/ Human Resources

Prescription Plans At a Glance

2019/20 in-network plans

  Blue (Traditional) Plan Orange (HDHP) Plan
preventive drug per aca guidelines $0 copay $0 copay
for short term medications up to a 30 day supply
in-network retail pharmacy network Not subject to deductible.

$10 generic copay
$40 preferred brand copay
$80 non-preferred brand copay
10% coinsurance up to $150 maximum, specialty drugs

After deductible.

$10 generic copay
$40 preferred brand copay
$80 non-preferred brand copay
10% coinsurance up to $150 maximum, specialty drugs
for long term maintenance medications
CVS or Target retail pharmacy or CVS/Caremark mail service pharmacy (up to a 90 DAY SUPPLY) Not subject to deductible.

$20 generic copay
$80 preferred brand copay
$160 non-preferred brand copay
Specialty drugs not eligible, due to maximum 30-day supply limit.
After deductible.

$20 generic copay
$80 preferred brand copay
$160 non-preferred brand copay
Specialty drugs not eligible, due to maximum 30-day supply limit.
All other in-network retail pharmacies (limited to 30 day supply and copay with opt-out option*)

*90-day supplies are not available unless using cvs/caremark retail or mail order (see above).  to continue to receive long-term medications at any other in-network retail pharmacy, participants must first contact cvs/caremark at 1.888.321.4206 to opt out of 90 day refills and will be limited to 30-day supplies)
Not subject to deductible.

$10 generic copay
$40 preferred brand copay
$80 non-preferred brand copay
Specialty drugs not eligible, due to maximum 30-day supply limit.
After deductible.


$10 generic copay
$40 preferred brand copay
$80 non-preferred brand copay
Specialty drugs not eligible, due to maximum 30-day supply limit.
Maximum out of pocket Pharmacy co-pays combine with medical plan limits Pharmacy co-pays combine with medical plan limits
Deductible Not applicable. Pharmacy costs combine with medical plan deductibles.
Benefits at a glance Blue RX BAAG Orange RX BAAG