1Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Prescription Benefit Program Summary of benefits Additional features Customer service center Participating pharmacies

2Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Summary of Benefits

Retail Pharmacies○ Copay Plan Design

Non-Preferred Brands: $40Preferred Brands: $20Generics: $10

○ You can receive up to a 4 month supply of medication at a time but you will pay a copay for each month.

3Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Summary of Benefits

Mail Order Pharmacy○ Copay Plan Design

Non-Preferred Brands: $0Preferred Brands: $0Generics: $0

○ You will need to order at least a 3 month supply when ordering through mail order and can get up to 4 months.

4Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Summary of Benefits

Maintenance medications○ You should note that you will be able to get

non-maintenance medications at your local pharmacy. Maintenance medications can be filled ONCE locally, but after the initial fill you will be required to utilize mail order services. If you are taking a maintenance medication it is mandatory to utilize mail order services.

5Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Summary of Benefits What is a maintenance medication?

1. Anything taken on a “long term” basis, and2. Is on the NPS list of maintenance medications

Criteria for a Maintenance Medication1. The medication has a low probability for dosage or therapy

changes due to side effects, serum drug concentration monitoring, or therapeutic response over a course of prolonged therapy.

2. The medication’s most common use is to treat a chronic disease state. A drug may have an indication for maintenance therapy but lacks the maintenance drug code if that indication is its most common use.

3. Therapy with the medication is not considered curative or promoting of recovery.

4. The medication is administered continuously rather than intermittently or as needed.

6Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Summary of Benefits Maintenance medication drug class

examples:○ Cholesterol lowering drugs○ Diabetes medications○ Digestive aid medications○ Diuretics (water-pills)○ Estrogen therapies○ Heart medications○ High blood pressure medications○ Osteoporosis medications○ Potassium chloride supplements○ Prostrate medications○ Seizure medications○ Some multivitamins○ Thyroid dysfunction medications

7Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Prescription Benefit Program Summary of benefits Additional features Customer service center Participating pharmacies

8Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Additional Features Tablet splitting

○ Tablet splitting is the practice of splitting a higher dose of your medication in order to achieve the correct dose

○ As an example if you are currently taking a 20mg tablet, then a 40mg tablet could be prescribed and split in half to achieve the correct dose

○ Tablet splitting is a tremendous way to save money on your out of pocket expenses! Members who split their tablets will be rewarded by having their copay split in half!

○ As an example if your current copay is $40 and the medication you are taking falls under the tablet splitting program your copay will be $20

9Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Additional Features The following medications will be

available for the tablet splitting program:○ Aceon○ Lexapro○ Lipitor○ Norvasc / Amlodipine○ Pravachol / Pravastatin○ Toprol XL○ Zocor / Simvastatin○ Zoloft / Sertraline

10Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Additional Features

Over the counter (OTC) medications○ The plan will also offer coverage for Prilosec

OTC .○ Prilosec OTC will be covered at the generic

copayment.

11Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Prescription Benefit Program Summary of benefits Additional features Customer service center Participating pharmacies

12Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Customer Service Center The customer service center is located in

Omaha, NE Committed to guarantee high quality customer

service performance on an on–going basis. Toll free 800–546–5677 Translation services available Hearing impaired services available Call center hours of operation 24 hours a day, 7 days a week, 365 days a

year

13Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Prescription Benefit Program Summary of benefits Additional features Customer service center Participating pharmacies

14Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Participating Pharmacies

The NPS pharmacy network has over 63,500 pharmacies nationwide including all major chain and most independent pharmacies

○ You can locate a pharmacy by contacting the customer service center (800-546-5677) or via the NPS website at www.pti-nps.com.

15Prepared by: David Frazier & Associates, Inc.

(907) 561-9700

Participating Pharmacies

Integrated Home Mail Order (IHMO) Pharmacy

○ Located in Omaha, NE○ Pharmacists are available for consultation and

to answer questions○ Member can contact IHMO Pharmacy via

mail, phone (800-633-7928), fax, email or even via our website http://ihmo.pti-nps.com/

16Prepared by: David Frazier & Associates, Inc.

(907) 561-9700