- Added a $2,000 per person calendar year maximum out-of-pocket (CY MOOP) to all EUTF and HSTA VB retiree plans. The CY MOOP will apply to specialty and non-specialty drugs.
- Increased the non-preferred brand copays from $30 to $40 for a 30-day supply under the EUTF non-Medicare and Medicare retiree plans. A 90-day supply will continue to be two times the 30-day copay under the EUTF Medicare retiree plan and at a Retail 90 or Mail Order pharmacy under the EUTF non-Medicare retiree plan.
- Changed the out-of-network non-specialty member cost share to a 20% coinsurance under the EUTF Medicare retiree plan and a 30% coinsurance under the HSTA VB Medicare retiree plan.
CVS/SSI Retiree Benefits
What’s New?
Effective January 1, 2025:
Effective July 1, 2025:
- Implemented Hyperinflation Management where hyperinflated drugs that have readily available, clinically appropriate and more cost-effective alternatives are excluded under the EUTF non-Medicare retiree plan.
- Implemented the Basic Control Formulary where utilization management was added to non-preferred products in ten specific drug classes under the EUTF non-Medicare retiree plan.
- Revised prior authorization criteria for coverage of antidiabetic GLP-1s (e.g. Ozempic, Mounjaro, Rybelsus, Trulicity, and Victoza) under the EUTF non-Medicare retiree plan.
For EUTF Members
For HSTA VB Members