Notice of Pharmacy Benefit Network

Dear Employee:

Effective <INSERT EFFECTIVE DATE OF NEW PBN>, your prescription benefits for workers’ compensation will be handled by Cypress Care, a Pharmacy Benefit Network (PBN) – in accordance with California Labor Code 4600.2(a). As a result, prescription medications for work-related injuries may only be obtained through Cypress Care.

In the event of a workers’ compensation injury, you and your physician will be given instructions for obtaining prescription medications by our workers’ compensation carrier, Berkshire Hathaway GUARD Insurance Companies.

If you have any questions, please call Cypress Care at 1-800-419-7191. For a listing of participating pharmacies you may log into www.cypresscare.com.