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HD Protection Plus
Level 1
$5 Generic Benefit / $15 Brand Name Benefit / $300 Calendar Year Maximum
Level 2
$10 Generic Benefit / $25 Brand Name Benefit / $500 Calendar Year Maximum
Level 3
$10 Generic Benefit / $25 Brand Name Benefit / $600 Calendar Year Maximum
Level 4
$10 Generic Benefit / $25 Brand Name Benefit / $700 Calendar Year Maximum
Level 5
$10 Generic Benefit / $25 Brand Name Benefit / $800 Calendar Year Maximum
Level 6
$10 Generic Benefit / $25 Brand Name Benefit / $900 Calendar Year Maximum
Level 7
$10 Generic Benefit / $25 Brand Name Benefit / $1,000 Calendar Year Maximum
4-Tier Prescription Discount Program
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4-Tier Prescription Discount Program
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4-Tier Prescription Discount Program
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4-Tier Prescription Discount Program
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May 16, 2018
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June 26, 2018
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