Changes to the Prescription Drug Program for New York City Welfare Fund Participants

Effective June 1, 2010

The Trustees of the Local 237 Welfare Fund have taken action to preserve and expand benefits for current and future members.

While the costs of prescription drugs have increased sharply, Fund contributions and income have not kept pace with medical inflation, contributing to a projected operating deficit of over $10 million this year. Member co-pays were last increased in 1993, while the prescription cap was doubled, from a maximum benefit of $5,000 to $10,000, in 1999.

Rather than reduce benefits, the Fund Board of Trustees has voted to increase the maximum prescription benefit and also voted for a modest increase in member co-pays for prescription drugs.

Here are the changes to the Fund’s prescription program:

• The cap – or maximum annual drug benefit – will be increased from $10,000 to $12,500.

• Co-pays for a 34-day supply or less of a generic drug purchased at a local pharmacy will be increased to $5 and co-pays for a name-brand drug will rise to $15. If the prescription is for more than a 34-day supply, the co-pay at a local pharmacy doubles to $10 for generic drugs and $30 for brand name.

• A 90-day supply ordered through the voluntary Medco mail order program is available to members for a single co-pay. The cost will be $5 for generic and $15 for name-brand for a full 90-day supply, the same price as a 34-day supply purchased at a local pharmacy.

While the mail order program is optional, all members using “maintenance drugs” are encouraged to take advantage of the savings and convenience available through Medco. You can call Medco at 1-800-457-1020 or go to www.medco.com for more information.

Even with the modest increased co-pay, Local 237 members will have the lowest co-pays of any New York City employees. There are no changes to the other benefits provided by the Welfare Fund. Nor will these changes affect your City provided health care benefits.

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