Prescription Drug. (1) If an employee and/or eligible dependent receives prescription drugs at a participating PPO pharmacy, the employee shall be responsible for a five dollar ($5.00) co-pay for a generic drug. If there is no generic drug equivalent for the prescribed drug, the co-pay is ten dollars ($10.00). If the prescription is for a brand-name drug, or the prescription is written "dispense as written" and a generic equivalent exists, the co-pay is twenty-five dollars ($25.00). If participating pharmacies are not used, additional ten dollar ($10.00) co-pay shall be imposed. Effective January 1, 2018, the employee shall be responsible for a five dollar ($5.00) co-pay for a Tier 1 drug. For a Tier 2 drug, the co-pay is fifteen dollars ($15.00). For a Tier 3 drug or if the prescription is written “dispense as written” and a lower tier drug exists, the co-pay is thirty dollars ($30.00). The annual out-of-pocket maximum per single contract per year will be two thousand dollars ($2,000.00); the annual out-of-pocket maximum per family contract per year will be four thousand dollars ($4,000.00).
(2) Mail order prescription drugs will be limited to a thirty (30) day minimum and a ninety (90) day maximum supply. Under the mail order program, the employee shall be responsible for a ten dollar ($10.00) co-pay for a generic drug. If there is no generic drug equivalent for the prescribed drug, the co-pay is twenty dollars ($20.00). If the prescription is for a brand-name drug, or the prescription is written "dispense as written" and a generic equivalent exists, the co-pay is fifty dollars ($50.00). Maintenance drugs may be obtained through the mail order program, if such maintenance drugs are available through the mail order program. Effective January 1, 2018, the supply limits described above will remain the same; the out-of-pocket maximums for prescription drugs fulfilled through mail order will remain the same as described in Section 18.1(B) above. Under the mail order program, the employee shall be responsible for a twelve dollar and fifty cent ($12.50) co-pay for a Tier 1 drug. For a Tier 2 drug, the co-pay is twenty-five dollars ($25.00). If the prescription is for a Tier 3 drug or if the prescription is written “dispense as written” and a lower tier drug exists, the co-pay is sixty dollars ($60.00).
(3) Effective January 1, 2018, the City will provide a prescription drug coverage plan that provides for the use of a formulary and prior authorization requirements for certain typ...
Prescription Drug any drugs or medications ordered by a Professional Provider by means of a valid prescription order, bearing the Federal legend: “Caution - Federal law prohibits dispensing without a prescription,” or legend drugs under applicable state law and dispensed by a licensed pharmacist. Also included are prescribed insulin and other pharmacological agents used to control blood sugar, diabetic supplies and insulin syringes.
Prescription Drug. Effective September 1, 2010, the co-pay for prescription drugs at retail shall be $10 for generic, $15 for formulary and $25 for non- formulary. Effective September 1, 2010 the co-pay for prescription drugs secured via mail order shall be $15.00 for ninety day supply for generic and $20.00 for formulary and non-formulary for ninety day supply. Maintenance drugs are available via mail order, and must be obtained after the third retail refill. Generics are mandatory unless the physician requires a brand name by an explanation of the medical reasons that the generic does not provide an equivalent benefit.
Prescription Drug. A drug or medication prescribed by a duly licensed health care provider for current use by the person possessing it that is lawfully available for retail purchase only with a prescription.
Prescription Drug. A drug lawfully available for retail purchase only with a Doctor’s prescription.
Prescription Drug. A. Prescription drug benefits shall be provided to Employees represented by the Association, regardless of the University health plan in which they are enrolled, under a program administered by Caremark or other administrator(s) as may be agreed to.
B. The prescription drug program implemented pursuant to the agreement shall be as specified in the MSU/Coalition Memorandum.
C. The appropriate premiums for the prescription drug program shall be paid by the University for full-time Employees and proportionately for part-time Employees.
Prescription Drug. Effective February 1, 2013, the Board shall provide prescription drug insurance (card) with the following provisions: $40 co-pay for multiple-source drugs (a drug where there is a generic drug available, but the teacher opts for the name-brand drug) $20 co-pay for single-source drugs (a drug where no generic drug is available) $10 co-pay for generic drugs $20 co-pay for generic drugs purchased through mail order, $40 co-pay for single-source drugs purchased through mail order, and $80 co-pay for multiple-source drugs. All mail order purchases are for a 90-day supply.
Prescription Drug. Employees will contribute 12% of monthly funding rate for individual or family coverage. The Board will notify the Union of any funding rate adjustment within two weeks after the Board determines any funding rate adjustment. The Board will provide the Union with the actuarial report regarding any funding rate adjustments. The out of pocket maximum for prescription drugs will be in accordance with the allowable maximum under the Affordable Care Act. Prescription drug coverage, including oral contraceptives, with a Seven Dollar ($7.00) co-pay feature for generic drugs and Twenty-Five Dollar ($25.00) co-pay for legend or name brand drugs will be provided for all employees by the Board at Board expense. Mail orders will have a $17.50 co-pay for generic and $62.50 co-pay for legend or name brand. Retail drugs will be limited to a 30 day supply and mail order to a 90 day supply. Prescription drug coverage, including oral contraceptives, with a Seven Dollar ($7.00) co-pay feature for generic drugs, Twenty-Five Dollar ($25.00) co-pay for preferred name brand drugs and Fifty Dollar ($50.00) co-pay for non-preferred drugs will be provided for all bargaining unit members by the Board at Board expense. Mail orders will have a $17.50 co-pay for generic, $62.50 co-pay for preferred name brand, and $125.00 co-pay for non-preferred drugs. Retail drugs will be limited to a 30 day supply and mail order to a 90 day supply. Determinations regarding whether a drug falls within the classification of generic, preferred name brand, non-preferred or excluded will be according to the Pharmacy Benefits Manager’s (PBM) preferred drug formulary. Compound medications are covered by the plan if determined to be medically necessary. Specialty drugs will be dispensed via the PBM’s Exclusive Specialty Pharmacy.
Prescription Drug. Teachers will pay the following percentage of the premium for Prescription Drug coverage for the duration of this agreement. The Board will pay the balance of the premium costs. Employee Contributions for Insurance: 7/1/16-6/30/19 15% Subject to the following caps: Family Prescription 2016-17 15% not to exceed $41.00/month 2017-18 15% not to exceed $43.00/month 2018-19 15% not to exceed $48.00/month Single Prescription 2016-17 15% not to exceed $19.00/month 2017-18 15% not to exceed $20.00/month 2018-19 15% not to exceed $23.00/month High Deductible Plan: 2016-19 5%
Prescription Drug. Prescription drug coverage is part of the health coverage. The program will include a $10, $20, $30 CORE Plan.
