Summary Plan Description

Nonparticipating Pharmacies

You may purchase covered prescription drugs at pharmacies that do not participate in the program. However, when you purchase a covered prescription from a nonparticipating pharmacy, you must pay full retail price and submit a Prescription Drug Reimbursement/Coordination of Benefits Claim Form to Express Scripts. Express Scripts will reimburse you at 100 percent of the "average wholesale price" – the program's discounted price – less the appropriate copayment.