HomeMy WebLinkAboutMO # 1116MUNICIPAL ORDER NO. 1116
A MUNICIPAL ORDER AMENDING MUNICIPAL ORDER NO. 1101
ENTITLED, "A MUNICIPAL ORDER ADOPTING AN AMENDMENT TO THE
COMPREHENSIVE HEALTH INSURANCE BENEFIT PLAN SUMMARY FOR
EMPLOYEES OF THE CITY OF PADUCAH"
WHEREAS, it has become necessary to amend the prescription drug
formulary for the health insurance plan year beginning January 1, 2005.
as follows:
BE IT ORDERED BY THE CITY OF PADUCAH, KENTUCKY:
SECTION 1. That Municipal Order No. 1101 is hereby amended to read
"The City of Paducah adopts an amendment to the Comprehensive Health
Insurance Benefit Plan Summary for Employees of the City of Paducah. This
amendment is to include the following formulary for prescription drugs for the plan year
beginning January 1, 2005, through December 31, 2005.
Retail Copay per
Prescription/Refill
Plan A
Plan B
Employee/Plan
Employee/Plan
Generic Drugs
20%/80% max. $150/Presc.
10%/90% max. $150/Presc.
Preferred Brand
30%/70% max. $150/Presc.
20%/80% max. $150/Presc.
Non -Preferred Brand
50%/50% max. $150/Presc.
50%/50% max. $150/Presc.
Mail Order Copay per
Prescription/Refill
Plan A
Plan B
Employee
Employee
Generic Drugs
$25 per prescription
$20 per prescription
Formulary Brand
$50 per prescription
$40 per prescription
Non -Preferred Brand
$125 per prescription
$100 per prescription"
SECTION 2. This order shall be in full force and effect from and after the
date of its adoption.
Mayor
ATTEST:
Tammara S. Brock, City Clerk
Adopted by the Board of Commissioners February 7, 2005
Recorded by Tammara S. Brock, City Clerk, February 7, 2005
\mo\health ins — amend #2A (prescription drugs)
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