About Your Prescription Drug Coverage and Medicare

Important  Notice  from  the Local 464A United Food & Commercial Workers' Union Welfare Service Benefit Fund

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the Local 464A United Food & Commercial Workers Union Welfare Service Benefit Fund (“the Local 464A Fund”) and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare Drug Plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

There are three important things you need to know about your current coverage and Medicare’s prescription drug coverage:

1.    Medicare prescription drug coverage 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 Prescription 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.

2.    The Local 464A Fund has determined that the prescription drug coverage offered in the Local 464A Fund is, on average for all Plan participants, NOT expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Non-Creditable Coverage. This is important, because most likely, you will get more help with your drug costs if you join a Medicare Drug Plan, than if you only have prescription drug coverage from the Local 464A Fund. This is also important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare Drug Plan when you first become eligible.

3.    You can keep your current coverage from the Local 464A Fund. However, because your coverage is Non-Creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join a drug plan. When you make your decision, you should compare current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this notice carefully - it explains your options.

When Can You Join A Medicare Drug Plan?

You can join a Medicare Drug Plan when you first become eligible for Medicare and each year from October 15th through December 7th. However, if you decide to drop your current coverage with the Local 464A Fund, since it is Employer/Union sponsored group coverage, you will be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare Drug Plan; however, you also may pay a higher premium (a penalty) because you did not have creditable coverage under the Local 464A Fund.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?

Since the coverage under the Local 464A Fund is not creditable, depending on how long you go without creditable prescription drug coverage, you may pay a penalty to join a Medicare Drug Plan. Starting with the end of the last month that you were first eligible to join a Medicare Drug Plan but didn’t join, if you go 63 continuous days or longer without prescription drug coverage that’s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (penalty) as long as you have Medicare coverage. In addition, you may have to wait until the following October to join.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?

If you decide to join a Medicare Drug Plan and you keep your current Local 464A Fund coverage, your current Local 464A Fund coverage will not be affected. You can keep your current coverage if you join a Medicare Drug Plan. If you do decide to join a Medicare Drug Plan and drop your current coverage, be aware that you and your dependents will not be able to get this coverage back.

For More Information About This Notice Or Your Prescription Drug Coverage…

Contact our office at (973) 256-6790 for further information. NOTE: You’ll get this notice each year. You will also get it before the next period you can enroll in Medicare prescription drug coverage, and if this coverage through the Local 464A Fund changes. You also may request a copy of this notice at any time.

For More Information About Your Options Under Medicare Prescription Drug Coverage…

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 your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.

•    Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

Date:    September 23, 2020

Name of Entity/Sender:    Local 464A United Food & Commercial

Workers Union

Welfare Service Benefit Fund

Contact/Position/Office:    Kathleen Pridmore

Director of Medical Benefits

Address:    245 Paterson Avenue, Little Falls, NJ 07424

Phone Number:    973-256-6790