|
|
Employee Benefits Home |
|
Medical Insurance |
|
Prescription Insurance (Rx) |
|
Dental Insurance |
|
Vision Insurance |
|
Health Reimbursement
Arrangement |
|
Flexible Spending Account (FSA) |
|
Employee Wellness Program |
|
Employee Assistance Program
(EAP) |
|
Short Term Disability Coverage
(STD) |
|
Family Medical Leave Act (FMLA) |
|
Group Life/AD&D Insurance |
|
Supplemental Group Term Life
Insurance |
|
Retirement Plan |
|
General Forms & Information |
|
Contact Information |
|
Frequently
Asked Questions (FAQs) |
|
|
 |
Prescription Insurance
Benefit
Summary - HRA
|
All information provided is
in summary format. For complete details of
coverage, exclusions, limitations, etc., please refer
to the summary plan document, certificate or master
contract, not this online summary.
|
|
Medco/Systemed |
Subject
to Calendar Year Deductible, then plan pays 50% or 80% (see below)
of discounted charges up to Out-of-Pocket Maximum |
|
Retail - 30 Day Supply
Mail
Order - 90 Day Supply |
After CYD
Generic and Preferred Brand -Plan pays 80%
Non-Preferred Brand -Plan pays 50% |
Benefit
Summary - Non-HRA
|
All information provided is
in summary format. For complete details of
coverage, exclusions, limitations, etc., please refer
to the summary plan document, certificate or master
contract, not this online summary.
|
|
Medco/Systemed |
Co-Payment Plan |
|
Retail - 30 Day Supply
|
10% copay
- Generic - $10 Cap |
|
25% copay
- Preferred Brand (formulary) - $30 cap |
|
*50%
copay - Non-Preferred Brand -$100 cap |
|
*NOT SUBJECT TO DEDUCTIBLE |
|
Mail
Order - 90 Day Supply |
10% copay
- Generic - $20 Cap |
|
25% copay
- Preferred Brand (formulary) - $60 cap |
|
*50%
copay - Non-Preferred Brand -$200 cap |
|
|
*NOT SUBJECT TO DEDUCTIBLE |
Find a Pharmacy
Medco Forms
Contact
Information
|
|
