Specialty Drug Savings Program Clause Samples

Specialty Drug Savings Program. All enrollees and dependents shall participate in the Specialty Drug Savings program. In doing so, the Employer agrees to an appeal process in which any member of the plan that is not reimbursed for the plan coinsurance on specialty medicines will be reimbursed by the Employer so that the “out-of-pocket” cost to the member shall not exceed the co-payment had the prescription been filled under the traditional prescription plan. Said appeals mechanism shall be coordinated through the Prescription Benefit Manager so that there is no up-front cost to the employee for these specialty medicines when copayment assistance is not available.