WELCOME to SilverScript (Employer PDP)
sponsored by Hawaii Employer Union Health Benefits Trust Fund

Hawaii Employer Union Health Benefits Trust Fund (EUTF Plan) has chosen SilverScript® Insurance Company to provide your Medicare Part D prescription drug coverage. SilverScript, an affiliate of CVS Caremark, is an approved Medicare Part D Prescription Drug Plan provider.

Service - It Is All About You!

As a plan member, you'll receive savings and service through plan features which include:

24x7 Customer Service Tools - Our plans all offer website access and our award winning customer service*–both are available to our members 24 hours a day, 7 days a week.

Large Pharmacy Network - More than 67,000** pharmacies nationwide make up the pharmacy network. These include retail, mail service, long-term care, home infusion, and Indian Health and Indian Tribal pharmacies.

Value-Added Services
Plan membership provides you with extra value and various ways to enjoy safety, savings, and service. Use the ExtraCare Health card and get a 20% discount on CVS/pharmacy brand health-related products available at more than 7,300*** CVS/pharmacy stores nationwide.
The value-added products and services described above are neither offered nor guaranteed under our contract with Medicare. In addition, they are not subject to the Medicare appeals process. Purchases eligible for the ExtraCare Health Card will not count toward your true-out-of-pocket expense (TrOOP) amounts. Any disputes regarding these products and services may be subject to the SilverScript Insurance grievance process.

The SilverScript (Employer PDP) Medicare Part D Plan,
sponsored by Hawaii Employer Union Health Benefits Trust Fund (EUTF Plan) Plan Features

Annual Deductible N/A
Initial Coverage Level The plan pays its share of the cost of your drugs and you pay your share of the cost. You stay in this stage until your payments for the year plus the plan’s payments total $2,970.
Prescription Benefit Network Retail
(up to 30-day supply) 		Network Mail Service
(up to 90-day supply)
Generic Drugs $5.00 $10.00
Preferred Brand Drugs $15.00 $35.00
Non Preferred Brand Drugs $30.00 $60.00
Specialty Drugs You pay 20% of the total cost up to $250/max per fill. N/A
 
Coverage After You Reach Your Initial Coverage Limit Your former employer, union, or trust will provide supplemental coverage that will keep your copays/coinsurance consistent through the Coverage Gap, therefore you will see no change in copays until you qualify for Catastrophic Coverage.
Generic Drugs $5.00 $10.00
Preferred Brand Drugs $15.00 $35.00
Non Preferred Brand Drugs $30.00 $60.00
Specialty Drugs You pay 20% of the total cost up to $250/max per fill. N/A
 
Catastrophic Coverage You qualify for Catastrophic Coverage once your true out-of-pocket (also known as TrOOP) costs reach $4,750 for the year. During Catastrophic Coverage you will pay no more than: the greater of 5% coinsurance or $2.65 for generics (or drugs treated as generic) and $6.60 for all other drugs. The Plan will pay the rest.
Generics (including brand drugs treated as generic) $2.65 or 5%
All other drugs $6.60 or 5%
Out-of-Network Plan drugs may be covered in special circumstances, for instance, illness while traveling outside of the plan’s service area where there is no network pharmacy. You may have to pay more than your normal cost-sharing amount if you get your drugs at an out-of-network pharmacy. In addition, you will likely have to pay the pharmacy’s full charge for the drug and submit documentation to receive reimbursement from SilverScript (Employer PDP) for its share of the costs. Please refer to your Evidence of Coverage for more information.
 
2013 Comprehensive Formulary Download
2013 Summary of Benefits Please contact Customer Care for a copy
2013 Evidence of Coverage Please contact Customer Care for a copy
Mail Order Form PDF Download

Options for Filling Your Prescription

With one of our Prescription Drug Plans, you will have access to more than 67,000** pharmacies nationwide. You also may choose to have your prescription filled and mailed directly to your home or office using our preferred mail service pharmacy. You may get your prescriptions filled at a non-preferred pharmacy; however, you may have to pay more for your prescriptions.

With mail service, you will receive up to a 90-day supply of your medication for a co-payment that is likely to be significantly less than you would pay for three 30-day co-payments at a participating retail pharmacy.

WITH THE CAREMARK MAIL SERVICE PROGRAM YOU HAVE:

  • The ease of having a prescription delivered to the location of your choice - home, office, vacation spot, etc.
  • Greater convenience with mail service of up to a 90-day supply of medication - including free standard shipping.
  • Personal service with a 24-hour, toll-free hot-line to speak with a registered pharmacist about any questions or concerns you may have.
  • Excellent quality through confidential, tamper-resistant and temperature-controlled - packaging of prescriptions.
  • Internet and refill-by-phone services to order your prescription refills 24 hours a day, 7 days a week.

The Caremark Mail Service offering also checks the availability of U.S. Food and Drug Administration-approved, generic substitutions to fill prescriptions when authorized by physicians and permissible by law. By using generics, you may reduce your prescription drug costs and avoid the coverage gap for longer if you should reach it.

If you have questions about your Hawaii Employer Union Health Benefits Trust Fund (EUTF Plan) Plan, please contact:

Prospective Members

Call Customer Care 24 hours a day, 7 days a week at:

  • 1-877-878-5715
  • TTY/TDD users should call 1-866-236-1069

Current Members

Call Customer Care 24 hours a day, 7 days a week at:

  • 1-877-878-5715
  • TTY/TDD users should call 1-866-236-1069

*CVS Caremark Customer Care was honored for "Providing an Outstanding Customer Service Experience" under the J.D. Power and Associates Certified Call Center Program℠. The call centers have held this distinction since 2006.

** As of 6/2012, Caremark Network Services states that there are more than 67,000 contracted network pharmacies.

*** As of 6/2012, Caremark Network Services states there are more than 7,300 CVS pharmacies nationwide.

This site is not reviewed by Medicare.