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bMedco Health Solutions, Inc. 100 Parsons Pond Drive Franklin Lakes, NJ 07417 www.medco.com/rph

Summary of New Plan Sponsors and Important Information

Plan sponsor: Effective date: Action requested:

See below January 1, 2010 Effective January 1, 2010 New Plan Sponsors Geographic area: Number of lives:

See below See below

Effective January 1, 2010, process claims for sponsors listed below using the newly issued ID card. Pharmacy must submit claims to Medco through the TelePAID® System using:

  • -

    Rx BIN number

  • -

    New Rx Group number

  • -

    Member's new ID number

RxBIN: Plan Sponsor AEGON USA, LLC.

610014

Rx Group # RXAEGCO

ID number format 12 numeric digits

  • #

    of lives

31,000

Geographic area Nationwide (esp. Mid-west)

Ball State University BCBSM – State of Michigan

BSURXRX BCBSMRX1

Blue Care Network of Michigan

MiBCNRX

BlueCaid of Michigan

BCNCAID

Coventry Health Care plans Cummins Cummins (HRA) Fidelity Investments FMR LLC

CVTYCOM CUMMINS CUMMINS FIDELITYRX

9 numeric digits

9 numeric digits (ignore first 3 alpha) 10 numeric digits (ignore first 3 alpha) 10 numeric digits (ignore first 3 alpha) 11 numeric digits

12 alphanumeric digits 12 alphanumeric digits 12 numeric digits

First Scripts

HD Supply HMSA HMSA Medicaid (Quest)

Indiana Comprehensive Health Insurance Association

FSNCVTY FSNUSPS FSNSFED HDSUPPLY

HMSA01 HMSAQST RXICHIA

9 numeric digits

12 numeric digits 13 alphanumeric characters 10 numeric digits 11 numeric digits

Johnson & Johnson Jackson Health Plan (Effective 12/1/09)

Lockhead Martin OmniCare Health Plan, Inc.(Medicaid) Owens Corning

Purdue University

SAIC State of Indiana

State of New Jersey

Southern Health Services, Inc. (Carenet) The Walt Disney Company

UAW Retiree Medical Benefit Trust – VEBA University Hospitals

Xerox

JJRXCOV

JMHSCOM LMCRX1

CVTYMCD

OWENSRX1 PURDUERX

SAICRX1 SOIDARX

NJSTATE CVTYMCD

DISNEYRX URMBTRX

UHRX XEROXRX

12 numeric digits 8 numeric digits

12 numeric digits 11 numeric digits

12 numeric digits

U followed by 8 digits (U12345678) 12 numeric digits

9 numeric digits (ignore 3 leading alpha) 12 numeric digits

11 numeric digits

12 numeric digits

12 numeric digits (Humana) 12 alphanumeric (BCBS) 12 digit numeric

12 numeric digits

80,000

Nationwide (esp. Boston,

MA)

340,000

Nationwide

7,500

Indiana

150,000

Nationwide

590,000

Michigan

19,000

Michigan

1.7 million

Nationwide

10,000

Nationwide (esp. IA, WI, TN)

20,000

Nationwide (esp. IA, WI, TN)

22,000

Nationwide (esp. GA)

450,000

Hawaii

105,000

Hawaii

6,500

Indiana

55,000

Nationwide

10,000

Florida

112,000

Nationwide

54,700

Michigan

35,000

Nationwide

26,000

Indiana

40,000

Nationwide

60,000

Indiana

800,000

New Jersey and Northeast

21,300

Virginia

140,000

Nationwide

800,000

Nationwide

22,000

Ohio

50,000

National (esp. NY)

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