PRESCRIPTION DRUG BENEFIT – See section 8 Benefit Funded by the Trust   Participating Retail Pharmacy (30-Day Supply) Preferred Participating Retail Pharmacy** (90-Day Supply) Mail Order Pharmacy Non-Participating Pharmacy*** Generic Drugs Participant co-payment is 35% of the total cost of the Drug. Participant co-payment is $20 for each prescription. Participant co-payment is $20 for each prescription. No reimbursement. Preferred Brand-name Drugs* Reimbursement Limitations apply, see below* Participant co-payment is 35% of the total cost of the Drug. Participant co-payment is $50 for each prescription. Participant co-payment is $50 for each prescription. No reimbursement. Non-Preferred Brand-name Drugs* Reimbursement Limitations apply, see below* Participant co-payment is 35% of the total cost of the Drug. Participant co-payment is $100 for each prescription. Participant co-payment is $100 for each prescription. No reimbursement. *REIMBURSEMENT LIMITATIONS: If you or your Physician request that your prescription be filled with a brand-name Drug when a generic equivalent is available, you will be responsible for paying the full difference in price between the generic and brand-name Drug in addition to your brand-name Prescription Drug co-payment. The generic drug price is that established by the Plan’s Pharmaceutical Provider. If you fail to use your prescription drug card at a participating pharmacy, there is no reimbursement. **HEALTHTRANS 90RX PROGRAM: Beginning April 1, 2007, through the HealthTrans Discount 90Rx program, after obtaining a long-term prescription (greater than a 34-day supply) from your physician, you may visit a preferred participating 90Rx pharmacy and fill up to a 90-day supply of select maintenance medications. A list of maintenance medication can be obtained by visiting the web site. ***OUT-OF-NETWORK: If no in-network pharmacy is located in the Participant’s area, Participant’s copayment is 50% of the Drug cost per each prescription filled out-of-network.