This is a summary of the benefits available to you under the Consumer Assistance Services Association Generic Only Prescription Drug Plan underwritten by ACE American Insurance Company. It is a summary only, and is not a policy or a contract of insurance.

You are eligible for this plan if you are actively enrolled in Consumer's Choice/USA through the America's Health Care Consumer Association.

This insurance will become effective on the effective date of your Consumer's Choice plan, provided the required premium is paid.

Insurance will end on the date the Policy terminates, the date the insured person is no longer eligible as described above, or the date the period ends for which premium has been paid.

Pharmacy Plan Highlights

• Pays for most Generic medications
• No Waiting Periods for Pre-Existing Conditions!
• Can be used REGARDLESS of current Health Conditions
• Never Pay Retail Cost for Generic or Brand Name Drugs Again!
• $50 Deductible Per Member
  • $15 Co-pay for covered Generic Drugs at a contracted participating Retail pharmacy / $45 Co-pay at the contracted Mail Service Facility
  • Receive a Discount below average wholesale price on Brand Name Drugs at a contracted participating pharmacy. Brand Name Drugs are not covered under the policy of insurance, but are available through an arrangement with RxEdo.
• $250 Monthly Maximum Benefit per insured person, $500 per family Monthly Maximum Benefit for Generic Drugs - No Lifetime Maximum
• Accepted by more than 51,000 Participating Pharmacies

No claim forms to file when prescriptions are filled at a contracted participating pharmacy with the prescription drug card. Your personal ID Card will be all you need at the time you fill your prescription. No waiting for reimbursement.

Safety First: Every prescription goes through an electronic drug screening process to assist your pharmacist in providing quality care. Your pharmacist is alerted to any harmful drug interactions or other dangers before filling your prescriptions.

Summary of Coverage

The benefit amounts are payable for Medically Necessary Covered Charges incurred by an insured person for the purchase of outpatient Prescription Drugs from a contracted Participating or Non-Participating Pharmacy. The Deductible must be satisfied before any benefits are payable, and any Co-payment must be paid for each Prescription Drug filled or authorized refill. All generic benefit amounts are subject to the $250 per month maximum benefit for an individual and $500 per month maximum benefit for a family (1+).

The insured person will be given a prescription drug card. The insured person is required to present the prescription drug card to the contracted Participating Pharmacy. The maximum covered supply is 30 days at a Retail pharmacy, and 90 days at Mail Service. When a Prescription Drug card is used at a contracted Participating Pharmacy, benefits are assigned to the Participating Pharmacy. If an insured person purchases a Prescription Drug at a Non-Participating Pharmacy or purchases a Prescription Drug at a contracted Participating Pharmacy without the prescription drug card, the Insured Person must pay the full cost for the Prescription Drug at the time of purchase and complete a claim form. Reimbursement, subject to the contracted Participating Pharmacy Rate and the Co-payment, will be made directly to the Insured when a Non-Participating Pharmacy is used, or where purchase is made without the Prescription Drug card at a contracted Participating Pharmacy.

*Exclusions and limitations apply--see certificate for details.