Ph: (229)249-0940 • Fax: (229)249-9840 • Toll Free: (877)949-0940

What's New in 2020

Pharmacy Benefit Manager (PBM)

ProCare will continue as the pharmacy benefit manager.

Non-Preferred Pharmacy Providers include the following pharmacies at which you will pay a higher copayment: CVS, Walgreens, Rite-Aid, Wal-Mart, Target, and SAM’S.

  • Effective September 1, 2019 Walmart Pharmacy at 340 Norman Dr., Valdosta, GA 31601 and Sam’s Pharmacy at 450 Norman Dr., Valdosta, GA 31601 will no longer participate in the Plan’s pharmacy network. Members who fill prescriptions at these facilities after September 1, 2019, will be responsible for 100% of the price of their medication cost.

Chancy Drugs is the Health Plan’s preferred pharmacy.

  • You may fill a 90-day prescription at any Chancy Drugs location (Lake Park, Valdosta, Hahira, Adel, and Moultrie)
  • Chancy Drugs is the Plan’s only approved Compounding Pharmacy

Participation in the Diabetic Management Program is required for all diabetics covered by the health plan. Medication co-pays are reduced for program participants. Participants who opt out of the program will be assessed an additional premium of $40.00 per month. Please contact TLC Benefit Solutions at 229-249-0940 for additional information.

Dental Insurance

There will be no changes to the dental benefits. Remember the annual maximum is now $1,500.

Health Insurance

Out of Pocket Expense will remain $6,850 (Single); $13,700 (Family) which breaks down to ($1,325 – single and $2,650 – family) for pharmacy expense and ($5,525 – single and $11,050 – family) for medical expense.

Marriage and/or Family Counseling - Marriage and/or family therapy will be a covered benefit, effective January 1, 2020.

Wellness and Pregnancy-related Wellness – The wellness benefit was expanded, please refer to the restated Summary Plan Document which will be mailed to your house in December 2019.

Orthospinology - Chiropractic care benefit is subject to $25 copayment per visit, there is no annual limit on the number of visits.

Hearing aids for children age 18 and under - New benefit limited to $2,500 per ear every 48 months, any amount over $2,500 is the member’s responsibility and will not apply towards out-of-pocket.

3D Mammograms - 3D mammograms are covered by the Plan when used as an alternative to the standard 2D mammogram. If 2D and 3D are performed on the same day, the 3D will be denied.

Centers of Excellence – The following facilities are reimbursed at 90% coinsurance and qualify for hotel reimbursements of no more than $100.00 per night in connection with surgery at these centers.

  • Jack Hughston Memorial Hospital, Phoenix City AL
  • Hughston Surgical Center, Columbus GA
  • St. Francis Hospital, Columbus GA
  • St. Vincent’s Medical Center Riverside and Southside, Jacksonville FL
  • Mayo Clinic*,Jacksonville FL
  • *Mayo Clinic in Jacksonville FL is a center of excellence but falls under 80% coinsurance

Wellness Programs – The Langdale Company Wellness Program has four components: (1) tobacco cessation, (2) annual health assessments and biometric screenings (when available), (3) a diabetes management program, and (4) a (chronic) disease management program. Lower medication copays, educational opportunities and care management are a few of the benefits offered.

Preferred Lab - Labcorp and Quest/Solstas  are the preferred Network providers for lab screening services, including specialty drug screens.

Sleep Apnea Program –Provides home sleep testing, treatment, equipment, supplies, care management support throughout therapy at no cost to you. Annual participation fees are $200 for the initial year, and $100 a year, thereafter. Free Sleep Apnea Evaluation is available at and the NEW SleepCharge App. Members must average 70% compliance in order to qualify for annual renewal. If your compliance is below 70% within 90 days of your renewal date, you will be required to meet with a technician prior to the renewal being paid.


Reminder: Adult children who turn 26 will be covered under the Plan until the end of the month in which they turn 26.


Health Premiums will increase 5%.

2020 Plan Materials

The updated Summary Plan Description (SPD) books will be mailed to employee households in December. They are also available through the TLC Benefits’ website under Forms -

Additional Member Resources

ELAPulse portal where members can submit and track progress of their Balance Bills from Facilities -

Pharmacy Member Portal allows you access to your Pharmacy Claims and Benefits and locate Pharmacies, as well as look up your cost and medication alternatives -

Access Your Member Portal

Log in to the Member Portal to access:

Please Note: Flexible Spending Accounts and Vision Insurance are not administered by TLC.

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