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Calculation of Earned Credits
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After you or your eligible dependents use other prescription drug coverage to obtain prescription drugs, you should submit a Prescription Incentive Program claim form to the Fund office. Attach your pharmacy receipts for each prescription filled showing the amount of your out-of-pocket costs and information which will identify the prescription drug.
The Fund office will then take the following steps:
Reimburse you for your out-of-pocket costs for using your other prescription drug coverage and
Calculate the earned credits to be recorded to your account based on the net savings to the Fund, as described below.
Net Savings
The earned credits to be recorded to your account will be a percentage of the net savings to the Fund as a result of your use of the other prescription drug coverage. The Fund's net savings is determined as follows:
1. The amount it would have cost the Fund to provide you or your eligible dependent with that prescription drug under the Fund's plan (the Fund's cost, less the co-pay and other costs you would have incurred under the Fund's Prescription Drug Benefits), minus
2. The amount of any out-of-pocket costs (co-pays, deductibles, coinsurance) that the Fund reimburses you for using your other prescription drug coverage.
Your earned credits will be a percentage of the net savings to the Fund. If you obtained your prescription drug at a Preferred Pharmacy or under the Fund's mail order program, the earned credits to your account will be an amount equal to fifty percent (50%) of the net savings to the Fund. If you obtained the prescription drug from a Non-Preferred Pharmacy, the earned credits to your account will be an amount equal to forty percent (40%) of the net savings to the Fund. See the section titled "Prescription Drug Benefits" for a list of Preferred Pharmacies.
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