Common use of Prescription Drug Clause in Contracts

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. 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 Effective October 1, 2015, prescription drug coverage, including oral contraceptives, with a Seven Dollar ($7.00) co-pay feature for generic drugs, drugs and Twenty-Five Dollar ($25.00) co-pay for preferred name brand drugs and Fifty Dollar ($50.00) co-pay for non-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, generic and $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 Also effective October 1, 2015, 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.