ITDR Low Cost Generics Program

℞℞℞ List of Participating Pharmacies

This program has been designed for the Trust by J. Smith Lanier & Co. and Express Scripts. This is the only such program established by Express Scripts. It is another benefit Trust Members are able to enjoy due to our size with over 24,000 Members.

Pharmacies participating in the ITDR Low Cost Generics Program: • Pharmacies from the Express Scripts’ network were chosen for the program to maximize Trust Plan Members’ access, following review of our Members’ geographic access and past utilization. • Members may select from over 95 participating grocery and chains with more than 19,000 locations.* The 10 largest participating chains in order of number of locations are Rite Aid, , Target, , , Safeway, Sam’s Club, , Winn-Dixie, and Shopko Pharmacy. • 97% of Members have access to a participating pharmacy within 10 miles of their home zip codes, 88% within 5 miles. Overall, 99% have access within 15 miles, with the remaining 1% of Members living in more remote locations.

How can you learn more about the ITDR Low Cost Generics program? Go online: 1. See the list of covered drugs on the Trust website, insurancetrust4deltaretirees.com . 2. Visit Express Scripts’ website at Express-Scripts.com . (Set up your account on or after January 1, 2015.) 3. Select My Rx Choices ® on the Express Scripts website. Follow the steps to select a covered drug and your participating pharmacy. You will then see retail pricing of $2 or $4, compared with the cost for Home Delivery. Call ITDR’s Express Scripts Customer Service, available now, 24/7, at 1-844-470-1529, TTY users 1-800-716-3231.

*Other pharmacies are available in the Express Scripts network. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.

2015 ITDR Low Cost Generics Program: Participating Pharmacies

Grocery/Retail Chain Name Grocery/Retail Chain Name Grocery/Retail Chain Name A & P Hartig Drug Rite Aid ACME Sav-on Pharmacy Harveys Ritzman Pharmacy Allcare Pharmacy H-E-B Rx Care Pharmacy Baker's Pharmacy Hometown Pharmacy Safeway Pharmacy Bashas' United Drug Pharmacy Sam's Club Bel Air Pharmacy Pharmacy Save Mart Pharmacy Bi-Lo Pharmacy Pharmacy Sav-on Pharmacy Carrs Pharmacy Kroger Pharmacy Shaw's Osco Pharmacy City Market Macey's Pharmacy Shaw's Pharmacy Clinic Pharmacy Martin's Shop 'n Save Coborn's Pharmacy Martin's Pharmacy Shopko Pharmacy Community Pharmacy Medical Arts Pharmacy Shoppers Pharmacy Costco Medical Center Pharmacy ShopRite Pharmacy Medical Plaza Pharmacy ShopRite Pharmacy Cub Medicine Shoppe Pharmacy Smith's Food and Drug Cub Pharmacy Pharmacy Southern Family Market Dillon Pharmacy Mina Pharmacy Stop & Shop Discount Drug Mart Osco Drug Super Fresh Express Pharmacy Owens Healthcare Super Rx Pharmacy Fagen Pharmacy Pharmacy Target Pharmacy Family Pharmacy Pharmacy The Medicine Shoppe Farm Fresh Pharmacy Payless Pharmacy Times Pharmacy Pharmacy Pharmacy Plus Tom Thumb Pharmacy Pharmacy Plaza Pharmacy U-Save Pharmacy Fred's Pharmacy Price Chopper Pharmacy UW Health Pharmacy Services Fresh Market Pharmacy Price Cutter Pharmacy Village Pharmacy Fry's Food And Drug Professional Pharmacy Pharmacy Giant Discount Drug Publix Waldbaum's Giant Pharmacy QFC Pharmacy Walmart Hannaford Food And Drug Raley's Drug Center Weis Pharmacy Pharmacy Ralph's Pharmacy Winn-Dixie Pharmacy Pharmacy Pharmacy Yokes Pharmacy