STAGE DEV MAY, 2013

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2017 Benefit Highlights

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Employer Group Plans Benefit Highlights

Rates

Employer Group Plans Rate - San Francisco County

Employer Group Plans Rate - Northern San Mateo County

Provider Directory

CCHP Provider Directory - Covered CA (English and Chinese)

CCHP Provider Directory - HMO (English and Chinese)

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Pharmacy Directory

CCHP Pharmacy Directory - Covered CA (English)

CCHP Pharmacy Directory (English)

Formulary

* There are four tiers in the drug formulary. Tiers include the types of drugs that are covered. Please refer to your Evidence of Coverage and Disclosure Form for details.

Tier Definition
1 1) Most generic drugs and low cost preferred brands.
2 1) Non-preferred generic drugs or;
2) Preferred brand name drugs or;
3) Recommended by the plan's pharmaceutical and therapeutics (P&T) committee based on drug safety, efficacy and cost.
3
 
1) Non-preferred brand name drugs or;
2) Recommended by P&T committee based on drug safety, efficacy and cost or;
3) Generally have a preferred and often less costly therapeutic alternative at a lower tier.
4

 

1) Food and Drug Administration (FDA) or drug manufacturer limits distribution to specialty pharmacies or;
2) Self administration requires training, clinical monitoring or;
3) Drug was manufactured using biotechnology or;
4) Plan cost (net of rebates) is >$600.

 

STAGE DEV MAY, 2013