Information Guide City Colleges of Chicago HMO Medical Plan January 1, 2017

Nearly one in every three Americans has a Blue Cross and Blue Shield product.

ExperiencePreventive care is essential to maintaining a healthier life, and no one understands this better than Blue Cross and Blue Shield of Illinois (BCBSIL). For more than 75 years, BCBSIL has provided quality health care benefits and services to its members and communities. BCBSIL provides members with programs and support to create customized wellness action plans, make smarter health care choices and help manage their health care.

Your Journey to WellnessWellness is defined as the state of being healthy in body and mind, especially as the result of deliberate effort. The choices you make each day can affect your health now and in the future. Deciding on the best approach for a healthier lifestyle can be challenging, but it may be easier than you think.

BCBSIL offers access to convenient online tools and resources to help you plan and manage your health care. BCBSIL health care plans include flexible options with the right combination of benefits, choice of providers and access to a wide variety of educational resources. Whether you are trying to improve your health or reach the next level of wellness, BCBSIL is here to help.

Take time to explore what Blue Cross and Blue Shield of Illinois has to offer. The coverage options, tools and resources can help you on your journey to wellness.

In This GuideThe following pages include a description of the medical plan and other features and services available to you. In some cases, your employer may be offering you more than one medical plan to choose from. Think carefully about how you and your family will use these benefits. Before you make a decision, consider the services that are covered, provider network, potential out-of-pocket costs and other options.

If you have questions, your employer can provide additional information or direct you to other resources for assistance.

The Choicefor Nearly 1 in 3 Americans

Blue Cross and Blue Shield of Illinois is a leader in health care benefits.

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The HMO Illinois® PlanThe HMO Illinois plan from Blue Cross and Blue Shield of Illinois provides valuable benefits, member services and flexibility, along with the security of predictable copayments so there are no financial surprises. Unlike other plans, BCBSIL’s HMO does not require you to pay a deductible.

When you join HMO Illinois, you choose a contracting medical group within your network and then a family practitioner, internist or pediatrician from your chosen medical group to serve as your primary care physician (PCP). Your PCP provides or coordinates your health care, helps you make informed decisions and, when necessary, makes referrals to specialists who are usually within your medical group network. Each specialist referral is authorized for a specific number of visits or timeframe (up to one year).

In addition to their PCP, female members also have the option of choosing a Woman’s Principal Health Care Provider (WPHCP) to provide or coordinate their health care services. The WPHCP and PCP must be affiliated with or employed by your Participating Medical Group. Physicians in the same medical group do have a referral arrangement. You do not need a PCP referral to see your WPHCP.

The HMO Illinois NetworkHMO Illinois offers access to one of the largest contracting health care provider networks in Illinois. In fact, your regular doctor may already be part of the network. If your doctor is not in the network and you are undergoing a course of evaluation and/or medical treatment or are in the second or third trimester of pregnancy when you join the plan, you may request transition of care benefits. Benefits for transitional services may be authorized for up to 90 days. After this period, all care must be transferred to a new PCP/medical group in the HMO network. Contact Member Services for more information.

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HMOs offer valuable benefits with the security of predictable copayments.

If you have a question, visit bcbsil.com or call Member Services at 800-892-2803.

Our HMOs have been awarded an Excellent Accreditation from the National Committee for Quality Assurance (NCQA). This accreditation level is awarded to plans that demonstrate levels of service and clinical quality that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement. The NCQA results are publicly reported in five categories:

• Access and Service • Qualified Providers • Staying Healthy • Getting Better • Living with Illness

Medical CareThe range of benefits includes coverage for:

• Physician office visits • Outpatient surgery and diagnostic tests• Breast cancer screening• Cervical cancer screening• Prostate cancer screening• Colon cancer screening• Inpatient hospital services• Maternity care• Outpatient hospital services• Mental health and substance abuse – inpatient and

outpatient treatment (Note: Physicians Care Network (PCN), Inc. members’ mental health care is directly coordinated with the network behavioral health provider.)

• Rehabilitative therapy (such as physical, speech and occupational therapy)

• Inpatient and outpatient treatments

To find a medical group and PCP in the network, go to bcbsil.com and use the Provider Finder® or refer to a printed directory. You can request a directory by calling Member Services at the toll-free number on the back of your BCBSIL ID card. Each covered family member can choose a different medical group or PCP from the network. It’s also easy to change your PCP or medical group for any reason. To select a different PCP within your existing medical group, just call the medical group. To change your medical group, call Member Services or use the Blue Access for Members online service at bcbsil.com. See Your Health Care Benefit Program booklet or call Member Services for more information.

Preventive CareAnother HMO benefit is coverage for preventive care and wellness services for children and adults, such as routine physicals, screenings, tests and immunizations, including childhood immunizations. Also, BCBSIL sends reminders to members to schedule flu shots, mammograms and Pap tests, and to have early childhood immunizations completed.

Vision Care Your vision care benefits are available through EyeMed Vision Care, a leading national provider of vision care programs. You have access to one of the nation’s largest networks of independent eye doctors and well-known retail providers — with many in-network providers offering extended weeknight and weekend hours. Call Customer Service at the number on the back of your ID card or visit eyemed.com for more information.

BlueCard® Urgent CareSM

This program covers HMO members traveling outside of Illinois who need medical attention for a condition that is not an emergency.

To find a contracting provider in the area in which you are traveling, call the BlueCard program toll-free at 800-810-BLUE (800-810-2583) or search the Blue Cross and Blue Shield Association’s Web site at bcbs.com. You can then call the provider directly to make an appointment. You pay the applicable copayment at the time of service and don’t need to submit claim forms.

If you have a question, visit bcbsil.com or call Member Services at 800-892-2803.

This document is for comparison purposes only and is a brief summary of benefits. For full benefit information, please refer to your contract or certificate (Health Care Benefit Program booklet).

Guest MembershipThis program covers members who are living out of the participating service area for at least 90 consecutive days. You can become a Guest Member with full benefits through a Blue Cross and Blue Shield HMO in another state. Guest Membership is a particularly valuable benefit for covered students who are living out of state while attending school or for members on extended travel out of state.

To find out if guest membership is available at your destination or to sign up with a host Blue Cross and Blue Shield HMO in another state, you must call Member Services before leaving home or before receiving any out-of-state services. If not, there will be no coverage for services received out of state. After applying, if you plan to continue with guest membership, you must renew it after a defined period of time.

Out-of-Area CoverageHMO Illinois gives you access to health care benefits when traveling or temporarily living out of state.

Emergency CareIf you, as a prudent layperson with an average knowledge of health and medicine, need to go to the emergency room of any hospital, your care will be covered. When a medical emergency occurs, we recommend you first try to call your PCP. Someone from your medical group is available 24 hours a day, seven days a week. Your PCP or another doctor in your medical group may be able to treat you in the office. If you are unable to call your PCP, go directly to the nearest hospital emergency room and notify your PCP as soon as possible.

If you are admitted, someone must contact your PCP immediately upon admission. Your emergency room copayment will be waived, but you will have to pay your inpatient hospital copayment, if applicable. Emergency care benefits are limited to the initial emergency treatment. To receive additional benefits, your PCP must provide or coordinate follow-up care.

Reconstructive SurgeryFederal and State of Illinois legislation require that group health plans and health insurers provide coverage for reconstructive surgery following a mastectomy. These laws state that health plans that cover mastectomies must also provide coverage in a manner determined in consultation with the attending physician and patient for reconstruction of the breast on which the mastectomy has been performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prostheses and treatment for physical complications for all stages of mastectomy care, including lymphedemas.

HMO Illinois covers these procedures and annual mammograms when ordered by a member’s primary care physician or Woman’s Principal Health Care Provider, subject to the terms of the member’s applicable health care benefit coverage. Visit bcbsil.com or call Member Services for more information.

Utilization ManagementHMO Illinois supports the belief that the best people to determine what medical care you need are you and your doctor. BCBSIL does not get involved in deciding your course of treatment. This sets it apart from most other HMOs. Your doctor is encouraged to listen to your concerns and discuss all treatment options with you to help you make informed decisions. Your network medical group may review certain referrals or procedures for appropriateness of care. Your HMO doesn’t get involved unless you request an appeal from BCBSIL because you disagree with decisions made by your PCP or medical group.

Substance Abuse TreatmentSubstance abuse treatment is provided at contracting facilities and a PCP referral is not needed. Call the number on the back of your ID card to locate a participating substance abuse provider.

If you have a question, visit bcbsil.com or call Member Services at 800-892-2803.

Prescription Drug Card ProgramYour HMO benefi ts also include prescription drug coverage. The outpatient prescription drug program is based on a tiered formulary structure. The formulary is a list of all generic drugs and a large selection of brand drugs. It is regularly reviewed and revised and is subject to change throughout the year. While coverage may vary depending on your health care benefi t plan, you usually pay less for covered formulary drugs than for non-formulary drugs. The BCBSIL formulary structure provides coverage for nearly all drugs, even those that are not on the formulary. Check the formulary at www.bcbsil.com.

Prescription Drugs

Save money by choosing generic drugs instead of brand drugs.

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Find what you need at Blue Access for MembersSM (BAM)

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1. My Coverage: Review benefit details for you and the family members covered under your plan.

2. Claims Center: View and organize details such as payments, dates of service, provider names, claims status and more.

3. My Health: Make more informed health care decisions by reading about health and wellness topics and researching specific conditions.

4. Doctors & Hospitals: Use Provider Finder® to locate a network doctor, hospital or other health care provider, and get driving directions.

5. Forms & Documents: Use the form finder to get claim and other forms quickly and easily.

6. Message Center: Learn about updates to your benefit plan, and receive notification of pending and finalized claims via secure messaging.

7. Quick Links: Go directly to some of the most popular pages for information, such as medical coverage, replacement ID cards, manage preferences and more.

8. Settings: Set up notifications and alerts to receive updates via text messaging and email, review your member information, and change your secure password at anytime.

9. Help: Look up definitions of health insurance terms, get answers to frequently asked questions and find Health Care School articles and videos.

10. Contact Us: Submit a question and a Customer Service Advocate will respond by phone or through the message center.

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Use BAM while you’re on the go. Register or log in by going to bcbsil.com from your mobile device Web browser for secure and convenient access.

It’s easy to get started

1. Go to bcbsil.com.

2. Click the Already a Member? tab. Then click the Register Now button in the BAM section.

3. Use the information on your BCBSIL ID card to complete the registration process.

Log in to Blue Access for MembersSM (BAM)

Your Online Resource

Would you like to know when your medical claims are paid and the payment amounts? Do you need to confirm who in your family is included under your coverage? BAM, the secure member portal from Blue Cross and Blue Shield of Illinois (BCBSIL), can help. Get immediate online access to health and wellness information, and:

• Check the status of a claim and your claims history

• Confirm the family members who are covered under your plan

• View and print an Explanation of Benefits (EOB) statement for a claim

• Select an option to stop receiving EOBs by mail

• Set your preferences to receive notifications for claims status and wellness updates through emails or text alerts.

• Locate a doctor or hospital in the network

• Request a new or replacement member ID card or print a temporary member ID card

• Join My Blue Community®, a social network for BAM members

Health Insurance FraudWhat You Should Know

Don’t Be a VictimIn addition to losing money through fraud, members may also experience physical and mental harm as a result of health care fraud schemes in which a provider performs unnecessary or dangerous procedures.

Identifying FraudCommonly identified schemes involving providers include:

• Misrepresenting services – Intentionally billing procedures under different names or codes to obtain coverage for services that aren’t included in a member’s plan.

• Upcoding – Deliberately charging for more complex or more expensive services than those actually provided.

• Non-rendered and/or “free” services – Some providers intentionally bill for tests or services never provided. This can also mean that the provider offered “free” services to bill the insurance company for services not performed or needed.

• Kickbacks, bribes or rebates – Referring patients to a provider or facility where the referring provider has a financial interest.

Commonly identified member schemes include:

• Identity swapping – Allowing an uninsured individual to use your insurance card.

• Identity theft – Using false identification to gain employment and the health insurance benefits that come with it.

• Non-eligible members – Adding someone to a policy who is not eligible or failing to remove someone when that person becomes ineligible.

• Prescription medicine abuse and diversion – Controlled substances can be obtained through deception or dishonesty for personal use or sale “on the street.” Prescription medications can be obtained through doctor shopping, visiting several emergency rooms or stealing doctors’ prescription pads.

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Fraud Affects EveryoneFraud may cost the health care industry (public and private payers) more than $200 billion each year. As a member of Blue Cross and Blue Shield of Illinois (BCBSIL ), this fraud may cause you to face rising premiums, increased copayments and deductibles, and the elimination of certain benefits.

Fraud increases costs and decreases benefits.

BCBSIL offers these tips:• Know your own benefits and scope of coverage.

• Review all Explanation of Benefits (EOB) statements. Make sure the exams, procedures and tests billed were the ones you actually had with the provider who treated you.

• Understand your responsibility to pay deductibles and copayments, and what you can and cannot be balance-billed for once your claim has been processed.

• Guard your health insurance card and personal insurance information. Notify BCBSIL immediately if your card or insurance information is lost or stolen.

• Sign and date only one claim form per office visit.

• Never lend your member ID card to another person.

• Don’t give out insurance or personal information if services are offered as “free.” Be sure you understand what is “free” and what you or your employer will be charged for.

• Ask your doctors exactly what tests or procedures they want you to have and why. Ask why the tests or procedures are necessary before you have them.

• Be sure any referrals you receive from your network provider are to other network doctors or facilities. If you’re not sure, ask.

• Monitor your prescription utilization via the BCBSIL website or your Pharmacy Benefit Manager (PBM). Make sure the medications billed to your insurance are accurate.

Fighting Fraud Our Special Investigations Department is one of the most effective in

the industry.

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Preventing Health Care FraudBCBSIL created the Special Investigations Department (SID) to fight fraud and help lower health care costs. The staff includes individuals with medical, insurance and law enforcement backgrounds as well as data analysts experienced in detecting fraudulent billing schemes. The SID aggressively investigates allegations of fraud and refers appropriate cases for criminal prosecution.

Fraud Isn’t Fair — Help Us Fight ItReducing health care fraud is a collaborative effort between BCBSIL, its providers and its members. Additional information — including a “fighting fraud checklist” — is available through the SID website at bcbsil.com/sid.

We also encourage you to report any suspected incidents of fraud by calling our Health Care Fraud Hotline, completing a form online or sending us a note in the mail. Suspicions of fraud can be reported to the SID anonymously.

3 Ways To Report Fraud To BCBSILThe SID is here to help you. You can contact the SID in any of the following ways:

1. 800-543-0867 The toll-free Fraud Hotline operates 24 hours a day, seven days a week. You can remain anonymous or provide information if you want to be contacted by a member of the SID.

2. bcbsil.com/sid/reporting This website address links to an online fraud-reporting form that you can complete and send to the SID electronically.

3. U.S. Mail You can write the SID at: Blue Cross and Blue Shield of Illinois Special Investigations Department 300 E. Randolph Street Chicago, Illinois 60601

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Understanding Your EOBExplanation of Benefits StatementsAn Explanation of Benefits (EOB) Statement is a notification provided to members when a health care benefits claim is processed by Blue Cross and Blue Shield of Illinois (BCBSIL). The EOB displays the expenses submitted by the provider and shows how the claim was processed.

The EOB has four sections:• Claim Information includes the member and patient name,

the member’s group and ID numbers, and the claim number.

• Summary highlights the financial information – the amount billed, total benefits approved and the amount you may owe the provider.

• Service Information identifies the health care facility or physician, dates of service and charges.

• Coverage Information shows what was paid to whom, what discounts and deductions apply, and what part of the total expense was not covered.

The EOB may include additional information:• Amounts Not Covered will show provider discounts, or

what benefit limitations or exclusions apply.

• Out-of-Pocket Expenses will show an amount when a claim applies toward your deductible or counts toward your out-of-pocket expenses.

• Appeals explains your rights regarding review of claim denials.

• Fraud Hotline is a toll-free number to call if you think you are being charged for services you did not receive or if you suspect any fraudulent activity.

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Your EOBs Are Available Online!Sign up for Blue Access for MembersSM (BAM) at bcbsil.com for convenient and confidential access to your claim information and history.

Choose to opt out of receiving EOBs by mail to save time and resources. Go to BAM, click on User Profile and change your User Preferences.

1 Account name (member’s company or organization)2 Date claim was finalized3 Toll-free number to call for additional information4 Member’s name and mailing address5 BCBSIL messages6 Member’s name7 Employer or group identification number*8 Member number that appears on the ID card*9 Claim number*q Person who received the services*w Summary box, including the total billed by the provider for the

services, the benefits approved and paid by BCBSIL, and the remainder you may owe. (See also 14, 20 and 21).

e Provider name (top line) and description of service (below)r Beginning and ending service dates

t Amount billed by the provider for each servicey Portion of the billed amount not covered by the plan (a footnote

explains the reason, for example, provider discounts)u Amount covered by the plan*i Total charges included on this claimo Plan reductions subtracted from billed amount, such as PPO

allowancesp Deductible and copayment or coinsurance amounts; can also

display applicable penalities and/or reductions for failure to preauthorize

a Payment approved before benefits are coordinated with other insurers, such as Medicare

s Amount the member may be responsible for payingd Total benefit approved for provider

* Please provide this information when contacting us about a claim.Not all EOBs are the same. The format and content of your EOB depends on your benefit plan and the services provided. Deductible and copayment amounts vary.

Sample EOB

Explanation of Benefits (EOB). This is not a bill.HEALTH CARE SERVICE CORPMonth/Date/Year

Customer Service: 1-800-XXX-XXXX

Claim InformationMember Name: Anthony DoeGroup No.: 12345Identification No.: ABC123454569Claim No.: 2020000000000XPatient Name: Anthony Doe

Total Billed: $45.00Total Benefits Approved: $16.20Amount You May Owe Provider: $1.80

Summary

The following shows how this claim was processed.

Service Information Amount NotService Description Service Date Billed Covered CoveredIMAGING RADIOLOGISTS LLCMedical Emerg X-Ray Month/Date/Year 45.00 27.00 (1) 18.00

Totals $45.00 $27.00 $18.00

Coverage Information

Totals $45.00 $27.00 $18.00

PARTICIPATING PROVIDER OPTION (PPO REDUCTION) -$27.00

Deductions Your 10% Coinsurance Amount............ 1.80Total Deductions -$1.80

Total Benefits Approved $16.20

Amount You May Owe Provider $1.80

Total covered benefits approved for this claim: $16.20 to IMAGING RADIOLOGISTS LLC.

300 East RandophChicago, IL 60601-5099

ANTHONY DOE100 BLUEBIRD LANECHICAGO, IL 60601-7332

Check here for BCBSIL messages.

Blue Access Mobile brings convenient, secure access to your mobile phone.

Blue Access MobileSM

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From your mobile phone Web browser, you can:SM

coverage details, access or request identification (ID) cards, check claims status, manage

There is no registration required to access the mobile site. However, BCBSIL members must enter their user name and password to log in to Blue Access for Members.

bcbsil.com/mobile

Prescription Drug and Wellness Information

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 20365.0716 POD

What is a prescription drug list (formulary)?

The Blue Cross and Blue Shield of Illinois (BCBSIL)drug list (also known as a formulary), which your prescription drug benefit plan is based on, is a regularly updated list of preferred drugs selected based on the recommendations of a committee comprised of individuals from throughout the country who hold a medical or pharmacy degree. U.S. Food and Drug Administration (FDA)-approved drugs are chosen based on their safety, cost and how well they work. The Generics Plus Drug List is a smaller version of the Standard Drug List. It includes mostly generic and select preferred brand drugs. All major drug classes are covered on both drug lists.

Why should I use the drug list?Your copayment/coinsurance amount for covered preferred brand drugs is usually lower than for non-preferred brand drugs. You have benefits for most covered medicines that are not on the drug list, but you may pay more out of pocket. The drug list is a reference for your doctor when prescribing medicines. But it is solely up to you and your doctor to decide the medicine that is best for you.

What are the advantages of using generic drugs?

Generics are recognized as safe and effective medicines. Generics often cost less than a brand drug. A generic can usually be substituted for a brand drug if it has the same active ingredients, the same strength and dosage form and produces the same results. Talk to your doctor or pharmacist to find out if a generic drug is available and right for you.

How do I know if a drug is on the drug list and what my cost will be?

The other side of this flier lists some commonly prescribed generic and preferred brand drugs. If a drug you are looking for is not on the list, search the drug list at bcbsil.com or call the Pharmacy Program number on the back of your ID card.

Your prescription drug benefit plan and whether the drug is on the drug list will determine the amount you may pay out of pocket. To find out what you will pay, visit bcbsil.com or call the Pharmacy Program number on the back of your ID card.

What are dispensing limits?

Based on FDA-approved dosage regimens and manufacturer’s research, certain drugs have dispensing limits. This means that these drugs have a limit on how much medicine can be filled per prescription or in a given time span. For example, coverage for the osteoporosis drug Actonel® (risedronate) is limited to 30 tablets per 30 days because the FDA-approved labeling states that the recommended dose is one 5 mg oral tablet taken daily.

What if I have questions?

Call the Pharmacy Program number on the back of your ID card, 24 hours a day, 7 days a week, or visit bcbsil.com.

Q&A: Prescription Drug List

July 2016 Commonly Prescribed Drugs

This list is a sample of commonly prescribed generic and preferred brand drugs for groups using the Standard Drug List or the Generics Plus Drug List. Refer to the BCBSIL prescription drug list at bcbsil.com for a more comprehensive and up-to-date list. The online drug list is updated quarterly. The drug list may contain medications not covered under your prescription drug benefit plan. In addition, prescription versions of over-the-counter (OTC) medications may not be covered based on your prescription drug benefit plan. If you have questions about your prescription drug benefit, call the Pharmacy Program number on the back of your ID card.

Preferred brand drugs are shown in all CAPITAL LETTERS. Generic drugs are shown in lower-case type. Drug trademarks and servicemarks are the property of their respective third-party owners.

* Preferred brands on the Standard Drug List only. 20365.0716 POD

ANTIHYPERTENSIVESAngiotensin Converting Enzyme (ACE) Inhibitors and Combinationsbenazeprilbenazepril/hydrochlorothiazidecaptoprilenalaprilenalapril/hydrochlorothiazidefosinoprilfosinopril/hydrochlorothiazidelisinoprillisinopril/hydrochlorothiazidemoexiprilmoexipril/hydrochlorothiazideperindoprilquinaprilquinapril/hydrochlorothiazideramipriltrandolapril

Angiotensin II Receptor Antagonist (ARBs) and CombinationsBENICAR* BENICAR HCT*candesartancandesartan/hydrochlorothiazideirbesartanirbesartan/hydrochlorothiazidelosartanlosartan/hydrochlorothiazidetelmisartantelmisartan/hydrochlorothiazidevalsartanvalsartan/hydrochlorothiazide

Beta Blockers and Combinationsacebutololatenololatenolol/chlorthalidonebisoprololbisoprolol/hydrochlorothiazidecarvedilolINNOPRAN XL*labetololmetoprolol succinate ext-releasemetoprolol tartratenadololpindololpropranolol ext-releasePROPRANOLOL SOLN*propranolol tabsTIMOLOL TABS*

Calcium Channel Blockers and Combinationsamlodipineamlodipine/atorvastatinamlodipine/benazeprilamlodipine/valsartanamlodipine/valsartan/hydrochlorothiazidediltiazem

diltiazem ext-releasefelodipine ext-releasenifedipine ext-releaseverapamil 80 mg, 120 mgverapamil ext-release

ASTHMA / COPDADVAIR DISKUS*ADVAIR HFA*albuterol 0.63 mg/3mL, 1.25 mg/3mLalbuterol inhal soln, 0.083%, 0.5%albuterol syrup, tabsANORO ELLIPTA*ARNUITY ELLIPTAASMANEX*ATROVENT HFA*BREO ELLIPTA*budesonideCOMBIVENT RESPIMAT*DULERA*FLOVENT DISKUSFLOVENT HFAFORADIL AEROLIZERINCRUSE ELLIPTA ipratropium inhal solnipratropium/albuterollevalbuterolmontelukastPROAIR HFAPROAIR RESPICLICKQVARSEREVENT DISKUS SPIRIVA HANDIHALERSPIRIVA RESPIMATSYMBICORTterbutalinetheophylline ext-releaseVENTOLIN HFAzafirlukast

CHOLESTEROLatorvastatincholestyraminecholine fenofibrate delayed-releasecolestipolfenofibratefenofibrate micronizedfenofibric acid delayed-releasegemfibrozillovastatinniacin ext-releasepravastatinrosuvastatinsimvastatinWELCHOL*

DEPRESSIONamitriptylinebupropionbupropion ext-releasecitalopram

clomipraminedesipraminedoxepinduloxetine delayed-releaseescitalopramfluoxetinefluvoxamineimipraminemirtazapinenortriptyline capsparoxetineparoxetine ext-releasephenelzinesertralinetranylcyprominetrazadonevenlafaxinevenlafaxine ext-release capsvenlafaxine ext-release tabs, 37.5 mg,

75 mg, 150 mg

DIABETESacarboseBAYER TEST STRIPSBYDUREON*glimepirideglipizideglipizide ext-releaseglipizide/metforminGLUCAGON EMERGENCY KITglyburideglyburide/metforminglyburide, micronizedINVOKAMET*INVOKANA*JANUMET*JANUMET XR*JANUVIA*JARDIANCEKOMBIGLYZE XR*LANTUSLEVEMIRmetforminmetformin ext-releasenateglinideNOVOLIN 70/30NOVOLIN NNOVOLIN RNOVOLOGNOVOLOG MIX 70/30ONGLYZA*pioglitazonepioglitazone/metforminrepaglinideROCHE TEST STRIPS*SYNJARDY*TOUJEO SOLOSTARTRESIBA*VICTOZA

To Purchase Your Long-Term Medicine at an Extended Supply Retail Pharmacy 1. Ask your doctor for a prescription for a 90-day supply of each of your long-term medicines.

2. Take your prescription to a contracting extended supply retail pharmacy.

To Purchase Your Long-Term Medicine Through a Mail Service Pharmacy 1. Ask your doctor for a prescription for a 90-day supply of each of your long-term medicines.

2. If you need to start your medicine right away, ask for a prescription for a one-month supply to take to a retail pharmacy.

3. To print a new prescription order form for the contracting mail service pharmacy you have chosen, go to bcbsil.com/member/rx_drug_hmo.html and scroll down to the 90-Day Supply Program section.

4. Mail your prescription, completed order form and payment to the mail service pharmacy. Or, call the contracting mail service pharmacy you have chosen.

5. Medicines take about 10 business days to deliver after the mail service pharmacy receives and verifies your order.

Or, you can ask your doctor to fax or e-prescribe your order to the mail service pharmacy. Be sure you have completed a new prescription order form to avoid a delay in processing your order.

If you have questions about the HMO 90-day supply program, call the pharmacy program number on the back of your ID card.

The 90-day supply benefit program can save you both time and money. With this program, you can get up to a 90-day supply of long-term (or maintenance) medicine through a network of contracting extended supply retail and mail service pharmacies. Your particular benefit plan and medicine will determine the amount you pay.

Visit bcbsil.com to find a contracting extended supply retail or mail service pharmacy convenient for you. Log into Blue Access for MembersSM (BAM) and click on My Coverage tab, Prescription Drugs on the left and Prime Therapeutics in the center. Then select Find a Pharmacy on the left.

HMO 90-Day Supply Prescription Drug Program

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The relationship between Blue Cross and Blue Shield of Illinois (BCBSIL) and contracting pharmacies is that of independent contractors, contracted through a related company, Prime Therapeutics LLC. Prime Therapeutics also administers the pharmacy benefit program. BCBSIL, as well as several other independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.

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PrimeMail, the mail-service pharmacy trusted by your health plan, delivers your long-term (or maintenance) medicines right where you want them. No driving to the pharmacy. No waiting in line for your prescriptions to be filled.

Savings • PrimeMaildeliversuptoa90-daysupplyof

long-term medicines. This can reduce what you pay out-of-pocket, and includes free standard shipping.

Convenience • Prescriptionsaredeliveredtotheaddressof

your choice, within the U.S.

• Youcanorderfromthecomfortofyourhome–either online, over the phone or through the mail. Or, you can have your doctor fax or e-prescribe your order.

• Youcanreceiveuptoa90-daysupplyof long-term medicine at a time.

• Youcanaskforrefillsonlineoroverthephone.

• Plain-labeledpackagingprotectsyourprivacy.

Service • Youcanreceivenotificationbyemailorphone–

yourchoice–whenyourprescriptionisreceivedand when your orders are sent.

• Memberserviceagentsareavailable24/7.

• Licensed,U.S.-basedpharmacistsareavailablesevendays a week.

• Choosetoreceiverefillremindernotificationsbyphone or email.

• Standarddeliveryisincludedatnoadditionalcost.

• PrimeMailpharmaciesarelocatedintheU.S.

PrimeMail® Delivers

PrimeMail will call or email when your prescription is received, when it ships and when it is due for a refill.

PrimeMail is a mail-order pharmacy service operated by Prime Therapeutics LLC, a pharmacy benefit management company. Blue Cross and Blue Shield of Illinois (BCBSIL) contracts with Prime Therapeutics to provide pharmacy benefit management and mail-order pharmacy services. BCBSIL, as well as several other independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.

PrimeMail is a registered trademark of Prime Therapeutics LLC.

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Existing PrescriptionsYoucanrequestthatPrimeMailcontactyourdoctortotransition your prescription.

• Visitbcbsil.com and log into Blue Access for MembersSM(BAM).ClickonMy Coverage tab, Prescription Drugs on the left and then Prime Therapeutics in the center.

• ClickGo to MyPrimeMail.com. Select Transition Prescriptions from Retail to PrimeMail and fill out the online form. Or, call PrimeMail at 877-357-7463.

• Medicinestakeabout8daystodeliverafterPrimeMail receives approval from your doctor.

New PrescriptionsMail your prescription or have your doctor fax or e-prescribe.

• Askyourdoctorforaprescriptionfora90-daysupply of each of your long-term medicines. Or, ask your doctor to fax or e-prescribe your order to PrimeMail. If you need to start your medicine right away,requestaprescriptionforaone-monthsupplyto fill at a local retail pharmacy.

• ToprintaPrimeMailNewPrescriptionOrderForm,go to bcbsil.com/member/rx_drug_choices.html. Fromthere,selectyourplancoverageandscrolldown to the Mail Service Program section. Or, call PrimeMail at 877-357-7463.

• Mailyourprescription,completedorderformandpayment to PrimeMail.

• Medicinestakeabout8daystodeliverafterPrimeMail receives and verifies your order.

Refills Are Easy Refilldatesareshownoneachprescriptionlabel.Youcanchoose to have PrimeMail remind you by phone or email whenarefillisdue.Choosethereminderoptionthatbestsuits you.

Online Visitbcbsil.com to refill a prescription or renew an expired prescription.LogintoBAMandclickonMy Coverage tab, Prescription Drugs on the left and then Prime Therapeutics in the center. Then click Go to MyPrimeMail.com. Select Refill to choose the medicine you would like to refill.

Over the Phone CallthePrimeMailautomatedrefillsystem at 877-357-7463.

Through the Mail CompleteandmailtheRefillPrescriptionOrderFormsentwith your order. Remember to allow time for your refill order to be received and processed.

Questions? To learn more, visit bcbsil.com.

Getting Started with PrimeMail

Need an alternative to visiting the ER*?Discount program for Illinois HMO MembersIllinois HMO members will receive a discount on a variety of health care services at Walgreens’ Healthcare Clinics. Simply show your Blue Cross and Blue Shield of Illinois (BCBSIL) HMO identification card at the time of service for the discount. Payment will be expected at time of service.

Convenient Care for You and Your FamilyHealthcare Clinics are staffed by nationally certified family nurse practitioners who diagnose and treat minor illnesses and injuries. A few examples of Healthcare Clinics’ health care services include:

• Treating respiratory illnesses, skin conditions and minor injuries

• Giving physicals and health evaluations

• Providing immunizationsNetwork Information

Accessible Services When and Where You Need ThemHealthcare Clinics are open seven days a week and appointments are not needed. To find a Healthcare Clinic near you, visit Walgreens.com.

It is important to inform your primary care physician (PCP) as soon as possible about any treatment or services you receive at Healthcare Clinic to help ensure your records are always up to date.

* For medical emergencies, go directly to the nearest hospital emergency room or dial 911. Notify your PCP as soon as possible.

** If your PCP refers you to a Healthcare Clinic, the services will be covered based on your benefits plan design.

22320.1015

As an HMO member, you should always try to see your PCP first (the doctor who knows you and your health history best) to receive services covered by HMO benefits and to ensure continuity of care. If you cannot get a timely office visit** with your doctor, Healthcare Clinics may offer an alternative to visiting an emergency room.

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Blue365® Discounts to Make Health and Wellness More Affordable

Davis VisionSM | TruVision®

You may save on eyeglasses as well as contact lenses,

exams and accessories. Davis Vision is made up of national

and regional retail stores as well as local eye doctors. You may

get possible savings on laser vision correction through the

TLC/TruVision group.

TruHearing® | Beltone™

You may get possible savings on hearing tests, evaluations

and hearing aids. Discounts may also be available for your

immediate family members.

Procter & Gamble (P&G) Dental Products

You may get savings on dental packages with Oral B® power

toothbrushes and Crest® products. Packages may include items

such as an electric toothbrush, mouth rinse, teeth whiteners

and floss.

Dental SolutionsSM

You may get dental savings with Dental Solutions. You may

receive a dental discount card that provides access to

discounts of up to 50 percent at more than 61,000 dentists

and more than 185,000 locations.*

Blue365 is just one more advantage of being a Blue Cross and Blue Shield of Illinois (BCBSIL) member. With this program, you may save money on health and wellness products and services from top retailers that are not covered by insurance. There are no claims to file and no referrals or pre-authorizations.

Once you sign up for Blue365 at blue365deals.com/BCBSIL, weekly “Featured Deals” will be emailed to you. These deals offer special savings for a short period of time.

Below are some of the ongoing deals offered to Blue365 members.

See all the Blue365 deals and learn more at blue365deals.com/BCBSIL.

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The relationship between these vendors and Blue Cross and Blue Shield of Illinois (BCBSIL) is that of independent contractors. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by the above-mentioned vendors.

* Dental Solutions requires a $9.95 signup and $6 monthly fee.

Blue365 is a discount program only for BCBSIL members. This is NOT insurance. Some of the services offered through this program may be covered under your health plan. Please check your benefit booklet or call the customer service number on the back of your ID card for specific benefit facts. Use of Blue365 does not change your monthly payment, nor do costs of the services or products count toward any maximums and/ or plan deductibles. Discounts are only given through vendors who take part in this program. BCBSIL does not guarantee or make any claims or recommendations about the program’s services or products. You may want to talk to your doctor before using these services and products. BCBSIL reserves the right to stop or change this program at any time without notice.

CORD:USE® | CorCell®

You can protect your family’s cord blood at a state-of-the-art

laboratory using high-quality cord blood banking practices

and technologies. Cord blood contains stem cells (like those in

bone marrow) that have the ability to develop into additional

cells and can be used to treat possible life-threatening diseases

in the future. You may save on cord blood processing and

storage fees.

Jenny Craig® | Seattle Sutton’s® Nutrisystem®

You may reach your weight loss goals with savings

from leading programs. You may save on healthy meals,

membership fees (where applicable), nutritional products

and services.

RetrofitSM

Receive 15 percent off Retrofit’s online, private weight loss

coaching sessions. Retrofit includes the use of a wireless Fitbit®

device and smart scale, one-on-one videoconferencing with

a personal team of experts and unlimited online support. You

will enjoy flexibility in scheduling and the ability to meet with

coaches anywhere there is an Internet connection.

Reebok | SKECHERS®

Reebok, a trusted brand for more than 100 years, makes top

athletic equipment for all people, from professional athletes

to kids playing soccer. SKECHERS, an award-winning leader

in the footwear industry, offers exclusive pricing on select

Performance, Sport, Work and Corporate Casual styles. You

will enjoy 20 percent off plus free shipping for your

online orders.

SeniorLink Care™

With SeniorLink Care, you may find support to help your aging

family members or friends lead fulfilling and comfortable

lives. From planning care to helping caregivers, SeniorLink

Care assists older adults and their loved ones in finding the

programs and services they may need most. You can save on

a three- or 12-month membership.

Handstand Kids

Handstand Kids brings the family together in the kitchen,

spending more time cooking and eating healthy, delicious

meals. The Handstand Kids Cookbook series features the

languages and cuisines of Italy, Mexico, China and many other

countries. Every book also introduces the language and culture

of each country. You may save up to 25 percent on cooking

accessories and Cookbook Kits.

For more great deals or to learn more about Blue365, visit blue365deals.com/BCBSIL.

Tobacco Cessation and Weight Management ProgramsA Path to Healthier Living

Two of the best things you can do for your health are to lose extra pounds and quit smoking. These are also tough goals to reach on your own – but Blue Cross and Blue Shield of Illinois (BCBSIL) can help.

Through Blue Care Connection®, BCBSIL offers two voluntary programs to help you reach your wellness goals – at no additional charge.

o Tobacco Cessation Program: Provides personal telephone coaching, self-directed online courses and tobacco cessation resources to help you become tobacco and nicotine free.

o Weight Management Program: Offers guidance and support to help you change your behavior and shed the extra pounds through personal telephone motivational coaching, self-directed online courses and weight management resources.

Enroll Today! Call Customer Service at the phone number listed on the back of your member ID card.

“I made a commitment to

myself to live a healthier

lifestyle. This program helped

me keep that commitment. On

occasion, when I would slip, a

follow up call from April

helped me be accountable for

missing any goals or losing

focus.”

- Member Participant

21338.1212

Personal Telephone Wellness Coaching A Wellness Coach will be assigned to help you meet your wellness goals. Your coach will take a look at your lifestyle and habits, and help you figure out what’s most important to you and what you need to be successful.

Self-Directed Courses You can also choose to take online courses that let you work at your own pace to reach your health goals. Learn more about nutrition, fitness, weight management, tobacco cessation and stress. Track your progress as you make your way through each lesson.

BCBSIL members also have access to:

o Blue365® Member Discount Program Offers exclusive health and wellness deals to BCBSIL members including discounts from top national and local retailers on fitness gear, gym memberships, family activities, healthy eating options and much more.

o Blue Access for MembersSM (BAM)

Secure member portal from BCBSIL gives you immediate online access to health and wellness information. The My Health tab features information on such topics as:

•SmokingCessation •Nutrition •Fitness •Obesity

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Wellness is more than healthy eating and working out. It involves making healthy choices that enrich your mind, body and spirit.

A New Way to Experience Wellness

Well onTarget offers personalized tools and resources to help all members — no matter where you may be on the path to health and wellness.Well onTarget is designed to give you the support you need to make healthy choices. All while rewarding you for your hard work.

Well onTarget Member Wellness PortalThe heart of Well onTarget is the member portal. It uses the latest technology to offer you an enhanced online experience. This engaging portal links you to a suite of innovative programs and tools.

• onmytime Self-directed Courses Online courses let you work at your own pace to reach your health goals. Learn more on nutrition, fitness, weight management, tobacco cessation and stress. Track your progress as you make your way through each lesson. Reach your milestones and earn Blue PointsSM.

• Health and Wellness Content Health library teaches and empowers through evidence-based, user-friendly articles.

• Tools and Trackers Interactive tools help keep you on course while making wellness fun. Use a food and exercise diary, symptom checker and health trackers.

onmyteam Wellness CoachingCertified health coaches offer you guidance in nutrition, fitness and stress management. You can interact with your coach by phone or send a secured message through the portal. wellontarget.com

* Blue Points Program Rules are subject to change without prior notice. See the Program Rules on the Well onTarget Member Wellness Portal for further information. Your company may have additional reward programs in place to encourage you to take advantage of certain preventive care and wellness activities or for making healthy changes. Check your employee benefits.

** The Fitness Program is provided by Healthways, Inc., an independent contractor which administers the Prime Network of fitness centers. The Prime Network is made up of independently-owned and managed fitness centers.

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Start experiencing the new wellness today by logging on to wellontarget.com. If you have any questions about the Well onTarget program, call Customer Service at 877-806-9380.

onmywayTM Health Assessment (HA) The HA features adaptable questions to learn more about you. After you take the HA, you will get a personal wellness report. This private record offers tips for living your healthiest life. Your answers will be used to tailor the Well onTarget portal with the programs that can help you reach your goals.

Blue Points* ProgramBlue Points will help motivate you to maintain a healthy lifestyle. Earn points by taking part in wellness activities. Points can be redeemed in the new online shopping mall. Real-time granting of points lets you instantly use your points. To earn a larger reward, you can add to your point total at checkout.

Fitness Tracking Earn Blue Points for tracking your fitness activity using popular fitness devices and mobile apps.

Online Wellness Challenges Challenge yourself with wellness, stress management, fitness and nutrition challenges. Team challenges let you join forces with others to compete in monthly contests.

Fitness Program**

Fitness can be easy, fun and affordable. The Fitness Program is a flexible membership program. Gain unlimited access to a nationwide network of fitness centers. With more than 9,000 gyms on hand, you can work out at any place or at any time. Choose a gym close to home and one near your office. Other program perks are:

• No long-term contract required. Membership is month to month. Monthly fees are $25 per month per member, with a one-time enrollment fee of $25.

• 2,500 bonus Blue Points for joining the Fitness Program. Earn additional points with weekly visits.

• Automatic withdrawal of monthly fee.

• Online tools for locating gyms and tracking visits

• Access to discounts through a nationwide Complementary and Alternative Medicine (CAM)network of 40,000 health and well-being providers such as massage therapists, personal trainers and nutrition counselors.

Sign up for the Fitness Program today! Call toll-free at 888-762-BLUE (2583), Monday through Friday, 8 a.m. – 9 p.m. in any continental U.S. time zone.

Important Notices

I. Initial Notice About Special Enrollment Rights in Your Group Health Plan

A federal law called Health Insurance Portability and Accountability Act (HIPAA) requires that we notify you about very important provisions in the plan. You have the right to enroll in the plan under its “special enrollment provision” without being considered a late enrollee if you acquire a new dependent or if you decline coverage under this plan for yourself or an eligible dependent while other coverage is in effect and later lose that other coverage for certain qualifying reasons. Section I of this notice may not apply to certain self-insured, non-federal governmental plans. Contact your employer or plan administrator for more information.

A. SPECIAL ENROLLMENT PROVISIONS

Loss of Other Coverage (Excluding Medicaid or a State Children’s Health Insurance Program) If you are declining enrollment for yourself or your eligible dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if you move out of an HMO service area, or the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 31 days after your or your dependents’ other coverage ends (or move out of the prior plan’s HMO service area, or after the employer stops contributing toward the other coverage).

Loss of Coverage For Medicaid or a State Children’s Health Insurance Program If you decline enrollment for yourself or for an eligible dependent (including your spouse) while Medicaid coverage or coverage under a state children’s health insurance program is in effect, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage. However, you must request enrollment within 60 days after your or your dependents’ coverage ends under Medicaid or a state children’s health insurance program.

New Dependent by Marriage, Birth, Adoption, or Placement for Adoption If you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents in this plan. However, you must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption.

Eligibility for State Premium Assistance for Enrollees of Medicaid or a State Children’s Health Insurance Program If you or your dependents (including your spouse) become eligible for a state premium assistance subsidy from Medicaid or through a state children’s health insurance program with respect to coverage under this plan, you may be able to enroll yourself and your dependents in this plan. However, you must request enrollment within 60 days after your or your dependents’ determination of eligibility for such assistance.

To request special enrollment or obtain more information, call Customer Service at the phone number on the back of your Blue Cross and Blue Shield ID card.

II. Additional Notices Other federal laws require we notify you of additional provisions of your plan.

NOTICES OF RIGHT TO DESIGNATE A PRIMARY CARE PROVIDER (FOR NON-GRANDFATHERED HEALTH PLANS ONLY)

For plans that require or allow for the designation of primary care providers by participants or beneficiaries: If the plan generally requires or allows the designation of a primary care provider, you have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. For information on how to select a primary care provider, and for a list of the participating primary care providers, call Customer Service at the phone number on the back of your Blue Cross and Blue Shield ID card.

For plans that require or allow for the designation of a primary care provider for a child: For children, you may designate a pediatrician as the primary care provider.

For plans that provide coverage for obstetric or gynecological care and require the designation by a participant or beneficiary of a primary care provider: You do not need prior authorization from the plan or from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals.

For a list of participating health care professionals who specialize in pediatrics, obstetrics or gynecology, call Customer Service at the phone number on the back of your Blue Cross and Blue Shield ID card.

Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

22963.0415

Prescription Order Form

CARDHOLDER INFORMATION Cardholder’s ID Cardholder’s Date of Birth (mm/dd/yyyy)

Cardholder’s Last Name Cardholder’s First Name MI

Patient’s Last Name (if different than cardholder) Patient’s First Name MI

Patient’s Gender: Male Female Patient’s Date of Birth (mm/dd/yyyy) Patient’s Phone Number

Patient’s Permanent Address

City State ZIP Code

Patient’s Email AddressContact by: Email Phone

DRUG ALLERGIES None

Aspirin

Codeine

Erythromycin

Sulfa

Penicillin

Other

HEALTH CONDITIONS Arthritis

Asthma

Diabetes

Depression

Glaucoma

Heart condition

High cholesterol

Hypertension

Other

PATIENT’S PRESCRIPTIONS Drug Name Physician/Prescriber’s Name and Phone Number Do not fill at this time

Total Number of Prescriptions:

Mail the original physician-signed prescriptions with this completed form. For multiple dependents please use multiple forms. If more than 3 prescriptions are needed, write the requested information from this table on a separate piece of paper and enclose with your order. Additional processing time may be required for prescriptions that require physician clarification.For prescriptions to be filled at a later date, call the customer service number above to activate.

CONTINUED ON BACK

Mail this form to:PrimeMail® PO Box 650041Dallas, TX 75265-0041

For added service:Visit www.bcbsil.com or call 800.423.1973TTY 711Llame la farmacia de PrimeMail en 800.423.1973 o el registro sobre nuestro sitio del web en www.bcbsil.com

SHIPPING INFORMATION Regular: No charge Second business day: $15* Next business day: $22* *Additional costs

charged to you.Shipping time does not include processing time. Shipping prices are subject to change.We are unable to ship second business day or next business day orders to PO boxes.Shipping address must be a physical location.

Alternate Shipping Address (if different than permanent address)

City State ZIP Code Phone Number

This is a change of address This is a one time address Seasonal address from to

PAYMENT INFORMATION Payment is due with each order and may be made by credit card, check or money order. Orders received without payment may delay processing. There is a $20 returned check charge.

Check or money orderPlease make check or money order payable to Prime Therapeutics and include your member ID on the memo line. Do not send cash.

Check Money Order

Credit card informationTo authorize payment by credit card, provide the account number, expiration date and signature. We accept Discover, MasterCard, VISA and American Express. This card will be used for this and all future orders unless we are notified otherwise.

Credit Card Number Expiration Date

Use credit card on file, with the last 4 digits of:

Signature Date

3208

Unless you or your doctor say not to, and when permitted by law, a brand-name drug may be replaced with a generic drug that has the same active ingredient. (If you choose to take a brand-name drug when a generic version is available, you may have to pay the difference in cost.) By returning this form, you agree to share your protected health information (PHI) with Prime Therapeutics LLC (Prime). Prime’s treatment of PHI is designed to comply with privacy laws.

PrimeMail® is a registered trademark of Prime Therapeutics LLC (Prime). PrimeMail is a home-delivery pharmacy service provided by Prime.

Blue Cross and Blue Shield of Illinois (BCBSIL) is a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

BCBSIL contracts with Prime to provide pharmacy benefit management and pharmacy services. In addition, contracting pharmacies are contracted through Prime. The relationship between Prime and contracting pharmacies is that of independent contractors. BCBSIL, as well as several other independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime.

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