We are introducing two additional tiers to our Prescription Drug Program for both the Welfare Fund and the Retiree Welfare Plan. We are moving from the traditional two-tier copayment structure, which included generic and preferred brand medications, to a four-tier structure, by adding a non-preferred brand (Tier 3) and specialty medications (Tier 4). Please note, the copayments for generic (Tier 1) and preferred brand (Tier 2) will remain the same for the 2017-2018 Plan Year. Please refer to the chart below outlining the indicated changes:
Please note…..If you are currently taking a preferred brand name medication that will be considered a non-preferred brand name medication as of April 1, 2017, you should have received a letter from the Fund Office. In addition, a Customer Service Representative from the Fund Office Pharmacy Department will be contacting you regarding the letter and to discuss your options.
If you have any questions regarding the content of the letter, please contact a Fund Office Pharmacy Benefit Customer Service Representative toll-free at (844) 367-4691, Monday through Friday from 8:00am – 5:00pm CST.
Specialty medications are typically high in cost, treat rare conditions, require special handling (like refrigeration), or are infused or injectable medications. The specialty medication copayment change will help the plan control costs and help members effectively manage their conditions. To help with the transition, the Board of Trustees has decided that if you are currently using a specialty medication before April 1, 2017, your specialty drug copayment for a 30-day supply of that medication will continue at the preferred brand copayment of either $10 or $40, depending on the Plan you are enrolled in (as shown in the chart to the right). The new copayment will apply to any new users of specialty medications or existing users that are prescribed a different specialty
medication starting on or after April 1, 2017.