Population Science Management
Thrive to Livelihood Benefit Transition
We understand that benefit changes can create a lot of questions. We are here to help you understand what is changing and what support is available.
Call Population Science Management Transition Support at (888) 538-1844 for questions about coverage, reimbursement, pharmacy needs, ongoing care, prior authorization or the transition.
Frequently Asked Questionsw
Understanding the Transition
Effective retroactively to Sept. 1, 2026, affected members are transitioning from GigCare Thrive to a mapped GigCare Livelihood benefit with access to the Aetna PPO network through Aetna Signature Administrators under the Population Science Management USA LLC Consolidated Health Plan.
Blue Cross and Blue Shield of Nebraska made the decision to deactivate GigCare Thrive benefits in its systems. This action was not initiated by Population Science Management or Detego Health. To support continued access to care, affected members are transitioning to GigCare Livelihood with access to the Aetna PPO network through Aetna Signature Administrators.
This transition applies to members currently enrolled in GigCare Thrive with access to the Blue Cross and Blue Shield of Nebraska network.
Call Population Science Management Transition Support at (888) 538-1844 for questions about coverage, reimbursement, pharmacy needs, ongoing care, prior authorization or the transition.
No. There is no gap in coverage for affected members. You are covered through the transition, and your GigCare Livelihood benefit is retroactively effective Sept. 1, 2026.
Mississippi members remain covered through Oct. 31, 2026. The transition to GigCare Livelihood and the Aetna PPO network does not change or extend the previously communicated termination date. Mississippi members should follow their earlier withdrawal communications to secure other coverage beginning Nov. 1, 2026.
No. No new enrollment is required. PSM has already mapped impacted members to the Livelihood plan that most closely matches their current coverage.
Members must continue meeting Working Owner program requirements and continue making required monthly contributions.
Plan Selection and Coverage Options
Members have the right to drop coverage. Please contact MemberServices@DetegoHealth.com and fill out the proper cancellation form.
If you would like to review other benefit options that may be available through PSM, please contact the agent or benefits consultant who originally enrolled you with PSM. They can help you understand the plans available to you and discuss any alternative options that may fit your needs. Members are encouraged to work with the enrolling agent who assisted them with PSM enrollment.
If you do not have an agent, or are unsure who enrolled you, please contact Member Services and we can connect you with a recruiter who can review available options and answer your questions.
Yes. Through a voluntary open enrollment period. While this is not legally required, PSM has made the business decision to offer members the opportunity to review and elect a different available plan if they wish to remain enrolled. Please work with your benefits consultant.
Costs, Rates and Accumulators
Here is some really good news. You will not get a rate increase Friday, Jan. 1, 2027. That’s right, no rate increases this January.
If you remain enrolled in your mapped GigCare Livelihood benefit under the Plan, amounts already applied toward your GigCare Thrive deductible will continue to count toward your deductible balance. Progress toward your out-of-pocket maximum will also transfer, including deductible payments, coinsurance, copayments and prescription drug cost-sharing already applied toward the out-of-pocket maximum.
If you selected a different Plan benefit during the limited election window, your deductible and out-of-pocket accumulators will not transfer. The newly selected benefit begins with new accumulator balances. All deductible and out-of-pocket maximum accumulators will reset Jan. 1, 2027, as part of the normal annual benefit-year process.
No. Your care continues, and your accumulated deductible and out-of-pocket amounts carry over as long as you stay in your mapped Livelihood plan.
No. The current payment method remains the same. Members enrolled in automatic payments do not need to take action.
Accumulator information will be available when your provider checks eligibility in the Detego Health Provider Portal.
Contact a Detego Health Care Guide for assistance. They can review your information and help determine whether any additional follow-up is needed.
Provider Network and Ongoing Care
PSM completed a provider network review and found approximately 98% overlap nationally with Aetna Signature Administrators. Members are encouraged to verify their provider using the provider lookup resource or by contacting the provider directly. Provider directory – Aetna.com/asa
If you are receiving ongoing treatment from a provider who may not participate in the Aetna PPO network, you may be eligible for Continuity of Care consideration. An approved accommodation may allow eligible members to continue receiving certain covered services from their current provider for a limited period while transitioning to the new network. Requests are subject to review and approval.
To request consideration, complete the Continuity of Care Request Form and submit it as soon as possible. The Care Management Team will review the request and provide next steps.
For a routine visit, find a nearby in-network provider at Aetna.com/ASA.
Please contact our Member Advocate team at (888) 538-1844 as soon as possible. Members in active treatment, with scheduled procedures, or with open prior authorizations should be identified before Sept. 1 so support can be coordinated.
Pharmacy: Because the pharmacy formulary is changing under the new Livelihood benefit, medications that require prior authorization will need a new prior authorization under the new plan. Members should review their current medications before September 1 and contact the Member Advocate team if they need help understanding whether a new prior authorization may be required.
Medical: Approved medical prior authorizations under the current benefit will not automatically transfer to the new Livelihood Aetna benefit. Any service that continues or begins on or after Oct. 1 will need to be reviewed and authorized through Aetna under the new benefit.
Please contact the Member Advocate team at (888) 538-1844 as soon as possible so we can help review your situation and coordinate next steps before the transition.
Eligibility and Coverage Verification
Eligibility information is available through your member resources and provider verification tools.
If you believe your eligibility information is incorrect, contact Member Services for assistance.
Ask your provider to verify eligibility using the information on your current member ID card or by visiting DetegoHealth.com/Providers where your provider can look up eligibility.
Pharmacy and Prescriptions
Beginning Sept. 1, pharmacy benefits will be supported through Kroger Prescription Plans. The Elite Impact Generic Formulary includes prescription options designed to support access and affordability. Visit Kroger Elite Impact Generic Only. Please reach out to our Member Advocate team at (888) 538-1844 for support.
Many commonly used medications are included in the Elite Impact Generic Formulary. Members should review the formulary and plan materials for details about specific prescriptions, covered medications, copays, and requirements. Visit Kroger Elite Impact Generic Only.
Yes. Effective Sept. 1, the prescription formulary changed.
Before contacting support, please review the available formulary resources to understand how your medications may be impacted.
Helpful Resources:
Use the Kroger Pharmacy Locator to find pharmacy locations, hours, contact information and available services.
Find a pharmacy: Kroger Pharmacy Locator
Claims and Reimbursements
At this time, claims information from BCBS is not yet available. We are actively working to obtain the data from BCBS. Please document your inquiry and follow up in approximately 30 days for updates.
Call Population Science Management Transition Support at (888) 538-1844 for help with existing BCBSNE claims and explanations of benefits.
If your date of service occurred before September 1, claim processing may require additional review as part of the transition.
Please have the claim submitted to Detego Health at the address on the back of your ID card, and our team will ensure it is routed and processed appropriately. If you have questions regarding a pre-transition claim, contact Member Services for assistance.
Medical Claims: Detego Health PO Box 211609, Eagan, MN, 55121.
The Rapid Reimbursement form can be found here: Rapid Reimbursement Form
If your claim was for services received before Sept. 1, it may have been rejected because it was submitted after the previous carrier’s claims submission deadline.
If this happens, contact your Care Guide for assistance. Our team has a process in place to help review eligible claims during the transition.
If you receive a bill for services with a date of service before Sept. 1 and believe the claim should be covered, contact a Care Guide as soon as possible. Our team can review the claim status and help determine the appropriate next steps.
Member Materials and Support
Yes. Your new digital ID card and benefit information are being processed and will be available in the member portal and Covered365 app. Your login information is the same for the member portal and Covered365 app.
Call Population Science Management Transition Support at (888) 538-1844 for questions about coverage, reimbursement, pharmacy needs, ongoing care, prior authorization or the transition.
Kroger Prescription Plans
KPP Portal
The KPP member portal allows you to access prescription-related information and other pharmacy resources.
View the steps on how to register:
- Visit KPP-Rx.com Member Portal and elect “Register as a Member” in the upper-right corner
- Select “Create an Account“
- Enter your member information exactly as it appears in your plan records
- Create your sign-in information
- Review and accept the legal statements to complete registration
Kroger Pharmacy Locator
Helps members find Kroger pharmacy locations, pharmacy hours, contact information, prescription refill/transfer options, vaccinations, and other pharmacy services.
Pharmacy Location Directory
Comprehensive pharmacy directory with participating pharmacy names, addresses, phone numbers, pharmacy types, hours of operation, and available services such as delivery, drive-thru, compounding, and accessibility information. Please use the pharmacy directory spreadsheet.
Formulary comparisons
- Livelihood - Thrive Formulary Comparison
- Livelihood Formulary
- Thrive Formulary
- Effective Sept. 1, the formulary is changing. Before contacting support with questions, please review the new Livelihood Formulary to understand how your prescriptions may be impacted.
Aetna Signature Administrators Provider Search
PSM completed a provider network review and found approximately 98% overlap nationally with Aetna Signature Administrators. Members are encouraged to verify their provider using the provider lookup resource or by contacting the provider directly.