following extended customer service hours at a phone line dedicated solely for members of the Clovis Unified School District Health Plan:

5:30 AM  –  6:00 PM  – Monday through Thursday

5:00 AM  –  6:00 PM  – Friday

7:00 AM – 10:00 PM – Saturday

HealthNow will continue to process claims with a date of service prior to 08-31-2025 & will continue to do so until 08-31-2026. For questions regarding claims with a date of service prior to 09-01-2025, members can continue to contact HealthNow at 855-323-1124.

New PPO Network – Anthem Blue Cross PPO

Effective 09-01-2025, the plan will shift from the current Blue Shield Tandem PPO network of providers to the Anthem Blue Cross PPO network.

This change broadens the existing physician network & increases access to specialty hospitals. The Anthem Blue Cross network will be utilized within the state of California while those utilizing the plan in the remaining 49 states will continue to use the BCBS Blue Card Network.

To search for providers within the Anthem Blue Cross PPO network, please click this link. Choose the Prudent Buyer/PPO option before searching.

To access the BCBS Blue Card Network, please click this link.

Changes to Prescription Coverage

1. Prior to 09-01-25 members have received a 90-100 day supply of their medication under the Maintenance Choice or Mail Order provision for the cost of 2 copays, essentially receiving one month at no cost.  Effective 09-01-2025 members will pay a 2.5 month copay for 90-100 day Maintenance Choice prescriptions. 

2. Effective 09-01-2025 the Generic, Preferred Brand Name and Brand name copays will increase while the Specialty copay will remain the same. This is how those changes will look when filling a prescription:

3. The CVS Cost Saver Program, powered by Good Rx, will be implemented on May 1, 2025 in an effort to save our members money on the generic prescriptions 85% of our members are filling. The Cost Saver will work behind the scenes at the pharmacy with no effort or initiation on the part of the member. When the member fills a generic prescription, the Cost Saver will automatically look to see if the Good Rx price is less than our generic copay. If the Good Rx price is less than our copay, the member will automatically be charged the lesser amount. 

Name Change for Halcyon Behavioral Health & Physmetrics

Effective 09-01-2025 the Physmetrics network will be referred to in accordance to their new branding as Simple Therapy.

Effective 09-01-2025 the Halcyon Behavior Health network will be referred to in accordance their new branding as Simple Behavioral.

New Insurance ID Cards

In August 2025, all covered employees and retirees will be receiving two new insurance ID cards from Allied Benefit Services which will reflect the following:
 

• CUSD Health Plan ID Card: This card will identify our new Anthem Blue Cross PPO network as well as our new TPA, Allied Benefit Services. The back of the insurance card will have all of the useful information you are used to such as contact numbers for Delta Dental, VSP, CVS Caremark, Simple Behavioral (formerly Halcyon) and Simple Therapy (formerly Physmetrics. Members with Employee Only Coverage will receive 1 card. Members with Employee Plus One or Employee Plus Two or More will automatically receive 2 cards. To request additional cards, you may call Allied Benefit Services, visit their online portal or download a virtual ID card to your mobile device via their mobile app.
• Direct Contracting ID Card:  This card will be used by members when utilizing California Medical Imaging and Radnet providers for imaging services. By presenting the card, members can have their copay and pre-authorizations waived for imaging services within these facilities.  Members with Employee Only Coverage will receive 1 Direct Contracting card. Members with Employee Plus One or Employee Plus Two or More will automatically receive 2 cards. To request additional cards, you may call Allied Benefit Services, visit their online portal or download a virtual ID card to your mobile device via their mobile app.