CVS/SSI Retiree Benefits

What’s New?
Recent CVS plan changes include:

  1. Added the RxSavingsPlus program to the EUTF and HSTA VB non-Medicare retiree plans effective July 1, 2022. This is a discount program where members can get additional discounts on certain non-covered drugs. (More information will soon be available on caremark.com/eutf.)
  2. Added prior authorization and quantity limits under the EUTF non-Medicare retiree plan effective July 1, 2022 for Opzelura (treats atopic dermatitis) and eye drops used to treat presbyopia (farsightedness) such as Vuity.
  3. Added the Drug Exclusion Plan Design program which excludes targeted drugs with little or no clinical value under the EUTF non-Medicare retiree plan effective January 1, 2022.
  4. Added utilization management such as prior authorization, step-therapy, and/or quantity limits under the EUTF non-Medicare retiree plan effective January 1, 2022 for the following drugs or classes: Acthar (treats infantile spasms); Afrezza (treats diabetes); Mupirocin (treats bacterial infections); Omega-3 fatty acids (treats hyperlipidemia); Palforzia (treats peanut allergies); products for migraine, neuralgia, psoriasis, and rosacea; and topical corticosteroids.
  5. Updated the coordination of benefits for secondary cardholders under the EUTF non-Medicare retiree plan effective January 1, 2022. Copayment may change depending on primary coverage.
For EUTF Members
CVS/SSI PlanJanuary 1 - December 31, 2022January 1 - December 31, 2021
EUTF SSI Prescription Drug Plan (Medicare)Summary of Benefits

Evidence of Coverage
Summary of Benefits

Evidence of Coverage
EUTF CVS Prescription Drug Plan (Non-Medicare)Benefits at a GlanceBenefits at a Glance
For HSTA VB Members
CVS/SSI PlanJanuary 1 - December 31, 2022January 1 - December 31, 2021
HSTA VB SSI Prescription Drug Plan (Medicare)Summary of Benefits

Evidence of Coverage
Summary of Benefits

Evidence of Coverage
HSTA VB CVS Prescription Drug Plan (Non-Medicare)Benefits at a GlanceBenefits at a Glance