Common use of Prescription Drug Plan Clause in Contracts

Prescription Drug Plan. A. The Employer will continue to provide a prescription drug benefit for employee, employee + 1, and family coverage. The plan shall provide for two cards for family coverage. B. Effective January 1, 2009, the County shall provide prescription plans (High Option Plan - $4/$8 co-pays and Standard Option Plan - $10/$20/$35 co-pays with a $50 deductible) for all active employees. Employees who select the Standard Option Plan shall pay 20% of the cost of the Standard Option Plan. The Employer shall pay the remaining 80% of the cost of the Standard Option Plan. For employees who select the High Option Plan, the employer shall pay 80% of the total premium cost of the Standard Option Plan Option and the employee shall pay the remainder of the High Option Plan premium.9 C. Both plans shall restrict generics. In the event the employee elects to receive a brand medication when a generic medication is available, the member shall pay the cost difference between the brand and generic medication, however, in the event a physician requires a brand medication, the employee shall not be responsible for the difference in cost. D. Both prescription plans shall require that if an employee fills a prescription at retail more than twice, rather than utilizing mail-order, the member shall pay the cost difference. E. Effective January 1, 2014, the Prescription Drug Plan will no longer offer the 90-day post formulary change grace period granted upon formulary changes. Plan participants affected by formulary changes shall be notified a minimum of 90 days prior to the effective date of the formulary change.

Prescription Drug Plan. A. The Employer will continue to provide a prescription drug benefit for employee, employee + 1, and family coverage. The plan shall provide for two cards for family coverage. B. Effective January 1, 2009, the County shall provide prescription plans (High Option Plan - $4/$8 co-pays and Standard Option Plan - $10/$20/$35 co-pays with a $50 deductible) for all active employees. Employees who select the Standard Option Plan shall pay 20% of the cost of the Standard Option Plan. The Employer shall pay the remaining 80% of the cost of the Standard Option Plan. For employees who select the High Option Plan, the employer shall pay 80% of the total premium cost of the Standard Option Plan Option and the employee shall pay the remainder of the High Option Plan premium.9premium.10 C. Both plans shall restrict generics. In the event the employee elects to receive a brand medication when a generic medication is available, the member shall pay the cost difference between the brand and generic medication, however, in the event a physician requires a brand medication, the employee shall not be responsible for the difference in cost. D. Both prescription plans shall require that if an employee fills a prescription at retail more than twice, rather than utilizing mail-order, the member shall pay the cost difference. E. Effective January 1, 2014, the Prescription Drug Plan will no longer offer the 90-day post formulary change grace period granted upon formulary changes. Plan participants affected by formulary changes shall be notified a minimum of 90 days prior to the effective date of the formulary change. F. Effective July 1, 2017, or as soon as administratively possible, the following Pharmacy Benefit Management programs will be implemented for both the High Option and the Standard Option prescription plans. The parties acknowledge that these are vendor specific programs and understand that a future change of vendors may necessitate revisiting the programs and possibly reopening bargaining.

Prescription Drug Plan. A. The Employer will continue to provide a prescription drug benefit for employee, employee + 1, and family coverage. The plan shall provide for two cards for family coverage. B. Effective January 1, 2009, the County shall provide prescription plans (High Option Plan - $4/$8 co-pays and Standard Option Plan - $10/$20/$35 co-pays with a $50 deductible) for all active employees. Employees who select the Standard Option Plan shall pay 20% of the cost of the Standard Option Plan. The Employer shall pay the remaining 80% of the cost of the Standard Option Plan. For employees who select the High Option Plan, the employer shall pay 80% of the total premium cost of the Standard Option Plan Option and the employee shall pay the remainder of the High Option Plan premium.9premium.15 C. Both plans shall restrict generics. In the event the employee elects to receive a brand medication when a generic medication is available, the member shall pay the cost difference between the brand and generic medication, however, in the event a physician requires a brand medication, the employee shall not be responsible for the difference in cost. D. Both prescription plans shall require that if an employee fills a prescription at retail more than twice, rather than utilizing mail-order, the member shall pay the cost difference. E. Effective January 1, 2014, the Prescription Drug Plan will no longer offer the 90-day post formulary change grace period granted upon formulary changes. Plan participants affected by formulary changes shall be notified a minimum of 90 days prior to the effective date of the formulary change. F. Effective July 1, 2017, or as soon as administratively possible, the following Pharmacy Benefit Management programs will be implemented for both the High Option and the Standard Option prescription plans. The parties acknowledge that these are vendor specific programs and understand that a future change of vendors may necessitate revisiting the programs and possibly reopening bargaining.

Prescription Drug Plan. A. The Employer will continue to provide a prescription drug benefit for employee, employee + 1, and family coverage. The plan shall provide for two cards for family coverage. B. Effective January 1, 20092023, the High Option Plan shall be eliminated and the County shall provide one stand alone prescription plans plan (High Option Plan - $4/$8 co-pays and Standard Option Plan - $10/$20/$35 co-pays with a $50 14 Per Action taken on May 26, 2011, the County Council did not approve full funding for this provision. On that date, the Council adopted a different cost-sharing arrangement for bargaining unit employees to become effective on deductible) for all active employees. Employees who select the Standard Option Plan shall pay 20% of the cost of the Standard Option Plan. The Employer shall pay the remaining 80% of the cost of the Standard Option Plan. For employees who select the High Option Plan, the employer shall pay 80% of the total premium cost of the Standard Option Plan Option and the employee shall pay the remainder of the High Option Plan premium.9retirees. C. Both plans shall restrict generics. In the event the employee elects to receive a brand medication when a generic medication is available, the member shall pay the cost difference between the brand and generic medication, however, in the event a physician requires a brand medication, the employee shall not be responsible for the difference in cost. D. Both prescription plans shall require that if an employee fills a prescription at retail more than twice, rather than utilizing mail-order, the member shall pay the cost difference. E. Effective January 1, 2014, the Prescription Drug Plan will no longer offer the 90-day post formulary change grace period granted upon formulary changes. Plan participants affected by formulary changes shall be notified a minimum of 90 days prior to the effective date of the formulary change. F. Effective July 1, 2017, or as soon as administratively possible, the following Pharmacy Benefit Management programs will be implemented for both the High Option and the Standard Option prescription plans. The parties acknowledge that these are vendor specific programs and understand that a future change of vendors may necessitate revisiting the programs and possibly reopening bargaining. 1. Exclusive Specialty Pharmacy - a program that requires plan members to purchase specialty medications through the pharmacy benefit manager’s exclusive specialty pharmacy arrangement. Any medication that the pharmacy benefit manager (“PBM”) does not designate as a specialty medication is not subject to this requirement. In instances where the specialty medication is not available at the PBM’s specialty pharmacy, the PBM shall coordinate purchasing arrangements with another specialty pharmacy within the PBM’s network. At the member’s request, the pharmacy benefit manager will deliver the specialty medication to the member’s home, the member’s physician’s office, or to a retail pharmacy of the member’s choosing that is part of the PBM’s pharmacy network.15

Prescription Drug Plan. A. The Employer will continue to provide a prescription drug benefit for employee, employee + 1, and family coverage. The plan shall provide for two cards for family coverage. B. Effective January 1, 2009, the County shall provide prescription plans (High Option Plan - $4/$8 co-pays and Standard Option Plan - $10/$20/$35 co-pays with a $50 deductible) for all active employees. Employees who select the Standard Option Plan shall pay 20% of the cost of the Standard Option Plan. The Employer shall pay the remaining 80% of the cost of the Standard Option Plan. For employees who select the High Option Plan, the employer shall pay 80% of the total premium cost of the Standard Option Plan Option and the employee shall pay the remainder of the High Option Plan premium.9premium.10 C. Both plans shall restrict generics. In the event the employee elects to receive a brand medication when a generic medication is available, the member shall pay the cost difference between the brand and generic medication, however, in the event a physician requires a brand medication, the employee shall not be responsible for the difference in cost. D. Both prescription plans shall require that if an employee fills a prescription at retail more than twice, rather than utilizing mail-order, the member shall pay the cost difference. E. Effective January 1, 2014, the Prescription Drug Plan will no longer offer the 90-day post formulary change grace period granted upon formulary changes. Plan participants affected by formulary changes shall be notified a minimum of 90 days prior to the effective date of the formulary change.

Prescription Drug Plan. A. The Employer will continue to provide a prescription drug benefit for employee, employee + 1, and family coverage. The plan shall provide for two cards for family coverage. B. Effective January 1, 20092023, the High Option Plan shall be eliminated and the County shall provide one stand alone prescription plans plan (High Option Plan - $4/$8 co-pays and Standard Option Plan - ‐ $10/$20/$35 co-pays co‐pays with a $50 deductible) for all active employees. Employees who select the Standard Option Plan shall pay 20% of the cost of the Standard Option Plan. The Employer shall pay the remaining 80% of the cost of the Standard Option Plan. For employees who select the High Option Plan, the employer shall pay 80% of the total premium cost of the Standard Option Plan Option and the employee shall pay the remainder of the High Option Plan premium.9retirees. C. Both plans shall restrict generics. In the event the employee elects to receive a brand medication when a generic medication is available, the member shall pay the cost difference between the brand and generic medication, however, in the event a physician requires a brand medication, the employee shall not be responsible for the difference in cost. D. Both prescription plans shall require that if an employee fills a prescription at retail more than twice, rather than utilizing mail-order, the member shall pay the cost difference. E. Effective January 1, 2014, the Prescription Drug Plan will no longer offer the 90-day post formulary change grace period granted upon formulary changes. Plan participants affected by formulary changes shall be notified a minimum of 90 days prior to the effective date of the formulary change. F. Effective July 1, 2017, or as soon as administratively possible, the following Pharmacy Benefit Management programs will be implemented for both the High Option and the Standard Option prescription plans. The parties acknowledge that these are vendor specific programs and understand that a future change of vendors may necessitate revisiting the programs and possibly reopening bargaining. 1. Exclusive Specialty Pharmacy - a program that requires plan members to purchase specialty medications through the pharmacy benefit manager’s exclusive specialty pharmacy arrangement. Any medication that the pharmacy benefit manager (“PBM”) does not designate as a specialty medication is not subject to this requirement. In instances where the specialty medication is not available at the PBM’s specialty pharmacy, the PBM shall coordinate purchasing arrangements with another specialty pharmacy within the PBM’s

Prescription Drug Plan. A. The Employer will continue to provide a prescription drug benefit for employee, employee + 1, and family coverage. The plan shall provide for two cards for family coverage. B. Effective January 1, 20092023, the High Option Plan shall be eliminated and the County shall provide one stand alone prescription plans plan (High Option Plan - $4/$8 co-pays and Standard Option Plan - ‐ $10/$20/$35 co-pays co‐pays with a $50 deductible) for all active employees. Employees who select the Standard Option Plan shall pay 20% of the cost of the Standard Option Plan. The Employer shall pay the remaining 80% of the cost of the Standard Option Plan. For employees who select the High Option Plan, the employer shall pay 80% of the total premium cost of the Standard Option Plan Option and the employee shall pay the remainder of the High Option Plan premium.9retirees. C. Both plans shall restrict generics. In the event the employee elects to receive a brand medication when a generic medication is available, the member shall pay the cost difference between the brand and generic medication, however, in the event a physician requires a brand medication, the employee shall not be responsible for the difference in cost. D. Both prescription plans shall require that if an employee fills a prescription at retail more than twice, rather than utilizing mail-order, the member shall pay the cost difference. E. Effective January 1, 2014, the Prescription Drug Plan will no longer offer the 90-day post formulary change grace period granted upon formulary changes. Plan participants affected by formulary changes shall be notified a minimum of 90 days prior to the effective date of the formulary change. F. Effective July 1, 2017, or as soon as administratively possible, the following Pharmacy Benefit Management programs will be implemented for both the High Option and the Standard Option prescription plans. The parties acknowledge that these are vendor specific programs and understand that a future change of vendors may necessitate revisiting the programs and possibly reopening bargaining. 1. Exclusive Specialty Pharmacy - a program that requires plan members to purchase specialty medications through the pharmacy benefit manager’s exclusive specialty pharmacy arrangement. Any medication that the pharmacy benefit manager (“PBM”) does not designate as a specialty medication is not subject to this requirement. In instances where the specialty medication is not available at the PBM’s specialty pharmacy, the PBM shall coordinate purchasing arrangements with another specialty pharmacy within the PBM’s network. At the member’s request, the pharmacy benefit manager will deliver the specialty medication to the member’s home, the member’s physician’s office, or to a retail pharmacy of the member’s choosing that is part of the PBM’s pharmacy network.16