Mandatory generic substitution Sample Clauses

Mandatory generic substitution. ▪ The program will continue to provide same coverage on medication as the one in effect prior to the expiration of the previous agreement. However, the refund to the employee will be limited to the price of the generic drug as long as it is available. If it’s not available, the brand name will be covered. If an employee is allergic to a generic drug, he will be eligible to the brand name drug.

Mandatory generic substitution. Failure to get generic when available will result in the member paying the difference in cost between the generic drug and the brand name drug plus the brand name drug copay. The mail order drug program has been enhanced to allow the member to receive a 3 month supply of generic medication for just one generic drug copay. DENTAL PPO DENTAL The PPO Dental plan benefits cover a wide range of dental services. You have the freedom to go in and out of network for care. You may visit a PPO dentist and benefit from the reduced contracted fee resulting in less out of pocket expense. You may also visit an out of network dentist, where services will be based on a reasonable and customary amount and you will be responsible for any amount owed after insurance has paid. FEATURE IN NETWORK OUT OF NETWORK Calendar Year Maximum $ 1,500 $ 1,500 Deductible (Ind. / Family) $ 50 / $150 $ 50 / $150 Plan Pays: Preventive 100% Deductible Waived for Preventive Services? Yes Basic Services 90 % 80 % Major Services 60 % 50 % Orthodontia (child only) 50 % 50 % Orthodontia Lifetime Max $1,500 The Vision Service Plan (VSP) provides professional vision care and high quality lenses and frames through a broad network of optical specialists. FEATURE IN NETWORK OUT OF NETWORK Deductible Examination $20 Prescription Glasses $20 Contact Lenses No Copay Lenses Single Vision 100 % $45 Benefit Bifocal 100 % $65 Benefit Trifocal 100 % $85 Benefit Frame $120 Benefit $47 Benefit Contact Lenses $120 Benefit $105 Benefit (in lieu of glasses) Frequency Exam 12 months Lenses 12 months Frames 24 months BASIC LIFE AND AD&D Award Metals provides full-time hourly employees with Basic Term Life and Accidental Death & Dismemberment (AD&D) insurance through Prudential Financial. The Basic Term Life benefit is $10,000. The AD&D benefit matches the Basic Term Life benefit. The AD&D benefit includes benefits for loss of life or limbs due to an accident. DEPENDENT LIFE Award Metals also provides full-time salaried employees with Basic Term Life insurance for their dependents through Prudential Financial. The Basic Term Life benefit is $5,000 for a spouse and $1,000 for each dependent child. VOLUNTARY LIFE AND AD&D You may elect to purchase additional Term Life insurance at group rates provided by Prudential Financial. You pay for this coverage with after-tax dollars through payroll deduction. Benefits are available to employees in increments of $10,000 up to $500,000. Coverage for your spouse and child(ren) is a...

Mandatory generic substitution. Only expenses for the least expensive drug equivalent to the drug prescribed are eligible, even if the healthcare professional has indicated on the prescription that no substitutions are to be made. Insureds wishing to be reimbursed based on the cost of the brand name drug or another generic must obtain the appropriate form from the Insurer and have it completed by their healthcare professional, specifying the medical contraindications associated with the least costly generic. The insured must then submit this form to the Insurer for analysis. Prescription drug refills for the drug that has been accepted by the Insurer will then be approved through the Insurer’s electronic transmission system. The medical form need not be completed again. Generic drugs: Generic drugs are copies of patented drugs whose market exclusivity is no longer protected by the patent.