Sheet Metal Workers' International Association
Local Union No.73
Pension Welfare and Annuity Funds

 












 


Notice of Prescription Drug Creditable Coverage
Sheet Metal Workers’ Local 73 Welfare Fund

Important Information about Your Prescription Drug Benefits and
Medicare Prescription Drug Coverage October 19, 2005

The Sheet Metal Workers’ Local 73 Welfare Fund will continue to provide prescription drug coverage for all eligible active and retired participants for 2006. If you are eligible for Medicare, you do notneed to join a Medicare prescription drug plan since you have coverage available through the Fund.

This Notice has information about:

  • New Medicare Prescription Drug Coverage (Medicare Part D) available to everyone with Medicare starting January 1, 2006.
  • How the Sheet Metal Workers’ Local 73 Welfare Fund’s existing prescription drug benefits are, on average for all Plan participants, at least as valuable as standard Medicare Prescription Drug Coverage.
  • What your choices are and what happens to your coverage under the Sheet Metal Workers’ Local 73 Welfare Fund Plan if you elect Medicare Prescription Drug Coverage.
  • Where to find more information to help you make decisions about your prescription drug coverage.

Please read this Notice carefully and keep it filed in a safe place for future reference. This Notice explains the options you have under Medicare Prescription Drug Coverage and can help you decide whether or not to enroll if you are eligible.

New Medicare Prescription Drug Coverage

Starting January 1, 2006, prescription drug coverage will be available to anyone entitled to Medicare Part A or enrolled in Medicare Part B through Medicare. Most people will have to pay a monthly premium for Medicare Prescription Drug Coverage. For people with limited income and resources, extra help paying for Medicare Prescription Drug Coverage is available. Medicare Prescription Drug Coverage is insurance provided by private companies that have been approved by Medicare. If eligible, you can get Medicare Prescription Drug Coverage through:

  • Medicare Advantage; or
  • Medicare Prescription Drug Plans.

All Medicare plans will provide at least a standard level of coverage as set by Medicare. Some Medicare plans might offer better coverage for a higher monthly premium .

If you are entitled to Medicare Part A or enrolled in Medicare Part B, you can enroll for Medicare Prescription Drug Coverage between November 15, 2005, and May 15, 2006. Each year after that, you will have the opportunity to enroll for Medicare Prescription Drug Coverage between November 15 and December 31. People who do not currently have prescription drug coverage as valuable as standard Medicare Prescription Drug Coverage and who do not enroll for Medicare Prescription Drug Coverage before May 15, 2006, may have to pay a higher Medicare premium when they decide to enroll in this Medicare coverage after May 15, 2006.

Existing Coverage Is as Valuable as Standard Medicare Prescription Drug Coverage

Keep this Notice. If you enroll for Medicare Prescription Drug Coverage after May 15, 2006, you will need a copy of this Notice when you enroll. This Notice verifies that you have creditable prescription drug coverage and that you are not required to pay the higher premium.

The Sheet Metal Workers’ Local 73 Welfare Fund has determined that your existing active and retiree Plan prescription drug benefits are, on average, “creditable coverage,” which means the Fund’s coverage is expected to pay as much in claims for all eligible participants (or more in some cases) as standard Medicare Prescription Drug Coverage.

Because your current prescription drug benefits with the Sheet Metal Workers’ Local 73 Welfare Fund are as valuable, on average, as Medicare standard coverage, you can stay covered under the h ealth benefit plan and join a Medicare plan later and not be subject to the higher premium.

Your Choices and the Consequences

If you are eligible for Medicare, you should compare your current coverage, including which medications are covered, with the coverage and cost of the Medicare plans in your area.

If you are eligible and do not enroll for Medicare Prescription Drug Coverage, you will continue to receive prescription drug benefits under the Sheet Metal Workers’ Local 73 Welfare Fund, as long as you are otherwise eligible to continue Plan coverage. Remember that the health benefit plan also covers medical benefits, in addition to prescription drug benefits. You will continue to be eligible to receive all current benefits.

If you are eligible and enroll for Medicare Prescription Drug Coverage, your coverage under the Sheet Metal Workers’ Local 73 Welfare Fund will be coordinated with your Medicare Prescription Drug Coverage. Remember that for most people, there is a monthly premium for Medicare Prescription Drug Coverage.

Note: If you are entitled to Medicare and drop or lose your coverage with the Sheet Metal Workers’ Local 73 Welfare Fund and do not enroll for Medicare Prescription Drug Coverage after your current coverage ends, you may pay more for Medicare Prescription Drug Coverage later. If after May 15, 2006, you go 63 days or longer without prescription drug coverage that is at least as valuable as Medicare Prescription Drug Coverage your monthly premium for Medicare Prescription Drug Coverage will increase. The increase will be 1% per month for every month after May 15, 2006, that you were eligible but did not have coverage. For example, if you go 19 months without coverage, your monthly premium will always be 19% higher than what most other people pay. You will have to pay this higher premium as long as you have Medicare Prescription Drug Coverage. In addition, you may have to wait until the next open enrollment period (November 15 – December 31 each year) to enroll.

For More Information about Medicare Prescription Drug Coverage

If you are eligible for Medicare, you will receive a “Medicare & You 2006” handbook in the mail from Medicare. More detailed information about Medicare Prescription Drug Coverage is included in this handbook, which is available beginning in October 2005. You will also receive information directly from Medicare plans.

To get more information, you can:

  • Visit www.medicare.gov for personalized help.
  • Call your State Health Insurance Assistance Program (the telephone number will be included in the “Medicare & You 2006” handbook).
  • 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 Coverage is available. To get more information about this extra help, you can:

  • Visit www.medicare.gov .
  • Call 1-800-772-1213 (TTY 1-800-325-0778).

For More Information about this Notice or Health Benefit Plan Prescription Drug Benefits

If you have any questions about this Notice or would like more information about your prescription drug benefits under the Sheet Metal Workers’ Local 73 Welfare Fund, please call the Fund Office at 708-449-7373.

In the future, the Sheet Metal Workers’ Local 73 Welfare Fund will periodically send you an updated copy of this Notice for your records. You also may request a copy of this Notice at any time by contacting the Fund Office.

Date: October 2005
Plan: Sheet Metal Workers’ Local 73 Welfare Fund
Contact: Fund Office
Address: 4530 Roosevelt Road, Hillside, Illinois 60162
Telephone Number: 708-449-7373

Benefits under the Sheet Metal Workers’ Local 73 Welfare Fund are not vested or guaranteed. Full details of the Sheet Metal Workers’ Local 73 Welfare Fund are contained in the documents that establish the Plan provisions. If there is a discrepancy between the wording here and the documents that establish the Plan, the document language will govern. The Trustees reserve the right to amend, modify, or discontinue all or part of the Plan at any time.

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