2025 formularies
For coverage dates starting 01/01/2025, please refer to the following lists.
- Value 4-Tier: Searchable List | PDF
- Premium 3-Tier: Searchable List | PDF
- Premium 4-Tier: Searchable List | PDF
Which formulary should I use?
You may need to check with your employer to know which formulary you should use. Or call the Member Services number on your member ID card.