Health Benefit Disclosures
Required Notice of Creditable Coverage Prescription Drug Coverage and Medicare
The Fund provides a prescription benefit to its members. If you join a Medicare Part D plan, you are not eligible to participate in any part of the Fund’s Groups Health Benefit.
1. The Fund provides a prescription benefit that has been determined to be equal to or greater than a Medicare Part D plan and is therefore considered Creditable Coverage. Because your prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
2. Medicare prescription drug coverage (Part D) became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
• Information for those with limited income and resources – www.socialsecurity.gov or 1-800-772-1213 (TTY 1-800-325-0778).
Notice About the Early Retirement Reinsurance Program
You are a plan participant, or are being offered the opportunity to enroll as a plan participant, in an employment-based health plan that is certified for participation in the Early Retiree Reinsurance Program. This is a Federal program established under the Affordable Care Act. Under the Early Retiree Reinsurance Program, the Federal government reimburses a plan sponsor of an employment-based health plan for some of the costs of health care benefits paid on behalf of, or by, early retirees and certain family members of early retirees participating in the employment-based plan. By law, the program expires on January 1, 2014.
Under the Early Retiree Reinsurance Program, your plan sponsor may choose to use any reimbursements it receives to reduce or offset increases in plan participants’ premium contributions, copayments, deductibles, co-insurance, or other out-of-pocket costs. If the plan sponsor chooses to use the Early Retiree Reinsurance Program reimbursements in this way, you, as a plan participant, may experience changes that may be advantageous to you, in your health plan coverage terms and conditions, for so long as the reimbursements under this program are available and this plan sponsor chooses to use the reimbursements for this purpose. A plan sponsor may also use the Program reimbursements to reduce or offset increases in its own costs for maintaining your health benefits coverage, which may increase the likelihood that it will continue to offer health benefits coverage to its retirees and employees and their families.