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International Union of Operating Engineers: Local 399
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2018 Summary of Benefits Coverage (SBC)

H&W Participating Members – The 2018 SBC document is now available!

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Prescription Benefits



International Union of Operating Engineers Local 399
Health & Welfare Fund

Summary of Prescription Drug Benefit

Effective February 1, 2015


           Pharmacy Benefit
  Deductible   None
  Plan Pays at the Retail
  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







  Cosmetic or weight loss

Fertility, i.e., Clomid

Impotency, i.e., Viagra


Smoking cessation

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




How to Use Your Prescription Drug Benefit


             Retail:  Present your prescription and your CAREMARK ID card at any pharmacy
in the CAREMARK 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 Caremark's 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 CVS caremark mail service order form below:



CVS Mail Order Form.jpg

Click form image to view/download


For additional information,click here to view/download a copy of our
2015 Summary Plan Description Book