(For Eligible Employees and Dependents)

The Fund provides prescription drug benefits for you and your dependents for drugs and/or medicines that are prescribed by your physician. The Fund will pay the cost of the prescription, less any co-payment after you have paid your deductible. The co-payments and deductible are listed in the Schedule of Benefits in Section 3.

Retail Pharmacy Network
Mail Order Prescription Drug Service
Prescription Drug Exclusions and Limitations

The prescription drug program provides coverage for both acute medications (immediate treatment) and maintenance medications (long term treatment).

14.1 Retail Pharmacy Network

The retail pharmacy network is offered through Caremark Prescription Service. Acute medications should be filled at a participating network pharmacy. To find out whether a particular pharmacy is a participating network pharmacy, call a Caremark customer service representative at
1-800-776-1465 or visit the website at www.caremark.com.

Acute medications are usually prescribed to treat acute conditions of a short-term or temporary nature, such as an infection or the flu. To fill this type of prescription simply:

1. Obtain a newly written prescription for each acute medication,
   
   
2. Take the prescription to a participating Caremark network pharmacy,
   
   
3. Identify yourself as an eligible Local 73 Welfare Fund Participant (for instance, by showing your prescription drug plan Caremark I.D. card), and
   
   
4. Pay the required co-payment and any deductible as shown in the Schedule of Benefits and you will then receive the prescription drug with no additional paperwork or charge.
   

Acute medications are limited to a 34-day supply.

If you fill your prescription at a non-participating network pharmacy, you will be required to pay for the entire cost of the medication up front. You must then complete a Caremark Claim Form and submit the original prescription receipt to the Caremark Claims Department for reimbursement at the negotiated pharmacy rate less the appropriate co-payment. You may obtain a Caremark Claim Form by contacting Caremark at 1-800-776-1465, visiting their website at www.caremark.com or calling the Fund Office.

14.2 Mail Order Prescription Drug Service

The mail order prescription drug service is administered by Caremark. If your physician has prescribed a maintenance medication (long term treatment), you should have your prescription filled by the mail order program. To fill a maintenance prescription through Caremark, simply:

1. Obtain a new written prescription for each covered medication. Caremark can only dispense the amount of medication your physician has prescribed up to a 90-day supply. Show your physician the material attached to the prescription drug benefit brochure to help your physician write a prescription for this program.
   
   
2. Complete the Mail Service Order Form/Patient Profile.
   
   
3. Mail the written prescription, the profile, the order form and your co-payment to Caremark in the pre-addressed envelope. The co-payment for each prescription order is shown in the Schedule of Benefits in Section 3. If you need assistance determining the co-payment amount, call Caremark at 1-800-776-1465 or visit their website at www.caremark.com.
   

You will receive refill labels (if refills remain) and a new order form in your prescription package. To obtain a refill order, simply affix the refill label to the back of the order form and send it to Caremark. If you have no refills remaining or if your prescription has expired, contact your physician for a new written prescription to send to Caremark.

If you have a question about your prescription, call Caremark at 1-800-776-1465. Customer Service Representatives will be available to answer questions weekdays from 7:30 a.m. - 9:00 p.m. and Saturdays from 8:00 a.m. - 12:00 p.m. Central Standard Time.

14.3 Prescription Drug Exclusions and Limitations

Benefits are not payable under this Prescription Drug Benefit for:

1. Medicines or drugs obtainable without a physician’s prescription, except insulin,
   
   
2. All forms of contraceptives, including medicines and devices,
   
   
3. Medications used for cosmetic purposes, including Vitamin A derivatives (retinoids) for dermatological use (i.e. Retin A, Renova),
   
   
4. Vitamins and nutritional supplements,
   
   
5. Smoking deterrents (except as provided under the Wellness Benefit),
   
   
6. Fertility drugs (except as provided under the Infertility Benefit),
   
   
7. Viagra and other erectile dysfunction drugs,
   
   
8. Anabolic steroids
   
   
9. Antiviral drugs used for influenza (flu) treatment or prevention,
   
   
10. Weight control or drugs or anorexiants, except those used for treatment of children with attention deficit disorder (ADD) or individuals with narcolepsy.
    
    
11. Serum allergy antigen solutions.