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Prescription Drug Lists (PDLs) for Fully Insured Commercial Plans (non-exchange)

The PDL includes brand and generic medications separated into cost levels called tiers. When selecting a medication, review the PDL to see if there is a Tier 1 option (lowest cost) to treat your condition. If your medication is in Tier 2, 3 or 4 (highest cost), you may pay more. In addition we are providing a sample of a plan design offered in your market. This includes high level detail of all benefits provided, including prescription drugs.  

Small Group Plans

Fully Insured Health plans that have 2-50 employees

*groups up to 99 employees

Large Group Plans

Fully Insured Health plans that have 51 or more employees

Drug Lists

Summary of Benefits Coverage

Drug List

Summary of Benefits Coverage

Drug List

Summary of Benefits Coverage

Drug List

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