Quote your mail discount for Mail Generic generic products that are (MAC) included on your MAC list Part 1.0, Question 1.2 Continued FINANCIAL DRUG COSTS UNDER A 100% TRANSPARENT ARRANGEMENT CALENDAR YEAR 2010 ETF’s Current National Narrow Network Dispensing Fees Network Network Match Quote as a dollar amount per Retail Dispensing Fee brand claim (Brand) Quote as a dollar amount per Retail Dispensing Fee generic claim (Generic) Dispensing Fees Mail Service Pharmacy Quote as a dollar amount per Mail Dispensing Fee brand claim (Brand) Quote as a dollar amount per Mail Dispensing Fee generic claim (Generic) PROPOSED ADMINISTRATION FEES UNDER A 100% TRANSPARENT ARRANGEMENT AS DEFINED IN SECTION A Calendar Year 2011 2011 Administrative Fees Retail Mail Per Claim – Quote dollar amount per paid Admin Fee Electronic electronic claim Quote dollar amount per paid Admin Fee Paper paper claim
Quote your mail discount for generic products that are included on your MAC list Mail Generic (MAC) Part 1.0, Question 1.2 Continued FINANCIAL DRUG COSTS UNDER A 100% TRANSPARENT ARRANGEMENT CALENDAR YEAR 2010 Dispensing Fees National Network Narrow Network ETF’s Current Network Match Quote as a dollar amount per brand claim Retail Dispensing Fee (Brand) Quote as a dollar amount per generic claim Retail Dispensing Fee (Generic) Dispensing Fees Mail Service Pharmacy Quote as a dollar amount per brand claim Mail Dispensing Fee (Brand) Quote as a dollar amount per generic claim Mail Dispensing Fee (Generic) PROPOSED ADMINISTRATION FEES UNDER A 100% TRANSPARENT ARRANGEMENT AS DEFINED IN SECTION A Calendar Year 2011 2011 Administrative Fees – Per Claim Retail Mail Quote dollar amount per paid electronic claim Admin Fee Electronic Quote dollar amount per paid paper claim Admin Fee Paper
PBM_RFP_SecD_Cost%20Proposal.docx