[
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0010010",
    "marketing_name": "Bronze Standard",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0010010-01-b-standard-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2026",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 25,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 75,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 62.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 50,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 125,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 100,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 300,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 250,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 500,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 1500,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 1250,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0010020",
    "marketing_name": "Silver Standard",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0010020-01-s-standard-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2027",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 20,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 60,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 50,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 40,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 120,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 100,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 80,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 240,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 200,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 350,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 1050,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 875,
            "copay_opt": "AFTER-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0010030",
    "marketing_name": "Gold Standard",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0010030-01-g-standard-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2028",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 45,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 37.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 30,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 90,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 75,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 60,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 180,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 250,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 750,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 625,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0020010",
    "marketing_name": "Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0020010-01-b-complete-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2030",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 35,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 105,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 87.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 450,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 375,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0020011",
    "marketing_name": "Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0020011-01-b-complete-d-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2031",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 35,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 105,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 87.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 450,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 375,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.5,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0020020",
    "marketing_name": "Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0020020-01-s-complete-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2032",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 45,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 37.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 50,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 125,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0020021",
    "marketing_name": "Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0020021-01-s-complete-d-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2033",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 45,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 37.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 50,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 125,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0020030",
    "marketing_name": "Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0020030-01-g-complete-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2034",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 12.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 30,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 90,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 75,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0020031",
    "marketing_name": "Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0020031-01-g-complete-d-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2035",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 12.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 30,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 90,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 75,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0030010",
    "marketing_name": "Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0030010-01-b-elite-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2036",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 35,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 105,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 87.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 450,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 375,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0030011",
    "marketing_name": "Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0030011-01-b-elite-d-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2037",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 35,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 105,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 87.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 450,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 375,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.4,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0030020",
    "marketing_name": "Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0030020-01-s-elite-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2038",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 45,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 37.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 50,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 125,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0030021",
    "marketing_name": "Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0030021-01-s-elite-d-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2039",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 45,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 37.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 50,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 150,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 125,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.3,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0030030",
    "marketing_name": "Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0030030-01-g-elite-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2040",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 12.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 30,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 90,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 75,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  },
  {
    "plan_id_type": "HIOS-PLAN-ID",
    "plan_id": "31981OH0030031",
    "marketing_name": "Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx",
    "summary_url": "https://antidotehealth.com/assets/docs/26/m-sbc-26-oh-en-ifp-31981OH0030031-01-g-elite-d-on.pdf",
    "marketing_url": "http://www.antidotehealth.com/assets/docs/26/m-pb-26-oh-en-es-270019.pdf",
    "formulary_url": "http://antidotehealth.com/insurance/formulary-info-az-2041",
    "plan_contact": "product-issue-report@antidotehealth.com",
    "years": [
      2026
    ],
    "last_updated_on": "2025-09-15",
    "network": [
      {
        "network_tier": "TIERONE"
      },
      {
        "network_tier": "TIERTWO"
      }
    ],
    "formulary": [
      {
        "drug_tier": "ZERO-COST-SHARE-PREVENTIVE",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": "NO-CHARGE",
            "coinsurance_rate": 0,
            "coinsurance_opt": "NO-CHARGE"
          }
        ]
      },
      {
        "drug_tier": "GENERIC",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 15,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 12.5,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 30,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 90,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 75,
            "copay_opt": "BEFORE-DEDUCTIBLE",
            "coinsurance_rate": 0,
            "coinsurance_opt": null
          }
        ]
      },
      {
        "drug_tier": "NON-PREFERRED-BRAND",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      },
      {
        "drug_tier": "SPECIALTY",
        "mail_order": true,
        "cost_sharing": [
          {
            "pharmacy_type": "1-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-RETAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          },
          {
            "pharmacy_type": "3-MONTH-IN-MAIL",
            "copay_amount": 0,
            "copay_opt": null,
            "coinsurance_rate": 0.2,
            "coinsurance_opt": "AFTER-DEDUCTIBLE"
          }
        ]
      }
    ]
  }
]
