Laserfiche WebLink
Section 3 - Proposed Benefits g <br />41 City of Sunny Isles <br />• <br />Pharmacy With POS, PPO and Indemnity plans <br />Network Yes; mail-order drug options also available <br />Out -of- Network Services Available at a higher copayment for some <br />plans <br />Copayment Yes <br />Deductibles Only for self - funded plans <br />Claim Forms `' Only for out -of- network benefits <br />Funding Options Self - funded, full -risk prospectively rated, <br />split- funded group plan <br />Features A A full service administrative fee that encompasses all standard account <br />management and member service functions. <br />A Drug utilization review to promote, safe appropriate drug use before, <br />during, and after drugs are dispensed. <br />A Formulary programs that encourage physicians to prescribe <br />therapeutically appropriate cost- effective medications. <br />A One pharmacy claim system for retail and mail order claims, which <br />lowers administrative costs while helping promote safe drug <br />dispensing. <br />A Plan designs that promote quality dispensing and cost savings, along <br />with member choice. <br />Quarterly Pharmacy Utilization Reports for self- insured plans that <br />identify drug utilization patterns, determine plan cost effectiveness, <br />and improve plan performance. <br />1 Savings from substantial retail network and mail order discounts <br />passed in full to self- insured plans and reflected in the premium for <br />insured plans. <br />A Simplified plan administration that provides the convenience and cost - <br />efficiencies of one -stop shopping for account management and <br />member services. <br />Visit our website: www.aetnaushc.com 11/17/2000 <br />