Common use of Anchor Choice with HSA Plan Clause in Contracts

Anchor Choice with HSA Plan. On the Anchor Choice Plan with HSA, MBUs shall pay the full retail rate for most prescriptions prior to meeting the deductible. However, if the medication is listed on the pharmacy benefit manager’s preventive therapy drug list, the applicable copay amount shall apply instead of the full retail rate. For all covered drugs, after the deductible is met, the applicable copay amount shall apply until the applicable OOPM is met. The drug copay after deductible for a 31-day supply shall be as follows: Tier 1 Tier 2 Tier 3 Tier 4 $10.00 $35.00 $60.00 $100.00 The drug copay after deductible by mail order shall be as follows: Tier 1 Tier 2 Tier 3 $20.00 $70.00 $120.00 Mail order network pharmacies: 3-month supply of a prescription drug for two (2) copayments. Maximum fill is a 3-month supply.

Anchor Choice with HSA Plan. On the Anchor Choice Plan with HSA, MBUs members shall pay the full retail rate for most prescriptions prior to meeting the deductible. However, if the medication is listed on the pharmacy benefit manager’s 's preventive therapy drug list, the applicable copay amount shall apply instead of the full retail yretail rate. For all covered drugs, after the deductible is met, the applicable copay amount shall apply until the applicable OOPM is ia met. , The drug copay after deductible for a 31-day supply shall be as follows: Tier 1 i Tier 2 Tier 3 Tier 4 $10.00 $35.00 35,00 $60.00 $100.00 The drug copay after deductible by mail order shall be as follows: Tier 1 2 Tier 2 Tier Tiex 3 $20.00 $70.00 $120.00 Mail order network pharmacies: 3-month supply of a prescription drug for two (2) copayments. Maximum fill is a 3-month +-month supply.. for the employee,

Anchor Choice with HSA Plan. On the Anchor Choice Plan with HSA, MBUs members shall pay the full retail rate for most prescriptions prior to meeting the deductible. However, if the medication is listed on the pharmacy benefit manager’s preventive therapy drug list, the applicable copay amount shall apply instead of the full retail rate. For all covered drugs, after the deductible is met, the applicable copay amount shall apply until the applicable OOPM is met. The drug copay after deductible for a 31-day supply shall be as follows: Tier 1 Tier 2 Tier 3 Tier 4 $10.00 $35.00 $60.00 $100.00 The drug copay after deductible by mail order shall be as follows: Tier 1 Tier 2 Tier 3 $20.00 $70.00 $120.00 Mail order network pharmacies: 3-3 month supply of a prescription drug for two (2) copayments. Maximum fill is a 3-month supply.

Anchor Choice with HSA Plan. On the Anchor Choice Plan with HSA, MBUs members shall pay the full retail rate for most prescriptions prior to meeting the deductible. However, if the medication is listed on the pharmacy benefit manager’s preventive therapy drug list, the applicable copay amount shall apply instead of the full retail rate. For all covered drugs, after the deductible is met, the applicable copay amount shall apply until the applicable OOPM is met. The drug copay after deductible for a 31-day supply shall be as follows: Tier 1 Tier 2 Tier 3 Tier 4 $10.00 $35.00 $60.00 $100.00 The drug copay after deductible by mail order shall be as follows: Tier 1 Tier 2 Tier 3 $20.00 $70.00 $120.00 Mail order network pharmacies: 3-month supply of a prescription drug for two (2) copayments. Maximum fill is a 3-month supply.