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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />RYAN L. BUTLER, CLERK <br />A. Network Pharmacy Services <br />Pharmacy help desk <br />Pharmacy reimbursement <br />Pharmacy network management <br />Network development (upon request) <br />B. Home Delivery Services <br />Benefit education <br />Prescrition delive – standard <br />Reporting <br />Web -based client reporting <br />Annual Strategic Account Plan report <br />Ad-hoc desktop parametric reports <br />Billing reports <br />Claims detail extract file electronic CPDP format <br />Inquiry access to claims processing system <br />Load 12 months claims history for clinical reports and <br />reporting <br />Website Services <br />Express-Scripts.com for Members — access to benefit, <br />Mobile App for Members — Includes My Rx <br />drug, health and wellness information; prescription <br />Choices, My Medicine Cabinet, Pharmacy <br />ordering capability; and customer service <br />Care Alerts, Refills and Renewals, and virtual <br />rescri tion ID card. <br />Implementation Package and ��Communications <br />• New Member packets (includes two standard resin ID <br />cards or virtual cards, depending on PBM's procedures) <br />• Member replacement cards printed via web (for hard- <br />copy cards, charges are passed through from the PBM <br />• Member -requested replacement packets or Client <br />$1.50 + postage per packet or card <br />requested re -carding <br />Concurrent Drug Utilization Review (DUR) <br />No Charge <br />Overrides <br />a. Client -requested overrides <br />b. Lost/stolen overrides <br />c. Vacation supplies <br />2.1 Administrator Protect Program <br />If elected, the Low Clinical Value ("LCV') exclusion option prevents unnecessary spending by <br />removing LCV medications from the formulary without impact to client rebates while providing <br />equal or more effective medicines at a lower cost. LCV medications are drugs that treat common <br />conditions that do not provide any additional or superior therapeutic value when compared to <br />currently existing therapies already in the marketplace. These medications are excluded in <br />addition to any products that would normally be excluded by the PBM Formulary. This <br />exclusion occurs without affecting Rebate minimum guarantees or contracted discount rates. <br />Administrator reserves the right to amend, from time to time, the list of low clinical value <br />medications. The list of low clinical value medications may be updated quarterly. Client may <br />request a current list of LCV medications. <br />If elected, Administrator's High Dollar Claim Review, Prior Authorization and Appeals <br />program ("HDCR"), will provide Client with umbrella protection against high-cost Prescription <br />Drug Claims for approved non -specialty formulary drugs. Prescription Drug Claims over the <br />threshold dollar amount are flagged prior to payment and reviewed for clinical appropriateness. <br />This additional level of clinical oversight protects against unnecessary spending, saving clients <br />money and providing improved visibility into claim reviews, decision processes, and cost <br />savings. If HDCR is elected, Administrator's Complex Clinical Intervention ("CCI") program <br />is included. CCI addresses complex case management issues for Members on a trajectory to <br />NOT FOR DISTRIBUTION. THE INFORMATION CONTAINED HEREIN IS CONFIDENTIAL, PROPRIETARY <br />AND CONSTITUTES TRADE SECRETS OF ESI AND RXBENEFITS <br />