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January 2023 Prescription Drug Options

Large Groups (101 and above)

You can offer your clients prescription drug options with a range of copayments and rates. These options – more than 85 in all – cover drugs and supplies in the Blue Shield Drug Formulary, including drugs and devices, contraceptives, diabetic supplies and more. You'll have flexibility when offering affordable choices that enhance your clients' medical plan.

Select a drug coverage plan to accompany the health plan your client is interested in. The information below is effective January 1, 2023 for groups with 101 or more eligible employees.

Broker Resources

2022 Prescription Drug Options | Forms and Applications  |  Benefit Modification Brochures | Group administrator guide | Employer Connection provides resources for your clients | Network 

Prescription Drug Options

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Basic Rx Riders for HMO and POS Plans Download Size
Basic Rx $10/20 with $0 Pharmacy Deductible English 
Spanish
1MB
1.7MB
Basic Rx $10/20 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Basic Rx $10/20 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Basic Rx $10/25 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Basic Rx $10/25 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Basic Rx $15/30 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Basic Rx $15/30 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Basic Rx $15/30 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB

 

Enhanced Rx Riders for HMO and POS Plans Download Size
Enhanced Rx $10/15/30 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/15/30 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/20/35 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/20/35 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/25/40 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/25/40 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/25/40 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/30/50 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/30/50 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $10/30/50 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/30/45 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/30/45 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/30/45 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/30/50% $100 max with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/30/50% $100 max with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/30/50% $100 max with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/40/70 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/40/70 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $15/40/70 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $20/40/60 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $20/40/60 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $20/40/60 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $5/10/25 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx $5/10/25 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/20/35 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/25/35 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/25/40 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/25/40 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/25/40 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/30/50 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/30/50 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $10/30/50 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $15/30/45 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $15/30/45 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $15/30/45 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $15/40/70 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $15/40/70 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $15/40/70 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $20/40/60 with $0 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $20/40/60 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Enhanced Rx - Value Formulary $20/40/60 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB

 

RX Spectrums Riders for HMO and POS Plans Download Size
Rx Spectrum $10/25/40 with $0 Pharmacy Deductible English 
Spanish
1MB
1.7MB
Rx Spectrum $15/30/45 with $0 Pharmacy Deductible English 
Spanish
1MB
1.7MB
Rx Spectrum $15/30/45 with $150 Pharmacy Deductible English 
Spanish
1MB
1.7MB

 

Not Marketed HMO/POS Plans Download Size
Basic Rx $10/15 with $0 Pharmacy Deductible English 
Spanish 
1MB
1.7MB
Basic Rx $10/15 with $150 Pharmacy Deductible English 
Spanish
1MB
1.7MB
Basic Rx $15/25 with $0 Pharmacy Deductible English 
Spanish
1MB
1.7MB
Basic Rx $15/25 with $150 Pharmacy Deductible English
Spanish
1MB
1.7MB
Basic Rx $15/25 with $250 Pharmacy Deductible English
Spanish
1MB
1.7MB
Premier Rx $0/10/25/40 with $0 Pharmacy Deductible English 
Spanish
1MB
1.7MB
Premier Rx $0/10/25/40 with $150 Pharmacy Deductible English 
Spanish
1MB
1.7MB
Premier Rx $0/10/25/40 with $250 Pharmacy Deductible English 
Spanish
1MB
1.7MB

 

Show full contents

Enhanced Rx Riders for PPO/EPO Plans Download Size
Enhanced Rx $5/10/25 with $0 Pharmacy Deductible English
Spanish
1.1MB
1.7MB
Enhanced Rx $5/10/25 with $150 Pharmacy Deductible English
Spanish
1.1MB
1.7MB
Enhanced Rx $10/15/30 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/15/30 with $150 Pharmacy Deductible English
Spanish 
1.1MB
1.7MB
Enhanced Rx $10/15/30 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/20/35 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/20/35 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/20/35 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/25/40 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/25/40 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/25/40 with $250 Pharmacy Deductible English
Spanish 
1.1MB
1.7MB
Enhanced Rx $10/30/50 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/30/50 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $10/30/50 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/30/45 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/30/45 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/30/45 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/30/50% $100 max with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/30/50% $100 max with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/30/50% $100 max with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/40/70 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/40/70 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $15/40/70 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $20/40/60 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $20/40/60 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx $20/40/60 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/20/35 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/20/35 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/20/35 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/25/40 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/25/40 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/25/40 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/30/50 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/30/50 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $10/30/50 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $15/30/45 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $15/30/45 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $15/30/45 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $15/40/70 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $15/40/70 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $15/40/70 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $20/40/60 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $20/40/60 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Enhanced Rx - Value Formulary $20/40/60 with $250 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB

 

Premier Rx Riders for PPO/EPO Plans Download Size
Premier Rx $0/10/25/40 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Premier Rx $0/10/25/40 with $150 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB

 

Rx Spectrum Riders for PPO/EPO Plans Download Size
Rx Spectrum $10/25/40 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB
Rx Spectrum $15/30/45 with $0 Pharmacy Deductible English
Spanish
1.1MB
1.7MB
Rx Spectrum $15/30/45 with $150 Pharmacy Deductible English
Spanish
1.1MB
1.7MB
Rx Spectrum $15/30/50% $100 max with $250 Pharmacy Deductible English
Spanish
1.1MB
1.7MB

 

Not Marketed Rx Spectrum Riders for PPO/EPO Plans Download Size
Rx Spectrum $0/10/25/40 with $0 Pharmacy Deductible English 
Spanish
1.1MB
1.7MB

 

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Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.