2019 Individual & Family Plans
Formulary (List of Covered Drugs)
Download the complete Formulary or search the list of covered drugs below.
Individual & Family Plans Formulary (PDF) Updated 04/01/2019
Prior Authorization Criteria
(PDF) Updated 04/01/2019
Step Therapy Criteria
(PDF) Updated 02/01/2019
Specialty Pharmacy Drug List (PDF) Updated 04/01/2018
October 2018