RXBIN: 004336 RXPCN: ADV RXGRP: RX1128 (CCAI) RX1078 (FHN) Community Care Alliance of Illinois and Family Health Network are existing plan sponsors with CVS/caremark. Effective February 1, 2016, CCAI and FHN will make the following formulary changes.

Effective February 1, 2016, CVS/caremark will begin to administer the prescription benefits for PETCO. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS/caremark. RXBIN: 004336 RXPCN: ADV RXGRP: RX1172 Member ID Format: 11 digits, "1PT" + 8 digits Person Code:not required

Heritage Health Solutions RXBIN: 004336 RXPCN: ADV RXGRP: RX1870 Heritage Health Solutions is an existing plan sponsor with CVS/caremark. Effective February 1, 2016, the Rx Group for this plan will change from RX1808 to RX1870. Please update member profiles with this new claims processing information. Beginning February 1, 2016, if claims are submitted using the old Rx Group number the following or similar reject will occur: Reject 69 : <Filled After Coverage Term/ Group Not Effective > <Use BPG 004336/ADV/RX1870>