Hawaii EmployerUnion Health Benefits Trust Fund Retiree Open Enrollment Sessions

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Hawaii Employer-Union Health Benefits Trust
FundRetiree Open Enrollment Sessions

• EUTFs PPO
• Prescription Drug Plan
• Administered by
• InformedRx

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EUTF Medicare Prescription Drug Plan (Employer
PDP)
Medicare-Eligible Retirees

• November 2009

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informedRx

• Formerly known as National Medical Health Card or
  NMHC
• Acquired by SXC Health Solutions Inc. renamed
  informedRx
• informedRx, pharmacy benefits administrator
• EUTF determines benefits informedRx administers
  benefits on their behalf
• informedMail (formally known as NMHC Mail), mail
  order pharmacy
• Ascend SpecialtyRx, specialty mail order pharmacy

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EUTF and Medicare Part D

• The EUTF is a Medicare Prescription Drug plan
• If you are eligible for Medicare, you do not need
  to enroll in another Medicare Part D plan
• Other Medicare Part D Plans may contact you and
  ask you to enroll with them
• Enrolling in another Medicare Part D Plan will
  terminate your EUTF Medicare Prescription Drug
  Plan
• No Deductible or Coverage Gap
• Benefits all year

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Co-Payments
Coverage is limited to certain situations see
Evidence of Coverage for details. Penalty
amounts may vary depending on the pharmacy's
charges. In addition to the co-pay noted in the
table, you will also be responsible for a penalty
charge that includes the difference in the
participating network cost and the amount the
pharmacy charged.
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Plan Questions and Information

• Oahu
• 201 Merchant Street, Suite 1510, Honolulu
• Monday Friday 800 a.m. 430 p.m.
• Customer Care Center
• 1-866-533-6977 TTY callers use 1-866-443-1094
• Toll-free / 24 hours a day / 7 days a week
• Online
• http//www.eutf.hawaii.gov
• informedRx (formerly NMHC) on the Link to
  Carriers Web Sites
• http//www.myinformedrx.com

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Medicare

• 1-800-MEDICARE, or 1-800-633-4227
• TTY users call 1-877-486-2048
• http//www.medicare.gov

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EUTF PPO Prescription Drug PlanFor Non-Medicare
Eligible Retirees
Non-Medicare Eligible Retiree

• November 2009

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Co-Payments For Non-Medicare Retirees Only
This table does not apply to those drugs that
are subject to the Reference-Based Pricing
Program effective 1/1/10. Penalty amounts may
vary depending on the pharmacy's charges. In
addition to the co-pay noted in the table, you
will also be responsible for a penalty charge
that includes the difference in the participating
network cost and the amount the pharmacy charged.
All Tier 4 (Specialty Drugs) have a 250
co-payment maximum per fill and a 2,000
out-of-pocket maximum per plan year.
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2009 Program HighlightsFor Non-Medicare Retirees
Only

• Mandatory Mail Order Program
• Maintenance medications are drugs used to treat
  ongoing chronic conditions such as high blood
  pressure, diabetes, heart disease, allergies, or
  thyroid conditions
• You can still go to your local retail pharmacy
  for all maintenance non-specialty medications
  that require refrigeration
• You can still go to your local retail pharmacy
  for all non-maintenance medications (i.e., pain
  medication, antibiotics, cough medicine, etc.)

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2009 Program HighlightsFor Non-Medicare Retirees
Only

• Reference-Based Pricing Program
• Program impacts three (3) categories or classes
  Online
• Cholesterol lowering medications (Statins)
• Anti-heartburn/ulcer medications (Proton Pump
  Inhibitors or PPIs)
• Allergy medications (Low or Non-Sedating
  Antihistamines)

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2009 Program HighlightsFor Non-Medicare Retirees
Only

• A Preferred Drug is identified in each class of
  medication
• Participants that take the Preferred Drug will
  continue to receive the generic co-payment
• Participants that take a Non-Preferred Drug will
  pay for any cost of the medication above the
  Preferred Drug

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2009 Program HighlightsFor Non-Medicare Retirees
Only

• Example
• Generic simvastatin is the referenced drug for
  the class of cholesterol medication or statins

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Plan Questions and Information

• Oahu
• 201 Merchant Street, Suite 1510, Honolulu
• Monday Friday 800 a.m. 430 p.m.
• Customer Care Center
• 1-866-533-6977 TTY callers use 1-866-443-1094
• Toll-free / 24 hours a day / 7 days a week
• Online
• http//www.eutf.hawaii.gov
• informedRx (formerly NMHC) on the Link to
  Carriers Web Sites
• http//www.myinformedrx.com
• Download the Evidence of Coverage, Program
  information

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• Thank you for your time!

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