Individual Members

General plan information

2019 Pharmacy Information

  • Commercial Metal 5-Tier Formulary Annual Notice of Change 2019
  • Commercial Metal 5-Tier Pharmacy Prior Authorization and Step Therapy Criteria 2019

2018 Pharmacy Information

  • Commercial Metal 5-Tier Formulary (list of covered drugs) 2018 PDF | Online Search
  • Commercial Metal 5-Tier Formulary Annual Notice of Change 2018
  • Commercial Metal 5-Tier Pharmacy Prior Authorization and Step Therapy Criteria 2018
  • Commercial Metal 5-Tier Formulary Monthly Notice of Change 2018

Participating providers

Forms


For information about your covered benefits (copays, deductibles, maximums, etc.), please log in.

Last updated 10/8/2018