Windstream Retiree Prescription Drug Plan

Administered by Express Scripts, For All Windstream Retirees

The Windstream Prescription Drug Plan provides coverage for retirees enrolled in Windstream medical plans. Windstream offersprescription coverage through Express Scripts. Co-payments are required, and an economical Home Delivery service must be used for maintenance medications.

If you have any questions regarding coverage for a particular medication or device, when a brand name penalty will be applied, plan exclusions, prior authorizations, Step Therapy, or in understanding a provision of the Windstream Prescription Drug Plan, please contact Express Scripts directly.

Express Scripts Contact Information

Phone: 1-866-804-7613

Web site:

Express Scripts Participating Pharmacies

The Express Scripts Express Advantage Network includes over28,500preferred pharmacies nationwide, and the National Plus Network includes over 67,000 pharmacies.Confirmation of Participating Pharmacies may be obtained by calling Express Scripts at 1-866-804-7613 or by accessing their Web site at You have the choice of both retail networks for non-maintenance medications, but your co-payment will be lower when you use an Express Advantage Network preferred pharmacy.

Express Scripts Formulary Drug List

You may obtain a Formulary Drug List at any time by calling the Windstream Benefits Center at 1-888-392-7597, or by contacting Express Scripts directly, or logging onto Express Scripts to check the status of your drug.The formulary list is provided to assist retirees in lowering out-of-pocket expenses; non-formulary drugs usually require a higher co-payment, so lower-cost alternatives are listed in the formulary chart. The formulary list is not a complete list of all drugs covered under the Prescription Drug Plan. The formulary list does change periodically. For the most up-to-date list and additional information, contact Express Scripts.

Retail and Mail Order Benefits

You may purchase up to a 30-day supply from retail pharmacies (using your Express Scripts ID card at participating network pharmacies). In addition, your benefit plan has a Mandatory Mail Order Program for maintenance medications (up to a 90-day supply). An Express Scripts Maintenance Medication list indicating the medications that must be obtained through mail orderis available upon request. You will be able to obtain your original prescription for a maintenance medication plus one refill at a local retail pharmacy. Thereafter, you must obtain your maintenance medication prescription refills using the Express Scripts home delivery pharmacy. You can get started with Home Delivery via the web or by phone. Your prescriptions can be mailed to:Express Scripts, P.O. Box 66566, St. Louis,MO63166-6566.

Please use an Express Scripts mail order form (can be obtained online or by calling Express Scripts). The mail order form confirms your Member ID, method of payment, etc.Your Physician can also fax your prescription to Express Scripts. Only Physician offices are allowed to use this fax number. Fax: 1-866-662-5267

Step Therapy

Step Therapy encourages the use of generic drugs since generics help you and Windstream get your medicine at the lowest possible cost.

How Does Step Therapy Work?

•Front-Line Medications: These are the drugs recommended for you to take first — usually generic medications, which have been proven safe and effective.

•Back-Up Medications: These are brand-name medications. They’re recommended for you to take if a front-line medication doesn’t work for you.

If you’ve already tried a front-line drug, or your doctor decides one of these drugs isn’t appropriate for you, then your doctor can prescribe a back-up drug, but at a higher cost. For more information on how the program works and how it benefits you, contact Express Scripts at 1-866-804-7613.

Co-Payment Schedule

Using generics and the preferred Express Advantage Network or Express Scripts Mail Order helps you get your medicine at the lowest possible cost.To learn about preferred pharmacies in the Express Advantage Network, call Express Scripts at 1-866-804-7613 or visit their Web site at .

Retail pharmacy co-payments per script / Preferred Pharmacies - Express Advantage
Network / Non-Preferred Pharmacies -
National Plus
Network / Out of Network
Generic (30-day supply) / $10.00 / $20.00 / If a prescription is filled at a non-network pharmacy, you will be responsible for paying 100% of the cost.
Formulary Brand-Name (30-day supply) / $40.00 / $50.00
Nonformulary (Non-preferred) Brand Name (30-day supply) / 50% of the cost
$40.00 minimum / 50% of the cost
$50.00 minimum
Home Delivery (Mail order)
co-payments / Out-of-Network
Generic (90-day supply) / $20.00 / No benefits for
non-network mail order services.
Formulary Brand-Name (90-day supply) / $80.00
Nonformulary (Nonpreferred) Brand Name (90-day supply) / 50% of the cost
$80.00 minimum
Specialty Medications (Mailed from Express Scripts’ specialty pharmacy: Accredo, formerly known as CuraScript)
Drugs requiring Accredo (formerly CuraScript) delivery via mail order (maximum 30-day supply) after one retail fill / 50% of the cost
$100.00 maximum per script / No benefits for
non-network
specialty
mail services.

Specialty medications (requiring Accredodelivery) are those used for chronic disease states such as (but not limited to): Hepatitis, Multiple Sclerosis, Growth Hormone Deficiency, Rheumatoid Arthritis, Infertility, Hemophilia, and Oncology.

This document is intended as an overview of the Windstream Retiree Prescription Drug Plan. In the event of a discrepancy between this summary and the official Plan Document, the Plan Document will control. In the event of any misstatement of any fact(s) affecting coverage under the Plan, the Plan shall be used to determine the proper coverage. Coverage means eligibility as well as the amount of any Benefit thereunder. Windstream reserves the right, in its sole discretion, to modify, change, revise, amend, or terminate any plan at any time, for any reason, and without prior notice, including subsidy levels.