Medicare Part D plans are available to every person who is eligible for Medicare. All such plans will provide at least a standard level of coverage set by Medicare and some plans may offer more coverage for a higher monthly premium. Note that the Medicare Part D prescription drug program is NOT a benefit provided through the Union Roofers Health & Welfare Fund. It is provided through Medicare and is marketed by various Medicare-approved “Prescription Drug Providers” (PDPs). If you are eligible for Medicare, you will have a chance to enroll in a Medicare-approved Part D plan from October 15th through December 7th of each year.
This notice is to inform you that your current prescription drug benefit program through the Union Roofers Health & Welfare Fund provides “creditable coverage,” as defined below. It also includes answers to questions you may have regarding your current prescription drug program and how it relates to Medicare Part D coverage.
This is your notice of creditable coverage. Be sure to read it carefully and keep it in a safe place where you can find it. If you lose this notice and need another copy, please call the Union Roofers Health & Welfare Fund’s Administrator at (562)-927-1434 or request a copy in writing from Sue Perillo, 9901 Paramount Blvd. Suite 211 Downey, Ca. 90240. Updated versions of this notice will be sent annually and you will be informed if the Union Roofer Health & Welfare Fund ever loses its creditable coverage status.
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special enrollment Period (SEP) to join a Medicare drug plan.
(2) If I am a retired Trust participant with Kaiser or Health Net, do I need to do anything now?
No, if you stay with Kaiser or Health Net then you have the Part D plan provided by that HMO. You cannot be enrolled in more than one Part D plan at a time, so if you attempt to sign up with another Part D provider you risk being disenrolled from your HMO medical and drug coverage. Call your HMO if you have any questions.
(3) If I am an active Trust participant, or a retired participant not with Kaiser or Health Net, do I need to do anything now?
No, you can keep using the Union Roofers Health & Welfare Fund prescription drug program the same as you always have. Your copayments will not change, nor will any pharmacy network.
When you first become eligible for Medicare*, Your Medicare Initial Enrollment Period will be the month in which you become age 65, plus the preceding three months and the succeeding three months., you will have the option to independently enroll in a Medicare Part D prescription drug plan. However, by enrolling in a Part D plan you will permanently lose your current prescription drug coverage under the Union Roofers Health & Welfare Fund and you will not be reimbursed for your Part D premiums. As mentioned above, the standard Part D benefit is not as good as the Union Roofers Health & Welfare Fund’s own prescription drug program (as described in your Union Roofers Health & Welfare Fund plan booklet).
You should compare your current prescription drug program, including which drugs are covered, with the benefits and costs of the Medicare Part D plans available in your area. To view the official summary of approved Medicare Part D plans in any U.S. state, visit https://www.medicare.gov/basics/forms-publications-mailings.
Note that a Part D plan might not include your regular prescription drugs on its formulary. The Union Roofers Health & Welfare Fund cannot provide you with a complete comparison of available Part D plans, but we urge you to carefully review any descriptions you may obtain.
(4) So why do I need to keep my notice of creditable coverage?
In case you ever drop or lose your Union Roofers Health & Welfare Fund coverage, or in the unlikely event that Union Roofers Health & Welfare Fund coverage becomes non-creditable, having this notice will allow you to immediately enroll in a Part D plan without having to pay a late enrollment penalty. Specifically, if you try to enroll after your initial eligibility period, you will be charged a permanent Part D premium surcharge of 1% for every month since your initial Medicare eligibility for which you cannot show that you had creditable coverage (if such non-creditable period exceeds 62 days). Also note that you may have to wait for the next regular annual Part D enrollment period, which will be October 15 th through December 7th for coverage in the following calendar year.
(5) How can I get more information on Medicare Part D?
More detail will be in the handbook “Medicare & You” that will be mailed to you by Medicare in October of each year. You may also be contacted directly by Medicare-approved Part D providers. At any time you can visit https://www.medicare.gov or call 1-800-MEDICAR (1-800-633-4227). TTY users should call 1-877-486-2048.
Every state has a Health Insurance Assistance Program to help Medicare beneficiaries and their families with their health insurance choices and with problems that might arise. In California it is called the “Health Insurance Counseling and Advocacy Program” (HICAP) and can be reached (by non-cell phones only) at 1-800-434-0222. Further assistance is available from the California Senior Information line (also by non-cell phones only) at 1-800-510-2020. Contact information for similar programs in other states will be listed in your “Medicare & You” handbook.
For people with limited income and resources, extra help paying for a Medicare prescription drug plan is available. For more information about this extra help, visit the Social Security Administration website at https://www.socialsecurity.gov or call them at 1-800-772-1213. TTY users should call 1-800-325-0778.
Date: October 7, 2022
Plan Sponsor: Union Roofers Health & Welfare Fund
Administrator: Sue Perillo
Address: 9901 Paramount Blvd., Suite 211 Downey, Ca. 90240
Telephone: (562) 927-1434