Prescription Drug Card. The State System shall provide prescription drug coverage for all of the SSHEGHP plans through a prescription drug card. The prescription drug coverage shall include:
a. A three-tier open formulary with retail co-payments of $10 for generic, $30 for brand formulary, and $50 for brand non-formulary drugs for up to a thirty (30) day supply.
b. Co-payments for mail order prescriptions of two (2) times the retail co-payments set forth in subsection 5.a. above for up to a ninety (90) day supply.
c. If a physician prescribes a brand name drug and indicates no substitution, then the employee will not pay the difference between that drug and the generic drug. However, if the employee chooses a brand name drug when his/her physician has indicated that substitution of a generic drug is acceptable, the employee must pay the difference in cost between the brand name drug and the generic drug.
Prescription Drug Card. The employee benefit program will allow for a prescription drug card.
Prescription Drug Card. A prescription drug card will be provided and paid for by the DISTRICT as included in the Union medical plan.
Prescription Drug Card. The Company agrees to introduce a Prescription Drug Card.
Prescription Drug Card. Members covered by Board hospitalization may elect to receive a prescription drug card with the following schedule of benefits consistent with the effective Prescription Drug Rider: Co-payment (paid by plan) Brand Name Drugs 80% Generic Drugs 95% Mail Order Drugs 100% The 100% benefit for mail order drugs covered by the plan is subject to a $1,500 single/$3,000 family cap. Any mail order prescriptions exceeding the cap will be subject to a 96/4 percent co-insurance.
Prescription Drug Card. The State System shall provide prescription drug coverage for all of the SSHEGHP plans through a prescription drug card. The prescription drug coverage shall include:
a. A three-tier open formulary with retail co-payments of $10 for generic, $30 for brand formulary, and $50 for brand non-formulary drugs for up to a thirty (30) day supply.
b. Co-payments for mail order prescriptions of two (2) times the retail co-payments set forth in subsection 5.a. above for up to a ninety (90) day supply.
c. If a physician prescribes a brand name drug and indicates no substitution, then the employee will not pay the difference between that drug and the generic drug. However, if the employee chooses a brand name drug when his/her physician has indicated that substitution of a generic drug is acceptable, the employee must pay the difference in cost between the brand name drug and the generic drug.
d. Effective January 1, 2016, the STATE SYSTEM implemented prescription drug clinical management programs (Managed RX Coverage Program (MRxC), including step edits, and expansion of Managed Prior Authorization Program) to encourage cost-effective utilization.
e. Effective January 1, 2016, the STATE SYSTEM established a mandatory Specialty Pharmacy Vendor program. Employees and their enrolled dependents who need to obtain specialty medications must purchase those medications from the designated Specialty Pharmacy Vendor to receive the in-network benefit.
Prescription Drug Card. The prescription drug card program shall consist of those pharmacies participating in the national Express Scripts/RxNet Program. Co-payment for prescription drug card users shall be: (1) $10.00 for generic drugs; (2) $20.00 for name-brand drugs when no generic drug is available; or (3) $100.00 or the actual cost of the drug, whichever is less, for name-brand drugs when a generic drug is available, unless medical documentation is submitted and approved by the Insurance Advisory Committee that negative health effects exist from use of the generic drug. All eligible outpatient prescription drugs shall be covered under the drug card plan only, unless not available.
Prescription Drug Card. Employees will pay the first five hundred dollars ($500) per person/one thousand dollars ($1,000) per family of $10/20 drug co-payment stop loss each calendar year and the District will pay the second five hundred dollars ($500) per person/one thousand dollars ($1,000) per family of co-payment stop loss each calendar year (District will not pay cost difference between brand name and generic if brand name is not medically necessary). MESSA Long Term Disability 66-2/3% 90 calendar day modified fill $4,000 maximum (effective 11/1/09) Freeze on Offsets Alcoholism/drug addiction and mental/nervous same as any other illness MESSA Dental MESSA/DELTA Class I, II, III 2008-2010 (80/80/80: $1,000 annual max) 2010-2011 (80/80/80: $1,200 annual max) Class IV Ortho 2008-2010 (75%: $750 lifetime max) 2010-2011 (75%: $950 lifetime max) MESSA Negotiated Life $25,000 AD&D Vision VSP-2 Silver (effective 11/1/09) Plan B (For employees not electing health insurance) Class I, II, III 2008-2010 (80/80/80: $1,000 annual max) 2010-2011 (80/80/80: $1,200 annual max) Class IV Ortho 2008-2010 (75%: $1,300 lifetime max) 2010-2011 (75%: $1,500 lifetime max) Vision VSP-3 Gold (effective 11/1/09) MESSA Long Term Disability Same as in Plan A above For employees eligible for the District-provided hospitalization insurance but choosing Plan B, the District will provide a cash option to health insurance benefits. The cash amount will be ninety dollars ($90.00) per month. If sixteen (16) or more teachers select Plan B, increase cash option to two hundred dollars ($200); and if eighteen (18) teachers or more select Plan B, increase cash option to three hundred dollars ($300). The District will formally adopt a qualified plan document which complies with Section 125 of the Internal Revenue Code. The amount of the cash payment received may be applied by the member to any tax deferred/sheltered annuity selected by the member with a company that is a district-approved carrier. Each bargaining unit member must elect to be covered by either Plan A or Plan B as specified above.
Prescription Drug Card. The State System shall provide prescription drug coverage for all of the SSHEGHP plans through a prescription drug card. The prescription drug coverage shall include: