ANSWER: Yes, the prescription drug program is administered by Express Scripts (ESI). There is a mail order program and a retail (drug card) program. For more information please refer to the Benefit Summary Tab or SPD. You can also contact Express Scripts at 1-(877)-327-0568 (toll free) or www.express-scripts.com.
ANSWER: You should only use the Drug card Program (retail) for buying short term or acute prescription drugs. Your out of pocket costs will be lower if you use the Mail Order Program for your long term prescription drug needs.
ANSWER: To use the Mail Order Program, you or your physician submits the prescription to ESI. You can also use the internet to request refills after the initial fill. You can pay by check or credit card. The Comprehensive Major Medical regular deductible and payment percentage provisions don't apply to the mail order program. Instead you pay the following co-pays to Express Scripts each time you order up to a 90 day supply of your covered medications.
Generic drugs - $10 Preferred brand name drugs - $20 Non-preferred brand names - $35
If you choose a brand name drug instead of an available generic, you must pay the difference in cost between the brand name drug and its generic equivalent, in addition to the $10 generic co-payment.
The Plan pays 100% of the rest of the prescription cost directly to Express Scripts.
ANSWER: "Preferred" prescription drugs are brand name medications that have been evaluated by Express Scripts physicians and pharmacists and determined to be the most effective for treatment of certain conditions for most patients, and which are reasonably priced.
ANSWER: You must use the Accredo Specialty Pharmacy, which is a mail-service pharmacy that provides specialized medications, and LINECO's exclusive provider for specialty pharmacy medications. Specialty drugs are high cost injectable, infusion, IV and certain oral medications prescribed for disease such as multiple sclerosis, rheumatoid arthritis, and hepatitis C. These drugs require special storage and handling and are not usually stocked in retail pharmacies. These drugs may be for home use or for use in your doctor's office. You are required to use Accredo Specialty Pharmacy for your specialty drug needs. For more information, call Accredo's at 1-877-476-2267.
ANSWER: You have the option of dropping the LINECO drug plan and switching to a Medicare Part D plan; however, most participants will NOT benefit by doing so, and LINECO is not encouraging anyone to switch to a Part D plan.
ANSWER: Instead of paying full price and filing a claim for prescription drug benefits, Medicare eligible individuals must use a participating ESI Pharmacy. They then pay a 20% co-pay when they purchase their covered drugs. When a Medicare eligible individual's 20% retail co-pays and his mail-service co-pays combined total $1000 during a calendar year, his retail and mail-service co-pays during the remainder of that year will be $0. Use of participating pharmacies is mandatory, and, in addition, use of the mail service pharmacy is mandatory after the original supply plus one refill of any prescription. Note: Don't send your 20% percent co-pays to the Fund office—these are your responsibility.
ANSWER: Yes, if the LINECO Plan is secondary to any other group plan that provides coverage for prescription drugs, the person for whom LINECO is secondary cannot use LINECO's Prescription Drug Programs. Instead they must follow the rules of their primary plan first and then file a claim with LINECO.
LINECO is a multiemployer self-funded, self-administered welfare benefit plan set up to provide medical, dental, vision, and disability benefits as well as Life Insurance for outside members of the International Brotherhood of Electrical Workers working under bargaining agreements between the International Brotherhood of Electrical Workers and the National Electrical Contractors Association.
Descriptions of benefits on this website do not constitute a guarantee of coverage or payment--all claims are subject to eligibility and Plan limitations at the time services are rendered.