Prescription Drug Reimbursement Pool Sample Clauses

Prescription Drug Reimbursement Pool. Beginning July 1, 2008 a prescription drug reimbursement pool totaling $15,000.00 shall be established. During the 2008-2009 school year, any prescription co-pay expense (according to MESSA plan guidelines, excluding over-the-counter medications) up to $20.00 per script shall be reimbursed by the board after any employee has documented $500.00 (July 1, 2008 to June 30, 2009) in prescription expenses. Total reimbursement through June 30, 2009 will not exceed $15,000.00 including other district employees in the MESSA $10/$20 Rx program. Any remaining funds in the reimbursement pool will be used to offset future increases in health care. All reimbursement requests must be signed by the employee and must have the receipt’s attached to the signed reimbursement form. Beginning July 1, 2009 a prescription drug reimbursement pool totaling $15,000.00 shall be established. During the 2009-2010 school year, any prescription co-pay expense (according to MESSA plan guidelines, excluding over-the-counter medications) up to $20.00 per script shall be reimbursed by the board after any employee has documented ($500.00 July 1, 2009 to June 30, 2010) in prescription expenses. Total reimbursement through June 30, 2010 will not exceed $15,000.00 including other district employees in the MESSA $10/$20 Rx program. Any remaining funds in the reimbursement pool will be used to offset future increases in health care. All reimbursement requests must be signed by the employee and must have the receipt’s attached to the signed reimbursement form. Any prescriptions that are reimbursed through Flexible Spending Account (FSA), a spouse’s health insurance policy or any other type of other reimbursement are not eligible for reimbursement through this pool.
Sample 1Sample 2
AutoNDA by SimpleDocs
Prescription Drug Reimbursement Pool. Beginning January 1, 2006, a prescription drug reimbursement pool totaling $50,000.00 shall be established. During the 2005-2006 school year, any prescription co-pay expense (according to plan guidelines) over $150.00 shall be reimbursed by the board. In 2006, 2007, any amount over $175.00 will be reimbursed; and in 2007-2008, any amount over $200.00 will be paid by the board. Total reimbursement for all three years will not exceed $75,000.00 including REA (see REA agreement, Insurance Provisions). Any remaining funds in the reimbursement pool will be used to offset future increases in health care.
Sample 1
Prescription Drug Reimbursement Pool. Beginning January 1, 2006, a prescription drug reimbursement pool totaling $50,000.00 shall be established. During the 2007-2008 school year, any amount over $200.00 will be paid by the board. During the 2008-2009 school year, and the duration of this agreement, any amount over $250.00 will be paid by the board.
Sample 1
Prescription Drug Reimbursement Pool. Beginning July 1, 2010 a prescription drug reimbursement pool totaling $15,000.00 shall be established. During the 2010-2011 school year, any prescription co-pay expense (according to MESSA plan guidelines, excluding over-the-counter medications) up to $20.00 per script shall be reimbursed by the board after any employee has documented $500.00 (July 1, 2010 to June 30, 2011) in prescription expenses. Total reimbursement through June 30, 2011 will not exceed $15,000.00 including other district employees in the MESSA $10/$20 Rx program. Any remaining funds in the reimbursement pool will be used to offset future increases in health care. All reimbursement requests must be signed by the employee and must have the receipt’s attached to the signed reimbursement form. Any prescriptions that are reimbursed through Flexible Spending Account (FSA), a spouse’s health insurance policy or any other type of other reimbursement are not eligible for reimbursement through this pool.
Sample 1
Prescription Drug Reimbursement Pool. Beginning July 1, 2008, a prescription drug reimbursement pool totaling $36,000 shall be established by the Board. During the 2008-09 school year, any prescription co-pay expense exceeding $225 shall be reimbursed by the Board; and in 2009-10 any amount exceeding $250 will be paid by the Board; and in 2010-11 any prescription co-pay expense exceeding $275 shall be reimbursed by the Board. The reimbursement pool is specifically designed for medication co-pays and not for ingredient cost associated with the selection of brand name drugs. Reimbursement totals for the duration of this agreement will not exceed $36,000. Any remaining funds will be used to offset future increases in health insurance cost. *Employees who select MESSA Super Care I shall pay the difference in premium between MESSA Choices II and MESSA Super Care I.
Sample 1

Related to Prescription Drug Reimbursement Pool

  • Prescription Drug Program 1. It is agreed that the State shall continue the Prescription Drug Benefit Program during the period of this Agreement. The program shall be funded and administered by the State. It shall provide benefits to all eligible unit employees and their eligible dependents. Each prescription required by competent medical authority for Federal legend drugs shall be paid for by the State from funds provided for the Program subject to a deductible provision which shall not exceed $5.00 per prescription or renewal of such prescription and further subject to specific procedural and administrative rules and regulations which are part of the Program.

  • Prescription Drug any drugs or medications ordered by a Professional Provider by means of a valid prescription order, bearing the Federal legend: “Caution - Federal law prohibits dispensing without a prescription,” or legend drugs under applicable state law and dispensed by a licensed pharmacist. Also included are prescribed insulin and other pharmacological agents used to control blood sugar, diabetic supplies and insulin syringes.

  • Prescription Drugs The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under Section

  • Prescription Drug Plan Effective July 1, 2011, retail and mail order prescription drug copays for bargaining unit employees shall be as follows: Type of Drug Prescriptions for 1-45 Days (1 copay) Prescriptions for 46-90 Days (2 copays) Generic drug $10 $20 Preferred brand name drug $25 $50 Non-preferred brand name drug $40 $80 Effective July 1, 2011, for each plan year the Prescription Drug annual out-of- pocket copay maximum shall be $1,000 for individual coverage and $1,500 for employee and spouse, employee and child, or employee and family coverage.

  • label Prescription Drugs This plan covers off label prescription drugs for cancer or disabling or life-threatening chronic disease if the prescription drug is recognized as a treatment for cancer or disabling or life-threatening chronic disease in accepted medical literature, in accordance with R.I. General Law § 27-55-1.

  • Prescription Drug Quantity Limits We limit the quantity of certain prescription drugs that you can get at one time for safety, cost-effectiveness and medical appropriateness reasons. Our clinical criteria for quantity limits are subject to our periodic review and modification. Quantity limits may restrict: • the amount of pills dispensed per thirty (30) day period; • the number of prescriptions ordered in a specified time period; or • the number of prescriptions ordered by a provider, or multiple providers. Our formulary indicates which prescription drugs have a quantity limit. Types of Pharmacies Prescription drugs and diabetic equipment or supplies can be bought from the following types of pharmacies: • Retail pharmacies. These dispense prescription drugs and diabetic equipment or supplies. • Mail order pharmacies. These dispense maintenance and non-maintenance prescription drugs and diabetic equipment or supplies. • Specialty pharmacies. These dispense specialty prescription drugs, defined as such on our formulary. For information about our network retail, mail order, and specialty pharmacies, visit our website or call our Customer Service Department.

  • Specialty Prescription Drugs (+ Prorated copayments for a shorter supply period may apply for network pharmacy only. See Prescription Drug section for details. When purchased at a Specialty Pharmacy (+): For maintenance and non-maintenance prescription drugs, a copayment applies for each 30-day period (or portion thereof) within the prescribeddosing period. Tier 5: $125 Not Covered When purchased at a Retail Pharmacy (+): For maintenance and non-maintenance prescription drugs, a copayment applies for each 30-day period (or portion thereof) within the prescribeddosing period. Specialty Prescription Drugs purchasedat a retail pharmacy will require a significantly higher out of pocket expense than if purchased from a Specialty Pharmacy. Our reimbursement is based on the pharmacy allowance. Tier 5: 50% Not Covered When purchased at a Mail Order Pharmacy: Not Covered Not Covered Covered Benefits Network Pharmacy Non-network Pharmacy (+) Preauthorization is required for thisservice. Please see Preauthorization in Section 3 for more information. You Pay You Pay Infertility Prescription Drugs - Three(3) in-vitro cycles will be covered per plan year with a total of eight (8) in-vitro cycles covered in a member’s lifetime. When purchased at a Specialty, Mail Order, or Retail Pharmacy Tier 1: 20% Not Covered Tier 2: 20% Not Covered Tier 3: 20% Not Covered Tier 4: 20% Not Covered When purchased at a Specialty Pharmacy (+) Tier 5: 20% Not Covered When purchased at a Retail Pharmacy (+): Specialty Prescription Drugs purchased at a retail pharmacy will require a significantly higher out of pocket expense than if purchased from a specialty pharmacy. Tier 5: 20% Not Covered Contraceptive Methods- Preventive Coverage includes barrier method (diaphragmor cervical cap), hormonal method (birth control pill), and emergency contraception. For non-preventive contraceptive prescription drugs and devices, the amount you pay will depend on the tier placement of the contraceptive prescription drug or device. See above for details. When purchased at a Retail Pharmacy: Up to a 365-day supply of contraceptive prescription drugs is available at all network retail pharmacies. For more information about this option, visit our website. Tier 1: $0 Not Covered When purchased at a Mail Order Pharmacy: Up to a 90-day supply. Tier 1: $0 Not Covered

  • Preferred Provider - Prescription Drugs The Board shall provide, through the Xxxxx County Council of Governments, a preferred provider drug program that, if the employee chooses to utilize, will include the following:

  • Designated Prescription Drug Prescribers and Pharmacies We may limit your selection of a pharmacy to a single pharmacy location and/or a single prescribing provider or practice. Those members subject to this designation include, but are not limited to, members that have a history of: • being prescribed prescription drugs by multiple providers; • having prescriptions drugs filled at multiple pharmacies; • being prescribed certain long acting opioids and other controlled substances, either in combination or separately, that suggests a need for monitoring due to: o quantities dispensed; o daily dosage range; or o the duration of therapy exceeds reasonable and established thresholds. The Amount You Pay for Prescription Drugs Our formulary includes a tiered copayment structure, which means the amount you pay for a prescription drug will vary by tier. See the Summary of Pharmacy Benefits for your copayment structure, benefit limits and the amount you pay. When you buy covered prescription drugs and diabetic equipment and supplies from a retail network pharmacy, you will be responsible for the copayment and deductible (if any) at the time of purchase. You will be responsible for paying the lower of your copayment, the retail cost of the drug, or the pharmacy allowance. Specialty prescription drugs are generally obtained from a specialty pharmacy. If you buy a specialty prescription drug from a retail network pharmacy, you will be responsible for a significantly higher out of pocket expense than if you bought the specialty drug from a specialty pharmacy. The amount you pay for the following prescription drugs is not subject to the tiered copayment structure: • Contraceptive methods; • Over-the-counter (OTC) preventive drugs; • Nicotine replacement therapy (NRT) and smoking cessation prescription drugs; • Infertility specialty prescription drugs; and • Covered diabetic equipment or supplies bought at a network pharmacy. See the Summary of Pharmacy Benefits for benefit limits and the amount you pay. This plan allows for medication synchronization in accordance with R.I. General Law

  • Random Drug Testing All employees covered by this Agreement shall be subject to random drug testing in accordance with Appendix D.

Time is Money Join Law Insider Premium to draft better contracts faster.