May 2005
Important Prescription Drug Plan Benefit Changes
Dear CSBA Member:
Effective July 1, 2005, psychotropic and asthma medications will no longer be available through the City's PICA program.
The trustees of the CSBA Welfare Fund have voted to pick up coverage of psychotropic and asthma medication through the CSBA Welfare Fund. In order to be able to offer this coverage, it will be necessary to impose an annual one hundred dollar ($100) deductible on prescriptions for all medications effective July 1, 2005. This deductible will apply to members, spouses and domestic partners.
The trustees voted to impose this deductible rather than eliminate prescription drug coverage. It should be noted that the Management Benefits Fund, as well as some other Union welfare funds, do not cover prescription drugs. If we took such a drastic step, members would have to pay for prescription drug riders out of every paycheck, whether or not they used prescription drugs. We have attached a breakdown of the rider costs of the various health plans effective July 2004. These rates are expected to rise substantially in July 2005. (Of course, one could decide not to purchase the rider, and pay the full cost of any prescriptions out-of-pocket.)
Accordingly, effective July 1, 2005, there will be an annual deductible of $100 per member, spouse/domestic partner. Children up to age 19 (or age 23 if full-time student) will be exempt from the deductible. Once each member, spouse or domestic partner has met his or her annual deductible for each fiscal year (July 1-June 30), out-of-pocket expenses for prescriptions will be the CSBA co-payments as detailed below. One should present his or her Express Scripts card to the pharmacy in order to track usage under the deductible amount.
(Psychotropic and asthma medications will be administered the way they were under the PICA program, i.e. via clinical step therapy.)
- $5 for generic medications;
- $15 for preferred brand name (formulary) medication (regardless of generic availability; and
- $50 for non-preferred brand name ( non-formulary) medications
- $10 for generic medications;
- $30 for preferred brand name (formulary) medications (regardless of generic availability); and
- $100 for non-preferred brand name (non-formulary) medications.
| Gloria Johnson Chairperson |
Abbot Gorin Administrator |
