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International Union of Operating Engineers: Local 399
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Prescription Benefits


 

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International Union of Operating Engineers Local 399
Health & Welfare Fund

Summary of Prescription Drug Benefit


Effective January 1, 2019


 

           Pharmacy Benefit
Manager
    OPTUM RX
       
  Deductible   None
 
 
   
  Plan Pays at the Retail
Pharmacy
  70% generic;   60% brand name
50% after 3rd retail fill of same drug
 
 
   
  Plan Pays at Mail Order
or CVS Pharmacy
      70% generic and brand name
for 90-day supply
 
 
   
 

Excluded Prescription Drug
Catagories

 

 

 

 

 

 

  Cosmetic or weight loss

Fertility, i.e., Clomid

Impotency, i.e., Viagra

Vitamins

Smoking cessation

Experimental or not approved by
FDA
 
 
   
  Plan Exclusion   Prescriptions filled at Wal-Mart &
Sam's Club


 

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How to Use Your Prescription Drug Benefit

 

            

Retail:  Present your prescription and your OptumRX ID card at any pharmacy
in the OptumRX network (most major chains are included).  You will be asked 
to pay your 30% or 50% coinsurance.

Maintenance Drugs:  Long-term medications can be filled for 90-day supplies at
any CVS pharmacy or through the OptumRX mail order program.  90-day supplies
are covered at 70% and typically cost the amount of two 30-day fills.

Prescription mail order forms are available at the Fund Office or view download
the OptumRX mail service order form below:


 

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Click form image to view/download

 



For additional information, click here to view/download a copy of our
2019 Summary Plan Description Book