The ClearScriptSM Advantage

1. The ClearScriptSM Advantage City of Duluth December 10, 2009 Intro: Who are we?Intro: Who are we?

2. What is ClearScript? The pharmacy benefit manager for the City of Duluth The pharmacy insurance portion of the medical plan Offer comprehensive & flexible pharmacy benefit programs in association with NPS, a national pharmacy network & claims processor Programs include MTM & Specialty Drug Pharmacy As a corporation we�re� NPS offer over 61,000 pharmacies throughout the nation�and pharmacist Amanda Brummel will go into more detail on the MTM program.As a corporation we�re� NPS offer over 61,000 pharmacies throughout the nation�and pharmacist Amanda Brummel will go into more detail on the MTM program.

3. Our Goal: To reduce overall healthcare costs through proper medication management To have healthier, productive & satisfied members How do we do this????How do we do this????

4. 2010 ClearScript Pharmacy Benefits $0 Tier 1 Generics $15 Tier 2 Preferred Brand 30% co-insurance ($30 min/$100 max) Tier 3 Non-Preferred Brand Remember to check your current EOB�s to see what tier your medications are on. If it�s on Tier 3, check to see what the lower cost alternatives are.Remember to check your current EOB�s to see what tier your medications are on. If it�s on Tier 3, check to see what the lower cost alternatives are.

5. What are Generic medications? Identical to brand name medications but less expensive Same dosage form, strength, quality as brand name medications Same active ingredient Equally effective as brand name medications Safe � FDA approved Made by same pharmaceutical firms Typically cost significantly less than brand name medications Emphasize the use of generic medication� saving money for you �the retiree- and saving healthcare dollars for the city. Equally effective, same quality drug while saving you money! This is what ClearScript offers all our clients.Emphasize the use of generic medication� saving money for you �the retiree- and saving healthcare dollars for the city. Equally effective, same quality drug while saving you money! This is what ClearScript offers all our clients.

6. When you choose a generic that is equivalent to the brand name� Save money Not compromising on quality Remember four important colors for today: green, yellow, red & teal.Remember four important colors for today: green, yellow, red & teal.

7. Where to find Generics and Brand Name ClearScript/NPS Formulary Preferred copay structure Color-coded Similar to a stop light. Three colors.Similar to a stop light. Three colors.

8. ClearScript/NPS Formulary Tier 1 Generics (Green) Equally effective but less expensive Lowest copay Tier 2 Preferred Brand (Yellow) No generic equivalent but less expensive that Tier 3 Tier 3 Non-Preferred Brand (Red) Brand name medications with equally effective or less costly alternatives on Tier 1 or Tier 2 Highest copay ClearScript offers excellent alternatives in Tiers 1 & 2 in all classes of drugs Simple to understand�if you are taking a 3rd tier med, chances are you could be taking an equally effective drug that costs less.Simple to understand�if you are taking a 3rd tier med, chances are you could be taking an equally effective drug that costs less.

9. How much less?? Zocor � Cholesterol Lowering Agent Brand Name Drug (Red) Has equivalent generic drugs = $143/month OR Simvastatin Generic Brand (Green) Same active ingredient Equally effective = $9/month For example, Zocor. Popular cholesterol med, 3rd Tier, red. Look at cost. Same active ingredients. �but how do you know what right for you?For example, Zocor. Popular cholesterol med, 3rd Tier, red. Look at cost. Same active ingredients. �but how do you know what right for you?

10. Who decides what�s best for you? You, your physician and your pharmacist

11. Learn more about your options Check your 2009 Explanation of Benefit Summary Mailed twice a year in July for 1/1/09 � 6/30/09 in January with the 2010 ClearScript/NPS Formulary Take the formulary to your next doctor�s appointment It looks like this � hold up. Be an informed consumer.It looks like this � hold up. Be an informed consumer.

12. The EOB mailing is one of the many tools available to involve members in containing benefit costs. Education on generics and OTC alternatives Alerts employee to full cost of the benefit from the employer � not just the co-pay See where your health care dollars are going.See where your health care dollars are going.

13. Remember the 4th color: Teal. The ClearScript color. Look for envelopes with the teal ClearScript return address.Remember the 4th color: Teal. The ClearScript color. Look for envelopes with the teal ClearScript return address.

14. Learn More about Your Options Consult your pharmacist

15. Learn More About Your Options Go Online www.clearscript.org Claim History Pharmacy locator Preferred Drug Search Drug Information/Pricing We have copies in the backWe have copies in the back

16. Learn More About Your Options Call the Help Desk 800-546-5677 Number is on the front of your ClearScript ID card The nice thing about the Help Desk is�The nice thing about the Help Desk is�

17. Customer Service Toll Free: 800-546-5677 Provides alternative language services Alternate number available for hearing impaired Calls answered personally by representatives Hours: 24 x 7, 365 days a year So if you want to talk about sleep medications at 2AM�So if you want to talk about sleep medications at 2AM�

18. What�s new for 2010 New Prescription Copays for all tiers New ClearScript group number & ID card Step therapy for selected classes of drugs starting in February 2010 If you are diabetic, new blood glucose meters & test strips Other voluntary cost savings programs OTC programs Tablet Splitting

19. What�s staying the same Use the same pharmacies that you currently use

20. 2010 ClearScript Pharmacy Benefits $0 Tier 1 Generics (Green) Equally effective but less expensive Lowest copay $15 Tier 2 Preferred Brand (Yellow) No generic equivalent but less expensive that Tier 3 30% co-insurance ($30 min/$100 max) Tier 3 Non-Preferred Brand (Red) Brand name medications with equally effective or less costly alternatives on Tier 1 or Tier 2 Highest copay Remember to check your current EOB�s to see what tier your medications are on. If it�s on Tier 3, check to see what the lower cost alternatives are.Remember to check your current EOB�s to see what tier your medications are on. If it�s on Tier 3, check to see what the lower cost alternatives are.

21. Here�s what it look like. Present this new card to your pharmacist beginning New Year�s Day. Your old card won�t work.Here�s what it look like. Present this new card to your pharmacist beginning New Year�s Day. Your old card won�t work.

22. Look for this letter in the mail from ClearScript at the end of December. Your ID card is enclosed. CITY OF DULUTH - PLAN 1 JOHN SAMPLE Member ID # Member Name: BIN # 004758 PCN = NPS 123456789 ClearScript/NPS, a nationally recognized Pharmacy Benefits Management company (PBM), is the Pharmacy Benefits Manager for the City of Duluth. Attached, please find your new ID card for your prescription drug plan. Please take a moment to review your card for any errors or omissions. If you have any questions, please call the NPS Client Services Center at 800-546-5677. You will need to present your prescription drug card to a participating pharmacy at the time you order a new or remaining refill prescription. With the National Pharmaceutical Services (NPS) network, you can obtain your prescription at any of the more than 60,000 participating pharmacies located nationwide. The NPS network of pharmacies includes all major chains, as well as independent pharmacies. If you would like to locate the closest participating pharmacy, simply call NPS at (800) 546-5677 or log on to www.clearscript.org. We look forward to the opportunity to serve you and your family. If you have any questions or concerns, please do not hesitate to phone our Client Services Center at (800) 546-5677. Representatives are standing by to assist you 24 hours a day. Sincerely, � ClearScript/NPS Remember, it will have the ClearScript return addressRemember, it will have the ClearScript return address

23. Step Therapies for New Treatment Antidepressants/SSRI�s for depression/anxiety Nasal Steroids for allergies Non-steroid anti-inflammatories for arthritis Proton Pump Inhibitors (PPI�s) for heartburn Sedative/Hypnotics for insomnia Begins 2/1/09 Begins 2/1/09Begins 2/1/09

24. If you are diabetic� New blood glucose monitors & test strips for 2010 Abbott Diabetes Care � FreeStyle Lite�, FreeStyle Freedom Lite�Precision Xtra� Diabetes Meter and Test Strips. You will receive a letter from ClearScript/NPS this week with the details

25. Other Voluntary Cost Saving Programs OTC Prilosec PPI�s for Heartburn relief: try OTC Prilosec $0 copay If you currently take Prevacid, Protonix, Aciphex, Kapidex, Prilosec Zegerid or Nexium, you will receive a letter in the next few months Ask your MD about OTC Prilosec Your MD must write a new Rx for OTC Prilosec to get $0 copay

26. Other Voluntary Cost Saving Programs OTC OTC Claritin (Loratadine & Cetirizine-D) Non-sedating antihistamines for allergy relief $0 copay If you currently Clarinex, Zyrtec, Allegra, Allegra-D Ask your MD about OTC Claritin (Loratadine & Cetirizine-D) Your MD must write a new Rx for OTC Prilosec to get $0 copay

27. Other Voluntary Cost Saving Programs Tablet Splitting For Lipitor Instead of one tablet daily, take a half-tablet daily at � the copay Have your MD write a new Rx to double the strength with directions to take � tablet daily If you take Lipitor, you will receive a letter in the next few months Get a free tablet splitter from Human Resources

28. Conclusion: Generics - Identical to brand name medications but less expensive ClearScript offers excellent alternatives in Tiers 1 & 2 in all classes of drugs Questions? See ClearScript representatives at the back table There is an additional program offered to retirees who are diabetic or take several medications. It�s the MTM program. Amanda B is going to tell you more about that�There is an additional program offered to retirees who are diabetic or take several medications. It�s the MTM program. Amanda B is going to tell you more about that�