Common use of Prescription Plan Clause in Contracts

Prescription Plan. Effective 7/1/18, the HMO prescription plan will revert 18 to a three (3) system by the provider. Retail co-pay per thirty (30) day 19 prescription: $10 formulary; and $35 non-formulary. Mail order co-pay 20 for up to ninety (90) day prescription supply: $5 generic; $5 generic, $10 21 formulary; and $35 non formulary. 22

Prescription Plan. Effective 7/1/18, the HMO prescription plan will revert 18 8 to a three (3) system by the provider. Retail co-pay per thirty (30) day 19 9 prescription: $5 generic; $10 formulary; and $35 non-formulary. Mail order 10 co-pay 20 for up to ninety (90) day prescription supply: $5 generic; $5 generic, $10 21 11 formulary; and $35 non non-formulary. 2212

Prescription Plan. Effective 7/1/183/1/2013, prescriptions will be carved 5 into the HMO prescription plan will revert 18 to a three (3) system by the providerplan. Retail co-pay per thirty (30) day 19 prescription: $5 6 generic; $10 formulary; and $35 non-formulary. Mail order co-pay 20 7 for up to ninety (90) day prescription supply: $5 generic; $5 generic, $10 21 8 formulary; and $35 non non-formulary. 22Effective 1/1/2018, the Blue Shield 9 HMO prescription plan is being transitioned to a four (4) tier system by 10 the provider

Prescription Plan. Effective 7/1/18, the HMO prescription plan will revert 18 to a three (3) system by the provider. Retail co-pay per thirty (30) day 19 prescription: $10 formulary; and $35 non-formulary. Mail order co-pay 20 for up to ninety (90) day prescription supply: $5 generic; $5 generic, $10 21 formulary; and $35 non non-formulary. 22