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Dear Members,

Please see changes to your Health Benefit Plan that will take affect on October 1, 2010.

Important changes to Prescription Drugs:

There is now an annual deductible for Brand Name Drug Prescriptions of $150.00 per person per year (This is new. We have never had this before)
After 3 months of having the same name prescription filled at a retail pharmacy, you will not be able to get them at the pharmacy.
Get on - going prescriptions through mail order. Start that process now.

Through mail order, you get a 3- month supply of your prescription for the price listed below.

Formulary drug = The drug is listed on Blue Shield plan

Non - Formulary drug = The drug is not listed on Blue Shield Plan = they will suggest a formulary drug equivalent for you try. If it does not work, you will pay a higher deductible (see below).

Additionally, there are HMO office visit co-pay increases and PPO annual out of pocket maximum increases.

GTA realizes that the prescription drug changes will cause you some time to convert to mail order but understand this saved 1.7 million in Health Benefit renewal costs from a 17.9% renewal rate to 11.1%. This is money that does not have to then been saved through a CAP or other salary deductions.

Please be assured that you will be able to get the same prescriptions as before these changes. The formulary has not been changed.

Help us to keep our renewal rates lower by visiting your doctor's office instead of the ER or Urgent Care.

The lower the renewal rate, the less plan design changes we have to make. The District will be sending out open enrollment materials to your home this summer break. Keep your eye out for them if you want to change your plan type. If you have not received them by August 15 and want to change your plan type (from PPO to HMO or from 2-Pary to Family), contact the district.

Plan Provision	Current Benefit Level	Change effective 10/1/10 HMO
Plan Provision	Current Benefit Level	Change effective 10/1/10 HMO
HMO
Office visit co-pay	$15	$20
Chiropractic	$15	$20
Acupuncture co-pay	$15
Prescription Drugs Retail Prescriptions Generic Drugs Brand name		$10
Deductible per year	None	$150.00 per person per year
Formulary Brand Drugs	$15	$30
Non-Formulary Brand Drugs	$30	$35
Self - Injectibles		*Drugs are covered at retail pharmacies for the first 3 scripts for that drug, after that the drug is only available through mail (will reject at retail).
Mail Prescriptions (up to a 90 day supply)	$5
Generic Drugs		$10
Brand name		$150.00 (combined mail and
deductible per year	$30	$40
Formulary Brand		$70
Drug Non-formulary Brand Drug
PPO
PPO Network out of pocket maximum	$1,000.00 single ($2,000.00 family)	$1,500.00 single ($3,000.00 family
PPO Out of Network out of pocket maximum	$3,000.00 single (6,000.00 family)	$4,5000 single (9,000.00 family)
Prescription Drugs Retail Prescriptions Generic Drugs Brand name
Deductible per year	$5	$5
Formulary Brand	None	$150.00 per person per year

Plan Provision

Current Benefit Level

Change effective 10/1/10 HMO

Mail Prescriptions (up to a 90 day supply)

PPO

Mail Prescriptions
(up to a 90 day supply)