Products & Services

Prescription Benefits

TML IEBP offers Prescription coverage through its partnership with CVS/Caremark Inc. CVS/Caremark is one of the largest pharmaceutical services companies in the United States and one of the nation's leading prescription benefits managers (PBM). More than 20 million plan participants each year receive over 90 million prescriptions through CVS/Caremark, and more than 1,200 plan sponsors-corporations, insurance companies, managed care organizations, government entities, and unions-rely on Caremark to design and fulfill their prescription drug benefit plans. Caremark operates one of the nation's largest pharmacy networks with more than 55,000 participating pharmacies in all 50 states and nearly every city in the U.S. In addition, Caremark maintains four state-of-the art mail service pharmacies across the county.

MAC A
The MAC A Prescription benefit Plan only allows up to the generic Maximum Allowable Cost (MAC) for multi-source drugs on the Caremark MAC list. If a brand name drug is dispensed and a generic equivalent drug exists, the Covered Person pays the difference between the brand name and generic price in addition to the appropriate copayment for the brand name. The cost difference between the brand name and generic price does not apply to any individual deductibles or out of pocket amounts. The MAC differential applies to all prescriptions purchased through this program when a generic equivalent is available.

MAC C
The MAC C Prescription benefit Plan does not penalize covered individuals for choosing a brand name drug when a generic equivalent is available. Covered Individuals pay the appropriate copay for the prescription with no additional charges.

Copay Plan
On a Copay Prescription Plan, Covered Individuals pay either a generic or brand name copay for prescription drugs.

Tiered Copay Plan
The Tiered Copay plan has 3 separate copays for generic, brand and preferred drugs. The "preferred drug" copay applies to drugs listed on the Caremark Preferred Drug list. The preferred copay amount is typically more than the generic copay but less than the brand copay.

Core Plan
Core Prescription Plans pay pay 70% of eligible prescription expesnes. The Covered Individual pays 30% of eligible prescription expenses until the annual out of pocket prescription maximum of $2,000 is met.

Pass Through Plan
The Pass Through Prescription benefit plan is integrated with the covered individual's medical plan. Eligible prescription expenses go towards the covered individual's prescription deductible of $100, and a benefit percentage of 80% is applied.

Maintenance Dispensing Program
The Maintenance Dispensing Program allows Covered Individuals on certain maintenance medications to access up to a 90 day supply of medication at a discounted copay amount.

Mail Order
The Mail Order Prescription plan works in conjunction with the covered individual's prescription benefit plan and provides access to a 90-day supply of medication.

SpecialtyRx
The SpecialtyRx program provides covered individuals with a cost-effective method for purchasing injectable drugs. Covered individuals taking drugs on the SpecialtyRx list may purchase these drugs from the Caremark SpecialtyRx program instead of their provider. The injectable drugs are usually shipped to the provider for dispensement.

Performance Drug
The Caremark Performance Drug List contains preferred brand and generic drugs that help physicians identify products that help maximize clinical results and economic value. Purchasing drugs from the performance drug list can help reduce plan costs.