2013 Employee Benefits Guidebook - Administration Home

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Hormones, and all other biotech medications. Please call toll free at 1-888-782-8443 to preenroll in the Specialty Pharmacy program. Clinical Prior Authorization (CPA) Certain prescriptions may require “clinical prior authorization” or approval from Catamaran before they will be covered by your plan. The categories/medications that require clinical prior authorization may include, but are not limited to: Acne Topical (i.e. Retin-A, Avita, Differin) exceeding age 24 Actiq ADHD/Narcolepsy (i.e. Dexedrine, Ritalin, Cylert) exceeding age 19 Anabolic Steroids (oral, topical, injectable) Antiemetics (oral, i.e. Kytril, Zofran) are limited to a 7 day supply per 25 days. CPA if quantity limit is exceeded. Botulin Toxins (i.e. Botox, Myobloc) Butorphanol exceeding 2 bottles(5 ml)/25 days Byetta Crinone 8% Duragesic exceeding a quantity of 15/25 days Fentora Impotency (i.e. Viagra, Caverject, Levitra, Cyalis) CPA with max quantity of 8, if approved. Insomnia (i.e. Ambien, Restoril, Sonata) exceeding quantity of 90/144 days Lamisil/Sporanox/Penlac Oxycontin To request prior authorization for your prescription, the pharmacy, the physician or you may call the Prior Authorization Department toll free at 1-877-665-6609. Please have available the name of your medication, physician’s name, phone (and fax number, if available), your ID number, and your Rx Group number of 112359. Quantity Limits: Certain categories/medications may have quantity limits. These categories/medications may include, but are not limited to: Sleep Aids Pain Management Anti-Nausea Anti-psychotics Anti-depressants Migraine Your Cost: Retail, Mail-Order and Specialty Pharmacy When covered prescriptions are filled under this program, you will share a portion of the cost; the plan pays for the remainder. Your prescription drug program provides you with three-tier options. These formulary medications have received FDA approval as safe and effective. The Catamaran Preferred ©2008 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved. 2013 Employee Benefits Guidebook Updated January 2013
Medication List (PML)/formulary is available on the website at www.walgreenshealth.com. The online guide is updated regularly every calendar quarter or more often if needed to reflect important changes. Please note that although a drug is on a formulary, it does not necessarily mean that it is a covered drug under your plan. Refer to your Summary Plan Description for a list of coverages/exclusions. Walgreens Concierge Prescription Delivery to El Paso County Health Centers Walgreens is pleased to provide Concierge prescription delivery service to El Paso County RDC & CSC Health Centers effective January 2, 2013! With this new service offering, if you receive a prescription from a Take Care Health medical provider at the El Paso County CSC or RDC Health Center and would like to pickup your prescription at the CSC or RDC Health Center, you can take advantage of the Concierge Delivery Service. Below are a few highlights of this new service: Service Options: Concierge delivery service to the CSC Health Center is provided by Walgreens located at 4315 Centennial Blvd. (PH: 719-264-1400). Concierge delivery service to RDC Health Center will be provided by Walgreens located at 303 South Circle Dr. (Phone number: 719-444-8569). Sign-up for Express Pay: In order for Walgreens to deliver your prescription to the El Paso County Health Center (RDC or CSC), you must sign-up for Express Pay which allows payment for delivered prescriptions. There are two easy ways to enroll in Express Pay: 1) visit any Walgreens store and put a credit or debit card on file OR 2) register for Express Pay online at: http://www.walgreens.com/pharmacy/expresspay-info Request Concierge Service: Once you have signed up for Express Pay, you can request Concierge Prescription Delivery service by making a verbal request to your El Paso County Health Center medical provider for each El Paso County Health Center medical provider prescription (new or refill) that you would like to pick-up at the onsite health center. Please note if you have a refill prescription setup at another Walgreens (different from Service Options listed above), then you will need to contact Walgreens and request that the originating refill prescription be transferred to the designated Walgreens Pharmacy servicing El Paso County RDC or CSC Health Center. Same Day Delivery: Prescriptions submitted by El Paso County Health Center medical providers Mon-Fri by 12:00 pm to Walgreens will be eligible for same day pickup at the RDC or CSC Health Center between 2:30 pm-4:00 pm. Please note some exceptions may apply. Next Day Delivery: Prescriptions submitted by El Paso County Health Center medical providers Mon- Fri after 12:00 pm to Walgreens will be eligible for next day pickup at the RDC or CSC Health Center between 2:30 pm - 4:00 pm. Please note some exceptions may apply. Returns: Please note that any prescriptions not picked up by 4:00 pm each Friday will be returned to the Walgreens Pharmacy that delivered the prescription. ©2008 Walgreens Health Initiatives, Inc., a wholly owned subsidiary of Walgreen Co. All rights reserved. 2013 Employee Benefits Guidebook Updated January 2013
Page 1 and 2: EMPLOYEE BENEFITS Open Enrollment G
Page 3 and 4: PHONE DIRECTORY Employment, Benefit
Page 5 and 6: IMPORTANT INFORMATION SUMMARY OF BE
Page 7 and 8: EMPLOYEE CONTRIBUTIONS AND POP: The
Page 9 and 10: MEDICAL, VISION AND DENTAL PLAN PRE
Page 11 and 12: Questions regarding which protectio
Page 13 and 14: (including ER Physician services) M
Page 15 and 16: All subsequent prenatal visits, pos
Page 17 and 18: Note: The copayment will apply as l
Page 19 and 20: Pregnancy * Initial visit (to confi
Page 21 and 22: Wellness Exams The County Employee
Page 23: Walgreens Health Initiatives now Ca
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Page 29 and 30: Guardian DENTAL PLANS El Paso Count
Page 31 and 32: What is an FSA? FLEXIBLE SPENDING A
Page 33 and 34: You can only be reimbursed up to th
Page 35 and 36: VOLUNTARY TERM LIFE INSURANCE Volun
Page 37 and 38: DISABILITY BENEFITS SHORT TERM DISA
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2013 Employee Benefits Guidebook - Administration Home

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