Page 44 - Rx Drug Plan review for John

11/14/21, 9:56 AM MSRG_II

PHYSICIANS LIFE INSURANCE COMPANY - (800) Methodology: AA
325-6300

0 $1,741 - - - $2,175 - $1,894 - - - - $1,569

Restrictions Effective Date: 08/27/2021
STATE FARM MUTUAL AUTOMOBILE Methodology: AA
INSURANCE COMPANY - Contact Local State
Farm Agent

0 $1,309 - $2,397 $1,706 $2,420 - $1,710 - - - - $1,303
Restrictions Effective Date: 01/01/2021

TRANSAMERICA LIFE INSURANCE COMPANY - Methodology: IA
1-800-797-2643

180 - - - - - - $2,120 - - - - -

Restrictions Effective Date: 02/01/2020
TRANSAMERICA LIFE INSURANCE COMPANY - Methodology: IA
1-800-797-2643
180 $1,467 - $2,291 - $2,304 - - - - $1,365 - $1,581

Restrictions Effective Date: 05/01/2020
UNITED AMERICAN INSURANCE COMPANY - 1- Methodology: AA
800-755-2137

0 $1,524 $1,926 $2,494 $2,222 $2,548 $438 $2,069 $438 $1,322 $1,874 - $1,662
Restrictions Effective Date: 04/15/2021

UNITED WORLD LIFE INSURANCE COMPANY - Methodology: AA
(800) 667-2937

0 $1,864 - - - $2,588 - $2,046 $719 - - - $1,703
Restrictions Effective Date: 05/25/2021

USAA LIFE INSURANCE COMPANY - (800) 531- Methodology: AA
8000

0 $1,528 - - - $2,366 - $1,630 - - - - $1,632

Restrictions Effective Date: 07/01/2021

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