Providing benefits for state employees and retirees

Employee Group Insurance Benefits

Prescription Drug Plan Snapshot

Your prescription drug coverage is included in your medical coverage choice.

For details about the prescription drug plan, including copayment explanations, exclusions, limitations, and how the plan works, please see the Benefits Summary & Plan Contracts.

  Traditional PPO High-Deductible
IN OUT * IN OUT * IN OUT *
Tier 1: Generic $10 $10 $10
Tier 2: Formulary Brand Name $25 $25 $25
Tier 3: Non-Formulary Brand Name $50 $50 $50

*For a covered Prescription Drug dispensed by a Physician or a Licensed Pharmacist who is not a Participating Pharmacist, the Insured is responsible for paying for the Prescription Drug at the time of purchase and must submit a claim to BCI or one (1) of its designated claims processing vendors. The amount of payment for a covered Prescription Drug is the balance remaining after subtracting the Prescription Drug Copayment and/or Coinsurance from the lower of the Allowed Charge or the Usual Charge for the Prescription Drug.





QUESTIONS?
Phone:
Fax:
Email:
(208) 332-1860 or (800) 531-0597
(208) 332-1888
ogi@adm.idaho.gov


Snapshots

In order to provide quick and easy plan data, some of the information provided on this website is abbreviated. Please consult the Benefits Summary & Plan Contracts for complete documentation.

I Need:

Helpful Links