ARCHDIOCESE OF KANSAS CITY in KANSAS Prescription Drug Benefit Changes Effective January 1, 2019 CONFIDENTIAL

1 2 3 4 Table of Contents Formulary Change Copay Changes Rx to OTC Program 4 BIC Align Program CONFIDENTIAL

Formulary Change Changing to MedTrakRx Select Formulary Approximately 140 Excluded Medications Impacted Members will receive letters one month prior to the change advising of covered alternative drug options. Your medication may change from one copay tier to another. MedTrakRx works with the Archdiocese of Kansas City in Kansas to provide high-quality prescription benefits. In an effort to manage ever increasing medication costs, we conduct bi-annual formulary reviews to ensure your plan’s medications are safe, affordable and effective. CONFIDENTIAL

Rx Copay Changes Copay Changes are highlighted in yellow.

Rx to OTC Program CONFIDENTIAL

Rx to OTC Program (continued) Impacted Members will receive a letter one month prior to the change advising that their prescription medication will no longer be covered effective 1/1/19. The name of the covered OTC alternative will be provided. A new Prescription for the OTC product may be required. The member will be charged the generic copay for the OTC product. Newly prescribed prescription medications on 1/1/19 or after will reject at the point of sale. Messaging will appear for the pharmacist that will indicate what the covered OTC alternative is.

BIC Align Program Highlights The BIC Align Program is designed to reduce both member out-of-pocket expenses and plan pay on certain specialty medications. Targets certain specialty drugs, wherein manufacturer copay assistance has been identified. Members will never pay more than their plan’s designated brand flat copay for specialty drugs. Specialty pharmacies in the BIC network will assist the member in obtaining manufacturer copay assistance and will advise MedTrakRx if a member exhausts available copay assistance for the year so that the copay can be adjusted back to the plan’s specialty default copay for the remainder of the benefit year. Therapeutic Classes include: Hepatitis C PCSK9 Inhibitors HIV Pulmonary Fibrosis Agents / Cystic Fibrosis / Asthma Inflammatory Conditions Growth Hormones Multiple Sclerosis Infusion Channel Oncology CONFIDENTIAL

Thank You! CONFIDENTIAL