Pharmacy Benefit Summary

Standard Option Rx Benefits For 2010

No deductible applies.

† Specialty drugs are used to treat chronic, complex conditions and typically require special handling and close monitoring.

Standard Option Rx Benefits

Topic	You Pay
Topic	Generic (Network Provider)	Preferred Brands (Network Provider)	Non-Preferred Brands (Network Provider)	Specialty Drugs†	All Covered Brands (Non-Network Provider)
Up to a 30-day supply from a network pharmacy	$10 copay	$40 copay	$50 copay	$100 copay	50%
Up to a 90-day supply through mail order	$15 copay	$65 copay	$90 copay	$300 copay	Not covered

Value Plan Rx Benefits For 2010

No deductible applies.

Value Plan Rx Benefits

Topic	You Pay
Topic	Generic (Network Provider)	Non-Generic (Network Provider)	All Covered Rx (Non-Network Provider)
Up to a 30-day supply from a network pharmacy	$10 copay	50%	Not covered
Up to a 90-day supply through mail order	$30 copay	50%	Not covered

Consumer Option Rx Benefits For 2010

Annual deductible applies and it covers both medical services and prescription drugs.

Consumer Option Rx Benefits

Topic	You Pay
Topic	Generic (Network Provider)	Preferred Brands (Network Provider)	Non-Preferred Brands (Network Provider)	Non-Network Provider
Annual Deductible	$2,000 per person $4,000 per family	$2,000 per person $4,000 per family	$2,000 per person $4,000 per family	$2,000 per person $4,000 per family
Up to a 30-day supply from a network pharmacy	$10 copay	$25 copay	$40 copay	Not covered
Up to a 90-day supply through mail order	$20 copay	$50 copay	$80 copay	Not covered