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Prescription Benefits

If at the time of your retirement you're eligible for Medicare, you will be enrolled in SilverScript—a division of the CVS Health drug program—automatically. If you become Medicare eligible after your retirement date, you will be transferred to SilverScript once we receive a copy of your Medicare card indicating you have part A and B (you do not need to apply for part D). Failure to submit a copy of your Medicare card can lead to improper administration of your prescription drug plan or loss of coverage.

Once you are enrolled in SilverScript, you will receive a personal ID card. Learn more about your SilverScript prescription benefits. If you have questions or concerns about your enrollment, please contact SilverScript directly at 1-855-702-1187.

If you are not Medicare-eligible, you and any eligible non-Medicare dependents will receive ID cards from CVS Caremark and your coverage will continue under the “commercial” CVS Caremark Prescription Drug plan.

CVS Caremark Plan Highlights

Retirees Under Age 65 or Non-Medicare Eligible

Prescription

Retail

Preferred Network and Mail 90‐Day Supply

Annual Deductible

$150

None

Annual Out-Of-Pocket Maximum

None

None

Retirees Under Age 65 or Non-Medicare Eligible

Copays

Generic Drugs (A)

Preferred Brand Drugs (B)

NonPreferred Brand Drugs (C)

30-Day Supply (any network pharmacy*)

$15

$40

$60

90-Day Supply (Mail and Preferred Network Pharmacy**)

$25

$60

$100

SilverScript Plan Highlights

Retirees Over 65 or Under 65 and on Medicare

Prescription

Retail

Preferred Network and Mail 90‐Day Supply

Annual Deductible

$150

None

Annual Out-Of-Pocket Maximum

None

None

Retirees Over 65 or Under 65 and on Medicare

Copays

Standard Network Retail*

Preferred Network Retail**

Mail Order

Generic Drugs (A)

30-Day Supply

$15

$15

$25

60-Day Supply

$30

$30

$25

90-Day Supply

$45

$25

$25

Preferred Brand Drugs (B)

30-Day Supply

$40

$40

$60

60-Day Supply

$80

$80

$60

90-Day Supply

$120

$60

$60

Non-Preferred Brand Drugs (C)

30-Day Supply

$60

$60

$100

60-Day Supply

$120

$120

$100

90-Day Supply

$180

$100

$100

* The plan has a network of pharmacies, including retail, mail-order, long-term care and home infusion pharmacies. To find a network pharmacy near you, call the Pharmacy Benefit Manager at the number listed on your card.

** The network includes preferred network retail pharmacies, which may offer you lower costs than other network pharmacies. If you use a preferred network pharmacy, the deductible will be waived if your script is for a 90-Day supply.

(A) The active ingredients in generic drugs are exactly the same as the active ingredients in brand drugs whose patents have expired. They are required by the FDA to be as safe and effective as the brand drug.

(B) Brand drugs that do not have a generic equivalent and are included on a preferred drug list.

(C) Brand drugs that are not on a preferred drug list and usually are a higher cost. For information about your copays when you fill prescriptions for specialty drugs, please see the 2022 Summary of Benefits.

*CVS Health negotiated pricing for clinically equivalent brand name drug
**Visit caremark.com for a list of network pharmacies

 

Although Con Edison currently sponsors the Retiree Health Program, the information above does not alter the company’s right to change or terminate the program at any time due to changes in laws governing employee benefit plans, the requirements of the Internal Revenue Code, Employee Retirement Income Security Act, or for any other reason. The company is not obligated to contribute any fixed amount or percentage of program costs.

 

Notice of Privacy Practices

 The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires Con Edison and the health plans sponsored by the company to protect your personal health information (PHI). As a participant under one of the health plans offered by Con Edison, we are required to notify you of the privacy practices that will be followed by the company and the plans and your rights concerning your personal health information.

 

Under the law and privacy practices, we have the responsibility to protect the privacy of your personal health information by:

 

1.    limiting who may see it
2.    limiting how we may use or disclose it
3.    explaining our legal duties and privacy practices
4.    adhering to these privacy practices
5.    informing you of your legal rights

A required notice describing participant’s rights under HIPAA and how medical information about you may be disclosed