Prescription Drug Benefits

If you enroll in either medical plan, you are automatically enrolled in the prescription drug plan, administered by Express Scripts, Inc. Medications filled by a non-participating pharmacy will not be covered.

Traditional PPO. You pay nothing for preventive drugs and nothing for Sanofi US prescription drugs ordered in person or by mail.
SavingsPlus HSA. Under the SavingsPlus HSA plan, prescription drugs are subject to deductible and coinsurance, including Sanofi drugs, for which you pay the full cost until the deductible is met. (Once the deductible is met, you pay $0 for Sanofi drugs.) The exception is for preventive drugs on the preventive drug list, which you’ll receive at no cost before the deductible is met.

Prescription Drugs Comparison Chart

	SavingsPlus HSA	Traditional PPO
Sanofi US Prescription Drugs	Once the deductible is met, company products are $0	$0
Preventive	$0	$0
Retail
Generic	10% coinsurance after deductible ($15 min / $25 max)	10% coinsurance ($15 min / $25 max)
Formulary	10% coinsurance after deductible ($25 min / $50 max)	10% coinsurance ($25 min / $50 max)
Non-Formulary	10% coinsurance after deductible ($40 min / $80 max)	10% coinsurance ($40 min / $80 max)
Mail Order
Generic	10% coinsurance after deductible ($30 min / $50 max)	10% coinsurance ($30 min / $50 max)
Formulary	10% coinsurance after deductible ($50 min / $100 max)	10% coinsurance ($50 min / $100 max)
Non-Formulary	10% coinsurance after deductible ($80 min / $160 max)	10% coinsurance ($80 min / $160 max)

Example of Prescription Drug Costs: Traditional PPO vs. SavingsPlus HSA

The example below assumes:

You are purchasing a 30-day supply of a generic, non-preventive drug.
The drug has an actual cost of $100.

Your Cost Under the Traditional PPO

Your payment is not dependent on if you have met your annual deductible.
In this example, you would pay $15 for your prescription (10% coinsurance, with a minimum $15).

Your Cost Under the SavingsPlus HSA

What you pay for prescription drugs depends on if you have met your annual deductible.

If you have not met your annual deductible:

You pay the full cost of the drug: $100 in this example.
This payment counts toward the requirement to meet the annual deductible.
To help pay for the cost, you can use the tax-free funds in your HSA.
Sanofi contributes to your HSA, in part, to help offset the cost of your deductible.

If you have already met your annual deductible:

In this example, you would pay $15 for your prescription (10% coinsurance, with a minimum of $15).

Contact Express Scripts, Inc.: 877-531-4791 | www.express-scripts.com