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2026 Pharmacy Benefits

The Office of Group Benefits (OGB) provides comprehensive prescription drug coverage to help you and your family get the medications you need at an affordable cost. To provide an enhanced member experience for plan year 2026, OGB will partner with two Pharmacy Benefit Managers (PBMs): Liviniti and SilverScript.

Who Manages My Pharmacy Benefit

Liviniti will provide prescription drug coverage for active employees, retirees without Medicare, and their covered dependents enrolled in:

  • Magnolia Local
  • Magnolia Local Plus
  • Magnolia Open Access
  • Pelican HSA775
  • Pelican HRA 1000

To find a pharmacy, the cost of a prescription drug, or to see if a drug is in the Liviniti Network or the Liviniti formulary, visit the Liviniti website.

SilverScript will continue to provide prescription drug coverage for retired members enrolled in Medicare and their covered spouse who are also enrolled in Medicare. SilverScript offers a nationwide network of pharmacies, and plan benefits will remain the same for 2026 for retired plan members and their covered dependents enrolled in Medicare.

To find a pharmacy, the cost of a prescription drug, or to see if a drug is in the SilverScript Network or SilverScript/CMS formulary, visit the CVS Caremark website.

Pharmacy Benefits

The Magnolia Local, Magnolia Local Plus, Magnolia Open Access, Pelican HSA775, and Pelican HRA 1000 plans will use the Liviniti or SilverScript Formulary. This formulary is regularly reviewed to update drug tiers based on current prescription drug market trends. Members will continue to pay copays and coinsurance based on the drug type: generic, preferred brand, non-preferred brand, or specialty.

*Maintenance medications are not subject to the deductible, but are subject to the pharmacy copay format above. Please visit the Liviniti website to view those medications
For the plan members on the Magnolia Plans and the Pelican HRA 100, before meeting their $1,500 pharmacy out-of-pocket threshold, will pay the following co-pays:
Tier Member Responsibility*
Generic 50% up to $30
Preferred 50% up to $55
Non-Preferred 65% up to $80
Specialty 50% up to $80
After the out-of-pocket threshold amount of $1,500 is met by you and/or your covered dependent(s):
Generic $0 copay
Preferred $20 copay
Non-Preferred $40 copay
Specialty $40 copay
Members enrolled in the Pelican HSA will not have a pharmacy out-of-pocket threshold; however, you must meet your medical deductible based on your level of coverage to receive the following co-pay:
Generic $10 copay (31-day supply)
Preferred $25 copay (31-day supply)
Non-Preferred $50 copay (31-day supply)
Specialty $50 copay (31-day supply)

*For medications with a 32–62 day supply, the member copay would be 2 times the applicable tier copay.

*For medications with a 63–93 day supply, the member copay would be 3 times the applicable tier copay.

Note: $1,500 threshold does not apply to HSA775.

Note: Maintenance drugs are not subject to your medical deductible.

Disease Management

The Disease Management Program includes a pharmacy benefit that allows members enrolled in the program savings on medications used to treat the following conditions: asthma, diabetes, coronary artery disease, chronic heart failure (CHF), and Chronic Obstructive Pulmonary Disease (COPD).

GLP-1 Medication Coverage

OGB's pharmacy benefit does not cover GLP-1 medications unless they are prescribed for the treatment of Type 2 diabetes.

This means:

  • GLP-1 drugs used for weight loss, weight management, or any diagnosis other than Type 2 diabetes are not covered.
  • Coverage is only available when the prescriber documents a diagnosis of Type 2 diabetes and all applicable clinical guidelines (including prior authorization requirements) are met. Common GLP-1 medications include (but are not limited to): Ozempic®, Trulicity®, Victoza®, Mounjaro®, Rybelsus®, Saxenda®, Wegovy®.

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