2024 Prevea360 Large Group Plan Book_LG_SP

Preventive drug list† Now more medications are covered at $0 for large group members which helps you manage drug costs. New drugs added to the Preventive Drug List include: • Preferred mental health medications • Preferred brand diabetes medications • Preferred Insulin • Preferred inhalers and nebulizer solutions To see the most up-to-date list of $0 preventive drugs, visit Prevea360.com/PharmacyBenefits or review the Member Document Center on Prevea360.com . $0 Preferred diabetic supplies ** Cost should not be a barrier to controlling your diabetes. That’s why all formularies include preferred diabetic supplies such as syringes, lancets, and pen needles at $0 for large and small group members. This way you can focus on staying healthy, not the cost of getting there.

$35 cost-sharing cap on preferred insulin††

Lower costs on the diabetic medication you need. Access your formulary for the most up-to-date listing of insulins.

† B enefits are available only for large group (51+ employees) plans. †† B enefit available for ACA-compliant small group plans. All ACA-compliant small group members, including High Deductible Health Plans (HDHP), will not pay more than $35 a month for preferred insulin. * Members with tier 1 or tier 2 pharmacy benefits with coinsurance will still be charged the full coinsurance amount. ** B enefit is available for both large group (51+ employees) plans and ACA-compliant small group (2 - 50 employees) plans.

Visit Prevea360.com or call 1 (877) 230-7555 (TTY: 711 ) | 13

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