Prescription Insurance. 1. The Board shall provide a Family Coverage program of prescription insurance based upon the following co-pay amounts: Nonspecialty Retail Home Delivery (90-day supply) Generic $10 $20 Formulary $30 $60 Non-Formulary $60 $120 Specialty $100 $200 Step Therapy, Preferred Specialty Management, and Prior Authorization with additions shall be in effect. The Prescription insurance annual out-of-pocket maximum shall be Five Thousand Dollars ($5,000.00).
Appears in 2 contracts
Prescription Insurance. 1. A. The Board shall provide a Family Coverage program of prescription insurance based upon the following co-pay amounts: Nonspecialty Retail Home Delivery (90-day supply) Generic $10 $20 Formulary $30 $60 Non-Formulary $60 $120 Specialty $100 $200 Step Therapy, Preferred Specialty Management, and Prior Authorization with additions shall be in effect. The Prescription insurance annual out-of-pocket maximum shall be Five Thousand Dollars ($5,000.00).
Appears in 2 contracts
Prescription Insurance. 1. A. The Board shall provide a Family Coverage program of prescription insurance based upon the following co-pay amounts: Nonspecialty Retail Home Delivery (90-day supply) Generic $10 $20 Formulary $30 $60 Non-Formulary $60 $120 Specialty $100 $200 Step Therapy, Preferred Specialty Management, and Prior Authorization with additions shall be in effect. The Prescription insurance annual out-of-pocket maximum shall be Five Thousand Dollars ($5,000.00).
Appears in 1 contract
Samples: Agreement
Prescription Insurance. 1. The Board shall provide a Family Coverage program of prescription insurance based upon the following co-pay amounts: Nonspecialty Retail Home Delivery (90-day supply) Generic $10 $20 Formulary $30 $60 Non-Formulary $60 $120 Specialty $100 $200 Step Therapy, Preferred Specialty Management, and Prior Authorization with additions shall be in effect. The Prescription insurance annual out-of-pocket maximum shall be Five Thousand Dollars ($5,000.00).
Appears in 1 contract
Samples: Agreement
