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Prescription Drug Benefits

Reliance Rewards plans include comprehensive prescription drug benefits through CVS Caremark. The CVS Caremark prescription drug benefits are the SAME for the High PPO and Low PPO plans. You share in the cost of the prescription drugs through copays and/or a percentage of the costs each time you fill a prescription. The CVS Caremark prescription drug benefits for the Saver Plan are treated as any other medical expense – subject to the annual deductible and plan coinsurance (no copays). Preventive drugs (for the treatment of high blood pressure, diabetes, etc.) covered at the plan coinsurance without being subject to the plan’s deductible. Prescription drugs are the fastest rising cost of healthcare today, affecting all employers and plans, including Reliance Rewards. You have the ability to help manage our costs by always asking your doctor if there is an equivalent generic prescription drug available. You can also save money if you utilize the CVS Caremark Maintenance Choice Mail Order Service for your maintenance prescriptions (not allowed in OK and MN).

CVS/CAREMARK MAINTENANCE CHOICE MAIL ORDER SERVICE* Up to a 90-day supply

RETAIL PHARMACY Up to a 30-day supply

HIGH PPO/LOW PPO

SAVER PLAN

HIGH PPO/LOW PPO

SAVER PLAN

$20 Copay

$10 Copay

Generic Drugs

You Pay 20% Coinsurance $60 minimum and $120 maximum You Pay 35% Coinsurance $100 minimum and $200 maximum

You Pay 25%Coinsurance $30minimumand $50 maximum You Pay 40%Coinsurance $50minimumand $80 maximum

In-Network 20% Coinsurance Out-of-Network 40% Coinsurance***

In-Network 20% Coinsurance*** Out-of-Network 40% Coinsurance***

Preferred Brand- Name Drugs**

With PrudentRx: $0 Copay Without PrudentRx: You Pay 30%

PrudentRx Specialty Medication

Healthcare Reform Preventive Drugs

$0 copay** for contraceptives, aspirin, and folic acid. If a generic equivalent is available, then the copay or coinsurance amount above will apply to obtain the brand name version of the medication.

* Discounted pricing for mail order prescriptions is not allowed in OK or MN ** If a generic equivalent is available and either you or your doctor requests a brand-name drug, you’ll pay the applicable generic copay amount (if any) plus the difference in cost between the brand-name drug and its generic equivalent *** After you meet your Saver Plan medical deductible

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