TML IEBP's Pharmacy Benefit Manager is CVS/Caremark. CVS/Caremark is one of the nation's largest pharmacy benefit managers that create the opportunity to deliver unique prescription benefits and services to ease prescription access and manage costs effectively.

Coverage for eligible prescriptions will be paid per the prescription schedule of benefits and will not be eligible under the medical plan. Ineligible benefit plan prescriptions may receive the Pharmacy Benefit Manager's discount, reducing the covered individual's out of pocket expenses.

Eligible SpecialtyRx/Biotech prescriptions may be adjudicated under the Pharmacy Benefit Manager and/or the Medical Plan for Network Providers.

For prescriptions purchased outside of the Pharmacy Benefit Manager, Specialty Pharmacy Benefit Manager or the Network Providers, the plan will pay at the out of network benefit percentage and will not, at any time, pay at 100%.

Prescription Card Program
A multitude of prescription plan options are available for the employer. Some of the options include: brand/generic copay plan, three-tiered brand, generic, formulary copay plan, benefit percentage plans, chronic disease value tiered copay plans and a generic value tiered network incentive plan. The Integrated Mail Service Program offers Covered Individuals the convenience of home delivery of a three-month maintenance prescription. Covered Individuals may reorder their mail service prescriptions through the TML IEBP website pharmacy link, by mail or by calling the toll free number.

Generics Prescriptions Could be a Viable Savings Opportunity!
With healthcare costs continuing to rise, generic medicine might by an easy and effective way to minimize out of pocket expenses.

1. Generic medications are reviewed by the US Food and Drug Administration (FDA) for safety and efficacy and are manufactured under the strict standards that apply to brand-name drugs.
2. Generic medications create competition, which assists in keeping the costs of prescriptions competitive.
3. Research shows that plan participants can save an average of 30% to 80% when they fill their prescriptions with a generic instead of a brand-name medication.

CVS/Caremark Value Tiered Network Incentive Plan
Copayments do not apply to any individual deductibles or out of pocket amounts.

• CVS Preferred Store Dispensement
      Generic Retail 34 day dispensement        -0-
      Generic Retail 90 day dispensement        $9.00 per prescription
  

• Caremark: www.caremark.com
  The homepage of Caremark allows you to search for pharmacies and refill prescriptions online.
• To take a Site Tour of the Caremark website, please click this link: http://www2.caremark.com/sitetour/.
• CVS retail pharmacy customers can now import their prescription and medication records into their Google Health PHR accounts. Sign up for the feature on the retail pharmacy network's Web site (www.cvs.com).
• Caremark SpecialtyRx
  • Specialty Rx List -- effective October 1, 2008
  • Caremark Specialty Rx Referral Form
  • A form Providers use to refer patients to the Specialty Rx program

SpecialtyRx/Biotech Prescriptions
TML IEBP offers a Pharmacy Benefit Manager SpecialtyRx service. This service provides a convenient and cost-effective way to order injectable drugs and supplies through Pharmacy Benefit Manager SpecialtyRx. The Specialty/Biotech copay for a 34 day Mail Service Prescription is $100.00.

To see a list of Specialty/Biotech drugs available through the Pharmacy Benefit Manager, please log in to the myTML IEBP web portal and click the "Prescription Benefits" link. SpecialtyRx is the most cost-effective way to purchase medications for Covered Individuals with chronic illnesses requiring life-sustaining medications. SpecialtyRx provides covered individuals with a cost-effective benefit to purchase specialty prescriptions. With SpecialtyRx, the covered individual will receive easy ordering and fast delivery from the Pharmacy Benefit Manager. In addition, the covered individual will receive an informative care management packet. The SpecialtyRx prescription may be delivered to the physician's or covered individual's address.

The SpecialtyRx plan provides many benefits to Covered Individuals:

• Single reliable source for injectable specialty prescriptions
• Easy ordering with toll-free number (866) 295-2779, 9:00 a.m. - 8:00 p.m. EST
• Express delivery to location of your choice ~ either to the covered individual's home or provider's office (Some providers have expressed a strong opinion for the prescription to be delivered to their offices if they are required to administer the prescription.)

Mail Service Prescription Option
Spend Less on Your Prescriptions!
TML Intergovernmental Employee Benefits Pool wants to remind you and your covered dependents about an important part of your benefit plan - the CVS/Caremark Mail Service Program. Take advantage of the Caremark Mail Service prescription benefit and you may save time and money on the medications you take each month. Enjoy the convenience and potential savings on the prescriptions you take each month, including injectable medications. Getting your prescription from the mail service pharmacy is simple with FastStart. Easy as 1-2-3!

1. Call FastStart toll free:
   Members - 1-800-875-0867
   Hearing Impaired - 1-800-231-4403
   Doctors - 1-800-378-5697
2. Let the FastStart representative know you wish to fill your prescription order through mail service.
3. Provide the information on your benefit ID card, the names of the long-term medications you take, your doctor's name and phone number, and your mailing address.

FastStart is quick and convenient, saving you a trip to the doctor's office for a new prescription. This service is available for the first-time orders only.

CVS/Caremark has made several recent enhancements to the technology and processes to help provide faster turnaround time and improve accuracy.

Enhanced Mail Service Processes include:

1. Personalized CVS/Caremark mailing address on the Mail Service Order Form included with each order. CVS/Caremark print the address of the mail service facility that can help provide a shorter wait time for covered individuals' prescription orders.
2. More accurate and efficient paperless environment in the mail service pharmacies has been achieved. Upon receipt of a prescription order, the contents of the envelope are scanned, creating an image of all documents enclosed. These images are then electronically sent to the appropriate pharmacy for processing.
3. Upgraded automated dispensing equipment in the mail service pharmacies to reflect state-of-the-art quality and efficiency of output, thus helping to reduce turnaround time in the pharmacy to a minimum.

This means faster and more accurate prescription dispensing and delivery to the participant. CVS/Caremark are extremely proud to be an innovator and a leader in this evolution in mail service pharmacy operations and look forward to serving the covered individuals with new capabilities.

Enjoy Benefits Like:

• Greater convenience with mail service of up to a 90-day supply of medication - including free standard shipping
• Personal service with a 24-hour, toll-free hotline to speak with a registered pharmacist about any questions or concerns
• Excellent quality through confidential, tamper-resistant and temperature-controlled packaging of your prescription orders
• Internet and refill-by-phone services to order prescription refills any time, any day

Option 1:

Call toll-free 1-866-273-5268 (TTY assistance call 1-800-863-5488)

Provide your: Plan Participant ID number (on your prescription benefit card) Prescription name Doctor's name and phone number Mailing address Payment information

The representative will contact your doctor -- and even fill out the order form for you!

Option 2:
Visit https://caremark.com and select the "Start a New Prescription" option. Next, log in and click the "Filling your long-term prescriptions is fast and easy with mail service!" advertisement or select "Manage Your Prescriptions". Lastly, follow the prompts and provide the requested information. CVS/Caremark will process your request and get in touch with your doctor on your behalf.

Option 3:
Get a 90-day prescription from your doctor, with as many as three refills (if appropriate). Complete the attached mail service order form and mail it in with your prescription and payment.

That's it! You can expect to receive your medication within 10 to 14 calendar days from the time CVS/Caremark receives your order. We encourage you to start saving time and money with your prescription benefit.

Prior Authorization List
Prior authorization from CVS/Caremark will be required on the following prescriptions:

• Growth Hormones
• Botox
• Myobloc
• Accutane and/or Prescription Equivalent
• Attention Deficit Disorder/Narcolepsy medications for individuals seventeen (17) years of age or older
• Oral Chemotherapy

For prescriptions that are purchased under the medical plan and require prior authorization, the prior authorization will need to be obtained from TML IEBP's Care Management Team at (800) 847-1213.

For prior authorization, call CVS/Caremark at (888) 413-2723. You will be asked a series of questions and will then be immediately approved or denied. For Specialty Prescription customer service please call CVS/Caremark at (866) 295-2779.

Over the Counter with MD Prescription Options

• Non-Sedating Antihistamines (Claritin, Alavert)
• Smoking Deterrents (Nicorette, Nicotine Patch)
• Stomach and Ulcer Medication (Prilosec)
• Allergy Medication (Zyrtec)

• MAC A
  The MAC A Prescription benefit Plan only allows up to the generic Maximum Allowable Cost (MAC) for multi-source drugs on the Caremark MAC list. If a brand name drug is dispensed and a generic equivalent drug exists, the Covered Person pays the difference between the brand name and generic price in addition to the appropriate copayment for the brand name. The cost difference between the brand name and generic price does not apply to any individual deductibles or out of pocket amounts. The MAC differential applies to all prescriptions purchased through this program when a generic equivalent is available.
• MAC C
  The MAC C Prescription benefit Plan does not penalize covered individuals for choosing a brand name drug when a generic equivalent is available. Covered Individuals pay the appropriate copay for the prescription with no additional charges.

• Date of Exam
• Location of Exam
• CVS Caremark plan participant ID

• Cholesterol
  • Total Cholesterol
  • LDL
  • HDL
  • Triglycerides
  • TC/HDL Ratio
  • Date of test
• A1c
  • A1c Result (%)
  • Date of test
• Glucose Level
  • Glucose Level (mg/dL)
  • Date of Test

Exam elements: (Please note: This is a sample.)

• Blood Pressure: 160/80
• Weight: 160 Lbs/72.6 Kg
• Blood pressure method: Digital
• Blood pressure site: R arm
• Cuff Size: Adult
• Height: 6 feet 0 inches/1.83 meters
• Body Mass Index: 21.7
• Waist measurement (inches): 32
• Framingham CHD Risk Score: NA
• Estimated 10-year Heart Disease Risk: Moderate Risk

Biometric Screening-Comprehensive

CPT	Description
99402	Preventive counseling, Individual
no code	Body Mass Index (BMI)
no code	Waist circumference
no code	Hypertension
82947*	Assay, glucose, blood quant
83036*	A1c - Glycosylated hemoglobin test
80061	Cholesterol - Lipid panel

*includes 82947 OR 83036 depending on diabetic status of patient

Cholesterol Screen Only

CPT	Description
99401	Preventive Counseling, Individual
80061	Cholesterol Screen

Glucose Screen Only

CPT	Description
99401	Preventive counseling, Individual
82947*	Assay, glucose, blood quant
83036*	A1c - Glycosylated hemoglobin test

*includes 82947 OR 83036 depending on diabetic status of patient

Hypertension Screen and Counseling

CPT	Description
99401	Preventive Counseling, Hypertension

BMI Screen and Counseling

CPT	Description
99401	Preventive Counseling, BMI

Patient History
The standard MinuteClinic exam captures additional patient history that is not shown in detail here. At a high level the patient history includes:

• Medication Allergies (medications use representative NDC codes)
• Medical Conditions
• Current Medications

Market	Host Store#	Common Name	Address	City	State	Zip
Austin	80	Lakeway	2306 RR 620 South	Lakeway	TX	787346269
Austin	0213	South Austin	5526 South Congress Ave	Austin	TX	787453106
Austin	6964	Lake Austin	2610 Lake Austin Boulevard	Austin	TX	787034453
Austin	7442	North Austin	11300 North Lamar Boulevard	Austin	TX	787532665
Austin	7827	Round Rock	1855 Gattis School Road	Round Rock	TX	786647428
Austin	8322	Northwest Austin	11725 North FM 620	Austin	TX	787501348
Austin	8387	Southwest Austin	3500 West Slaughter Lane	Austin	TX	787494421
Austin	7483	Downtown	500 Congress Ave	Austin	TX	787013502
Austin	8323	Georgetown	4426 Williams Dr	Georgetown	TX	786281341
Austin	8384	Cedar Park	851 S Bell Blvd	Cedar Park	TX	786133926
Dallas/Ft. Worth North	7824	Garland	5702 Lavon Dr	Garland	TX	750403126
Dallas/Ft. Worth North	3292	Wylie	750 W. Fm 544	Wylie	TX	750983913
Dallas/Ft. Worth North	7196	Carrollton	4100 State Hwy 121	Carrollton	TX	750101118
Dallas/Ft. Worth North	1104	Allen	1540 E. Main St.	Allen	TX	750024486
Dallas/Ft. Worth North	1745	Flower Mound	1100 Flower Mound Rd.	Flower Mound	TX	750283503
Dallas/Ft. Worth North	2977	Lewisville	100 W. Corporate Drive	Lewisville	TX	750676510
Dallas/Ft. Worth North	5962	Denton	3200 Teasley Ln.	Denton	TX	762108322
Dallas/Ft. Worth North	5965	Plano-Preston Rd	6761 Preston Rd.	Plano	TX	750242504
Dallas/Ft. Worth North	7825	Frisco	5401 Lebanon	Frisco	TX	750345150
Dallas/Ft. Worth North	8321	McKinney-Eldorado	2100 El Dorado Pkwy	McKinney	TX	750704356
Dallas/Ft. Worth North	8336	Little Elm	2591 Fm 423	Little Elm	TX	750686664
Dallas/Ft. Worth North	8393	Plano - Spring Creek	2101 W. Spring Creek Pkwy.	Plano	TX	750234103
Dallas/Ft. Worth North	334	McKinney-Custer	8995 Stacy Rd	McKinney	TX	750702167
Dallas/Ft. Worth South	15	Irving-MacArthur	5500 N. Macarthur	Irving	TX	750382603
Dallas/Ft. Worth South	2976	N. Richland Hills	6401 Precinct Line Rd.	North Richland Hills	TX	761804815
Dallas/Ft. Worth South	3134	Keller	801 N. Tarrant Pkwy.	Keller	TX	762486860
Dallas/Ft. Worth South	3207	Fort Worth-Basswood Blvd	4400 Basswood Blvd.	Fort Worth	TX	761371501
Dallas/Ft. Worth South	3708	Grapevine	3701 Ira E. Woods Ave.	Grapevine	TX	760514213
Dallas/Ft. Worth South	4985	Dallas-Westchester	8335 Westchester Dr., Suite 140	Dallas	TX	752255717
Dallas/Ft. Worth South	5314	Dallas - Downtown	1411 Main St	Dallas	TX	752024051
Dallas/Ft. Worth South	5869	Mesquite	1413 Oates Dr.	Mesquite	TX	751501345
Dallas/Ft. Worth South	7462	Bedford	601 N Industrial Blvd	Bedford	TX	760215234
Dallas/Ft. Worth South	7603	Saginaw	1301 N. Saginaw Blvd.	Saginaw	TX	761795095
Dallas/Ft. Worth South	8337	Rockwall	2004 N. Goliad Street	Rockwall	TX	750877317
Houston	8445	Missouri City	6220 Sienna Pkwy	Missouri City	TX	774596048
Houston	3702	Katy-Fry Rd	3103 N. Fry Rd.	Katy	TX	774496218
Houston	5977	Spring-Aldine Westfield	24802 Aldine Westfield	Spring	TX	773735926
Houston	7108	Spring-Grogans Mill Rd	25110 Grogans Mill Rd	Spring	TX	773802248
Houston	7151	Humble	8000 N. Sam Houston Pkwy East	Humble	TX	773962900
Houston	8335	Spring-Cypress & Champion Forest	8754 Spring Cypress Rd.	Spring	TX	773793135
Houston	1753	Houston-Memorial & Eldridge	15010 Memorial Dr.	Houston	TX	770794302
Houston	5807	Pearland-Broadway	9522 Broadway St.	Pearland	TX	775847724
Houston	5877	Pearland-FM 518 & Pearland Pkwy	2900 Broadway St.	Pearland	TX	775814507
Houston	7477	Beaumont - Nederland	2712 State Hwy 365	Nederland	TX	776274115
Houston	7753	Houston-5402 Westheimer Rd	5402 Westheimer Rd Ste K	Houston	TX	770565310

Get More for Your Health Care Dollars with the CVS Caremark ExtraCare® Health Card
As part of your benefit plan, TML IEBP is pleased to offer the CVS Caremark ExtraCare® Health card, a valuable new benefit that may help you save money on the health-related items you use most. The ExtraCare® Health card provides a 20 percent savings on certain CVS/pharmacy brand, flexible spending account (FSA)-eligible, health-related items.

How it Works
You may have already received three ExtraCare® Health key tags in the mail that can be used by you, your spouse and your dependents. Just present the key tag at the CVS/pharmacy register and automatically receive 20 percent off eligible items. A summary of your savings will appear on your receipt. You and your family can use the card at the more than 6,300 CVS/pharmacy locations nationwide.

Save up to $200 Annually*
The ExtraCare® Health card may provide savings on the health-related items you and your family use most, from cough and cold remedies to pain and allergy relief products. CVS/pharmacy brands are of the same high quality as national brands, but cost much less. With the ExtraCare® Health card, you can save even more-up to 40 percent-on these items. Please note that the discount does not apply to prescriptions, vitamins, nutritional supplements and non-health-related items.

Same Benefits as the ExtraCare Card
If you already have an ExtraCare® card, the ExtraCare® Health card will replace it. Using the ExtraCare® Health card also entitles you to all of the benefits of the ExtraCare® Rewards Program. This means in addition to your 20 percent discount, you will earn 2 percent in Extra Bucks® on non-prescription purchases and one Extra Buck® for every two prescriptions purchased.**

For more information or to transfer your ExtraCare® reward balance to your ExtraCare® Health card, call the toll-free number on the back of your new card.