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.
2022 Prescription Drug Options | Forms and Applications | Benefit Modification Brochures | Group administrator guide | Employer Connection provides resources for your clients | Network
| 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 |
| 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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Chico, CA 95927-2540
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