Exhibit_C_-_Current_Plan_Designs.pdf

This document is a series of Prime Benefits benefit summaries for multiple BlueOptions pharmacy benefit plans for the years 2023 and 2024, generated by Prime Therapeutics for THE SCHL BD OF MARION CN, a self-insured organization. The plans are PEP BlueScript commercial products with various plan codes, effective dates of 1/1/2005, and versions ranging from 2.4 to 12.6. The plans are consistently structured as self-insured (ASO), with a group number of 16153, and are not HSA plans. Each plan offers a standard commercial pharmacy benefit with a 3-tier retail copay structure, 30-day maximum supply, and coverage for various medication categories including generic, brand preferred/formulary, and brand non-preferred/non-formulary drugs.

The plans include comprehensive pharmacy benefits with standard network coverage, out-of-network options with 50% coinsurance, and various specialized programs such as compound medication coverage, ESN (Extended Supply Network) benefits, and specific incentive structures for different medication categories like diabetes supplies, high blood pressure, and cholesterol medications. The plans cover USPSTF ACA drug lists including preventive care items like bowel preps, breast cancer screenings, HIV PrEP, statins, and tobacco cessation. They also have specific provisions for diabetic supplies, contraceptives, and other medication types, with nuanced copay and coinsurance arrangements. Notably, the plans have Member Level Benefits with behavior-based incentive programs and include provisions for prior authorization, quantity limits, and step therapy programs.