The premium is the number on the first page, and it is the smallest change in the envelope.
Alderbrook Health Plan mails this every autumn to everyone in Alderbrook Choice Rx (PDP). It is a comparison document: 2026 in one column, 2027 in the next, effective January 1. The premium is on page 1. The drug list is on page 6.
The first page carries the two figures most people go looking for. The monthly premium goes from $38.40 to $39.10. The yearly deductible goes from $360 to $415. Over twelve months the premium change is $8.40.
Five pages later, a table lists the drugs whose tier changed for 2027. Rimvexa 25 mg, a once-daily maintenance drug, moves from Tier 3 to Tier 4 and picks up a requirement that the plan approve it before a pharmacy can fill it. For a member who fills that prescription every month, the row is worth $1,586.00. The notice never multiplies anything, so that number appears nowhere in it.
| Aspect | 2026, as it stands | 2027, as changed |
|---|---|---|
| Monthly premium | $38.40 | $39.10 |
| Yearly deductible | $360, and it applies to Tier 4 and Tier 5 only | $415, and it applies to Tier 3, Tier 4 and Tier 5 |
| Tier for Rimvexa 25 mg | Tier 3, preferred brand | Tier 4, non-preferred drug |
| What a 30-day fill costs | $47 flat copay | 45% of the plan's negotiated price |
| Approval before the pharmacy fills it | None | Prior authorization, plus a 30-tablet quantity limit |
| The January fill | $47.00 | $581.95, because the deductible comes first |
| Drug costs for the year | $564.00 | $2,150.00, which is the annual out-of-pocket limit |
| Premium and drug costs together | $1,024.80 | $2,619.20 |
What this brief could not check
- The 2027 List of Covered Drugs is referenced in Section 2.5 and was not enclosed, so this brief cannot say what the prior authorization criteria are, how long a decision takes, or whether a generic sits on a lower tier.
- Every 2027 dollar figure here is arithmetic on the 2026 negotiated price of $786.00 taken from the enclosed claims summary. The notice states no 2027 price, and footnote 4 says the price can change during the plan year.
- Evidence of Coverage Chapter 6 is cross-referenced three times, including for how costs count toward the $2,150 limit, and was not included with the mailing.
- This brief was written by hand as a design fixture. It is modelled on real documents, but no model read a source to produce it, and its claims should not be relied on.