• Available at over 42,000 pharmacies nationwide
• Automatic acceptance - no application with health questions
• No age limits
• No pre-existing conditions limitation
• Generic Drugs: You pay up to $10 (Tier 1)
• Brand and Select Generic Drugs: You pay up to $20 (Tier 2)
• Brand and Select Generic Drugs: You pay up to $50 (Tier 3)

This program is designed to save you money on prescription drug costs! HPA will help you find low-cost medications within the same therapeutic class as a drug you may currently be taking.

This formulary program has the following benefit tiers:

1^st TIER: Generic Drugs
Your payment is up to $10

2^nd TIER: Brand Name and Select Generic Drugs
Your payment is up to $20

3^rd TIER: Brand Name and Select Generic Drugs
Your payment is up to $50

4^th TIER: Brand Name Drugs
HPA has negotiated special discount prices that save you up to 45% off the retail cost.

To get the most out of this program you should ask your doctor to prescribe a drug within Tiers 1, 2 or 3 if possible. Often drugs within the same therapeutic class can be prescribed in place of an expensive brand name drug. Of course if you choose the higher price brand name drug, HPA has negotiated a substantial discount to you.

The effective date is the day after HPA's administrative office receives your application and your first month's payment. Your identification card will be mailed to you. The Member Enrollment Kit will be sent to you via email. A complete drug list is available on our web site.

Once a patent on a brand name drug expires, other drug companies may make a generic version of the drug, with the approval of the Food and Drug Administration (FDA). The FDA's standards for quality are the same for all manufacturers. This means the generic drug contains the same active ingredients as the brand name whose patent has expired, and that it is safe, potent and effective.

The use of generic prescription drugs, whenever available, is most cost effective. Don't be shy – discuss your prescription options with your doctor. Ask whether an alternative, less expensive option would work for your condition.

Simply ask your local pharmacist or call the customer service department to find out about generic equivalents for your prescription. Also ask your doctor to prescribe generics whenever possible and appropriate. (Your new member packet will include helpful materials you can share with your doctor.)

The brand name is the trade name under which the product is advertised and sold, and is protected by patents so that it can only be produced by one manufacturer for a predetermined number of years. Once a patent expires, other companies may manufacturer a generic equivalent, providing they follow stringent FDA regulations for safety.
Generic drugs are drugs for which the patent has expired, allowing other manufacturers to produce and distribute the product under a generic name. Generics are essentially a chemical copy of their brand name equivalents. The color or shape may be different, but the active ingredients must be the same for both. The list contains a wide range of generic and brand name preferred products that have been approved by the FDA.

A preferred drug list is a list of recommended prescription medications that is created, reviewed and continually updated by a team of physicians and pharmacists. The preferred drug list contains a wide range of generic and brand name preferred products that have been approved by the FDA. Your doctor can use this list to select medications for your health care needs, while helping you maximize your prescription drug benefit. A medication becomes a preferred drug based on safety and efficacy, then on cost-effectiveness.

A preferred brand name drug is a medication that has been reviewed and approved by a group of physicians and pharmacists, and has been selected for preferred status based on its proven clinical and cost effectiveness. A non-preferred brand name drug is a medication that has been reviewed by the same team of physicians and pharmacists who determined that a clinically equivalent alternative drug that is most cost effective is available. These designations may change as new clinical information becomes available.

The Competitor Rx product guide contains certain brand drugs for which the member's price is the scheduled amount listed. Drugs that are chemically or therapeutically similar to drugs listed on the product guide are not discounted. Prices are subject to change due to manufacturer price changes to pharmacies. On these drugs, the participant enjoys two distinct discounts, one through the Competitor Rx pharmacy network and the second through the manufacturer.

If you are currently taking a medication that has similar active ingredients or is used to treat the same conditions as the preferred brand drugs on the Competitor Rx Pay Card product guide, it will still be discounted. You will pay the Competitor Rx negotiated price for that drug. To take advantage of the potential program savings on listed preferred drugs, you should ask your pharmacist (where regulations permit) or a doctor to change your medication, where medically appropriate, to a less expensive product listed in the product guide.

Yes, if the Rx-Pay Card is for a child only (no adults will be using the card), list the child's name and information as the applicant and the parent and legal guardian must sign the enrollment form. The monthly cost is $19.99 (same as a member). If there is more than one child to be covered, list the oldest as the applicant and the others under Children Included. The monthly cost is $28.99 (same as a member + children).

The Competitor Rx-Pay Card is accepted at over 42,000 pharmacies throughout the United States. The network includes pharmacy chains, such as, CVS, Rite Aid, Medicine Shoppe, Walgreens, Wal-Mart, and more, as well as thousands of independent pharmacies throughout the country.

Information about different drugs, their tiers and your co-pay can be searched here.

If you are not completely satisfied with this plan for any reason and have not used your membership, you may return the Rx-Pay Card within 10 days and receive a full refund of the plan cost.

HPA is a fully licensed, full-service Third Party Administrator transacting business worldwide. Established in 1939, HPA is a third generation company providing state-of-the-art industry leading insurance services, including customer serivce, claims payment, billing and reporting. HPA's specialty products divison was founded by Michale Kosloske who now serves as a company president.

Founded in 2002, Advance Benefits develops innovative benefit designs and programs to meet the varying needs of employers and health plans. Advance Benefits is an experienced benefits management company that offers a variety of pharmacy benefits and leads the way in introducing novel programs for employers and healthcare providers.

PLEASE NOTE: Not all FDA approved Generic, Preferred or Brand Name drugs are included in Tiers 1,2,3 or 4. A complete list of all drugs included in this plan is listed here. Pricing and Tier Position are subject to change without notice. Tier position and pricing is only for quantities stated, additional quantities may result in higher costs. This is not an insured product.

Administered by: Health Plan Administrators, Inc. Rockford, IL

This brochure provides a brief description of The Competitor Rx-Pay Card. Plan may not include all drugs. The drug list is subject to change with additions or deletions without notice. The Pharmacy Benefit Manager is Advance Benefits. This plan is not an insurance plan.

©2004 HPA, Inc. All rights reserved.
Rx-Pay Card bro. 08/04

THIS IS NOT AN INSURANCE PRODUCT.