As of September 1, 2009, if you are currently enrolled in your employer-sponsored health plan, your prescription drug list (PDL) will be updated.

WHAT THIS MEANS TO YOU AS AN EMPLOYEE?
A PDL is a list of FDA approved brand name and generic medications. It is important to understand your PDL in order to make the best medication choices and informed decisions for you and your family. Your pharmacy benefit provides coverage for a comprehensive selection of prescription medications.

These medications are categorized within three tiers. The following is a summary of these tiers.

Tier 1 – Your Lowest-Cost Option
This is your lowest co-payment option. For the lowest out-of-pocket expense, you should always consider Tier 1 medications if you and your doctor decide they are right for your treatment.

Tier 2 – Your Midrange-Cost Option
This is your middle co-payment option. Consider Tier 2 medications if you and your doctor decide that a Tier 2 medication is right for your treatment.

Tier 3 – Your Highest-Cost Option
This is your highest co-payment option. Sometimes there are alternatives available in Tier 1 or Tier 2 that may be appropriate to treat your condition. If you are currently taking a medication in Tier 3, ask your doctor whether there are Tier 1 or Tier 2 alternatives that may be right for your treatment. Compounded medications, medications with one or more ingredients that are prepared “on-site” by a pharmacist, are classified at the Tier 3 level.

Please note: Some plans have a two-tier pharmacy benefit rather than a three-tier pharmacy benefit. Generally, a two-tier closed pharmacy benefit plan does not cover medications classified in Tier 3 of this PDL. A two-tier open pharmacy benefit plan covers one tier at the lower co-payment and covers a second tier at a higher co-payment. In addition, some plans have a four-tier prescription plan.

WHAT SHOULD I DO NEXT?
Please check with your employer for your specific plan details and to determine which medications are covered under your individual plan. It is important to review the list as some prescription drugs may have changed tiers.

If you or a family member have questions about this notice please feel free to reach out to your BenefitsVIP team for assistance. As your employer’s broker, Corporate Synergies will continue to closely monitor this issue and will keep participants informed of any additional changes as they occur.