Page 18 - Ches User's Guide 2018 v1.4
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Prescription Drug Plan

               a key part of the financial protection you have at Chesapeake is access to quality
               medications when the need arises for you or members of your family. The company

               offers comprehensive and economical access to prescriptions through our
               partnership with CVs/caremark.

               The benefits and amounts you will pay for medications will depend on which health
               plan option you choose and whether you fill prescriptions through a retail outlet or by
               mail order. The chart describes how much you will pay for prescription drugs under

               each plan and purchase option.

                Plan       Retail 30-day                                Mail ORdeR – 90-day
                HiP        Generic, Preferred Brand and Non-Preferred Brand:
                           non-Preventive drugs — employee pays 100% if deductible has not been met. after deductible has been met, plan
                           pays 70%, you pay 30%.
                           Preventive drugs — employee pays 30%, plan pays 70%, deductible does not have to be met (visit BenefitsNow to
                           view the Preventive Drug List).
                80/60      Generic:                                                               $10 Generic:                                                                  $20
                           Preferred Brand:                                                  $40 Preferred Brand:                                                   $80
                           non-Preferred Brand:                                          $70 non-Preferred Brand:                                          $140

                16   2018 ToTal RewaRds Guide
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