CVS/SSI Retiree Benefits

What’s New?
CVS plan changes for EUTF non-Medicare retirees:

  1. Excluded Glumetza (Metformin ER modified-release tablets), Fortament (Metformin ER osmotic tablets), and their respective generic formulations effective January 1, 2021.
  2. Updated the coordination of benefits for members who have EUTF coverage as secondary coverage effective January 1, 2022. Copays may be subject to change and may increase or decrease depending upon primary coverage.
For EUTF Members
CVS/SSI PlansJanuary 1 - December 31, 2021January 1 - December 31, 2020
EUTF SSI Prescription Drug Plan (Medicare)Summary of Benefits

Evidence of Coverage
Summary of Benefits
EUTF CVS Prescription Drug Plan (Non-Medicare)Benefits at a GlanceBenefits at a Glance
For HSTA VB Members
CVS/SSI PlanJanuary 1 - December 31, 2021January 1 - December 31, 2020
HSTA VB SSI Prescription Drug Plan (Medicare)Summary of Benefits

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