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GENERIC DRUGVOUCHER PROGRAM

A COST-SAVING ALTERNATIVE

The rising cost of medication is a concern for healthinsurance members, employers and physicians. As oneresponse to this concern, The ODS Companies (ODS) hasdeveloped the Generic Drug Voucher Program. The voucherprogram is designed to promote the use of safe andeffective medications that are not available as samplesat the doctor’s office.

For participating employer groups, the Generic Drug VoucherProgram allows members with prescription coverage throughODS to receive an initial 30-day supply of a selected genericdrug at a one-time $0 copayment.

The voucher can be found on page 2 of this document and isalso available at www.odscompanies.com through yourmyODS online account, at participating employer groupintranet sites or by mail when requested from ODS.

AT YOUR PROVIDER’S OFFICE

Members are encouraged to take avoucher to their provider appointments todiscuss if any of the vouchermedications would be appropriateas either a new medication or analternative to a medication theyare currently taking. If themember’s physician agrees thatone of the medications listed onthe voucher would be appropriate,the member should obtain a newprescription from his or herphysician to present at the pharmacywith the voucher.

AT YOUR PHARMACY

The preferred generic voucher form must be accompaniedby a new prescription. Your pharmacy will use theinformation on the voucher form to process theprescription at a one-time $0 copayment. Vouchers arevalid for only one drug at a time. The $0 copaymentapplies only once to the selected medication; anysubsequent refills will be subject to the copayment andprescription benefit guidelines for your program.

Voucher forms are only available to members anddependents of employer groups who participate inthis program.

Please keep in mind that your physician can best assessthe appropriateness of a medication available throughthe voucher program for your individual treatment.

Manage your benefits andaccess helpful tools and

resources online atwww.odscompanies.com

801172 (12/08) Rx-1090-Marquis

Drug Class Generic Drug Name Equivalent To Strength

ALLERGY/SINUS � Fluticasone nasal spray Flonase 50mcg/act

ANTIDEPRESSANT � Bupropion SR Wellbutrin SR 150mg

� Fluoxetine Prozac 10mg

� Fluoxetine Prozac 20mg

� Sertraline Zoloft 25mg

� Sertraline Zoloft 50mg

BLOOD PRESSURE � Amlodipine Norvasc 5mg

� Amlodipine Norvasc 10mg

� Atenolol Tenormin 50mg

� Hydrochlorothiazide Hydrodiuril 12.5mg

� Hydrochlorothiazide Hydrodiuril 25mg

� Lisinopril Zestril 10mg

� Metoprolol succinate Toprol XL 100mg

CHOLESTEROL � Lovastatin Mevacor 20mg

� Simvastatin Zocor 40mg

DIABETES � Glimepiride Amaryl 2mg

� Glipizide Glucotrol 5mg

� Glyburide Diabeta 5mg

� Metformin Glucophage 500mg

� Metformin Glucophage 1000mg

MIGRAINE � Sumatriptan Imitrex 50mg

� Sumatriptan Imitrex 100mg

PAIN/ARTHRITIS � Ibuprofen Motrin 800mg

� Naproxen Naprosyn 500mg

OSTEOPOROSIS � Alendronate Fosamax 10mg

� Alendronate Fosamax 70mg

STOMACH/ULCER � Omeprazole Prilosec 20mg

� Pantoprazole Protonix 40mg

� Ranitidine Zantac 150mg

Directions for Pharmacy

� Submit for drug on front ofvoucher as usual prescription

� Plan will pay all prescriptioncosts (no patient copayment)

� Plan name: ODS

� Carrier number: 38147

� Enter patient ID frommember card

� Enter person code frommember card

� Enter group number frommember card

� No reimbursement claim maybe submitted with respect tothe product covered byvoucher

� Call MedImpact at800-788-2949 or ODSPharmacy Customer Serviceat 888-361-1610

Good for initial prescription,one-time only. Refills followusual procedure.

This is a voucher only — do not dispense unless accompanied by a prescription.No co-payment on first 30-day prescription for the drugs listed below.

EFFECTIVE 1/1/2009

MARQUIS GENERIC DRUG VOUCHERPROGRAM DRUG LIST