October 1, 2007
In 2006, Medicare prescription drug coverage, Medicare Part D, became available. This benefit fills an important gap within the current Medicare program by covering prescription drugs. Enclosed is a Letter of Creditable Coverage that Medicare-eligible members will need if they choose to enroll in Medicare Part D after the initial enrollment period for this new plan.
As required by Federal law, all employers must notify their Medicare-eligible employees and dependents of this new benefit and inform those employees if the current prescription drug coverage is creditable, that is, if that coverage, on average, pays as much in benefits as the standard Medicare Part D prescription drug plan.
Although this Notice is only required to be sent to Medicare-eligible employees or dependents, we have elected to send the information to all participants since you may have a Medicare-eligible dependent of which we are unaware.
If you or any dependent are not eligible for Medicare coverage, this Notice does not apply to you. However, it may be beneficial to read the enclosed information so you are aware of the changes in the Medicare prescription drug benefits for the future.
If you or any dependents are eligible for Medicare, please read the enclosed information carefully. For further information, please visit the Medicare website at www.medicare.gov or call 1-800-633-4227.
State of Oklahoma Employees Benefits Council
Important Notice from the State of Oklahoma Employees Benefits Council About Your Prescription Drug Coverage and Medicare
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 State of Oklahoma Employees Benefits Council and new prescription drug coverage available for people with Medicare. It also explains the options you have under Medicare prescription drug coverage and can help you decide whether or not you want to enroll. At the end of this notice is information about where you can get help to make decisions about your prescription drug coverage.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare through Medicare prescription drug plans and Medicare Advantage Plans that offer 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. State of Oklahoma Employees Benefits Council has determined that the prescription drug coverage offered by the State of Oklahoma Employees Benefits Council Health Plans is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay and is considered Creditable Coverage.
Because your existing coverage is on average at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay extra if you later decide to enroll in Medicare prescription drug coverage.
Individuals can enroll in a Medicare prescription drug plan when they first become eligible for Medicare and each year from November 15 through December 31 . Beneficiaries leaving employer/union coverage may be eligible for a Special Enrollment Period to sign up for a Medicare Prescription drug plan.
You should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area.
If you do decide to enroll in a Medicare prescription drug plan and drop your State of Oklahoma Employees Benefits Council prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back.
If you want to review the current prescription drug coverage available through the State of Oklahoma Employees Benefits Council, please refer to the Plan Year 2008 Health Plan Comparison. As a beneficiary you will have two options available to you when Medicare Part D benefit becomes available:
> retaining your existing coverage and choosing not to enroll in Medicare Part D plan; or
> enrolling in a Medicare Part D plan as a supplement to, or in lieu of, your current coverage.
You should also know that if you drop or lose your coverage with the State of Oklahoma Employees Benefits Council and don’t enroll in a Medicare prescription drug coverage after your current coverage ends, you may pay more (a penalty) to enroll in a Medicare prescription drug coverage later.
If you go 63 days or longer without prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage, your monthly premium will go up at least 1% per month for every month that you did not have that coverage. For example, if you go nineteen months without coverage, your premium will always be at least 19% higher than what many other people pay. You’ll have to pay this higher premium as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to enroll.
For more information about this notice or your current prescription drug coverage… Contact our office for further information at 1-800-219-8115.
NOTE: You may receive this notice annually and at other times in the future such as before the next period you can enroll in Medicare prescription drug coverage, and if this coverage changes through State of Oklahoma Employees Benefits Council. You also may request a copy.
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 prescription drug plans. For more information about Medicare prescription drug plans:
• Visit http://www.medicare.gov/,
• Call your State Health Insurance Assistance Program (see 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.
For people with limited income and resources, extra help paying for a Medicare prescription drug plan is available. Information about this extra help is available from the Social Security Administration (SSA) online at http://socialsecurity.gov , or you call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this notice. If you enroll in one of the new plans approved by Medicare, which offer prescription drug coverage you may be required to provide a copy of this notice when you join to show that you are not required to pay a higher premium amount.
Date: October 1, 2007
Name of Entity/Sender: State of Oklahoma Employees Benefits Council
Contact--Position/Office: Benefits & Contracts Administration Division
Address: 120 N. Robinson, Suite 1100, Oklahoma City, OK 73102
Phone Number: (405) 232-1190