RX DRUG BENEFITS • Same benefit level for HMO, HMO HDP & PPO HDP • All major pharmacies are included • Pharmacy Benefit Manager is CVS Caremark • Member uses RSI debit card to cover the full cost of covered Rx drugs Member Responsibility Tier 1 Tier 2 Tier 3 30 Day (Retail) $0 $0 $0 90 Day (Mail Order) $0 $0 $0