Medicare Part D: INDIVIDUAL CREDITABLE COVERAGE DISCLOSURE NOTICE
We are required to share a creditable coverage disclosure notice regarding our health insurance plan with you every year by October 15th. No action is required on your part. This disclosure must be provided to Medicare-eligible active working individuals and their dependents, Medicare eligible COBRA individuals and their dependents, Medicare eligible disabled individuals covered under our prescription drug plan, and any retirees and their dependents. Please find the following information accordingly:
Medicare Part D: INDIVIDUAL CREDITABLE COVERAGE DISCLOSURE NOTICE – Important Notice from Capital City Tree Experts 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 Capital City Tree Experts through our group Dean Health Plan, and about your options under Medicare’s prescription drug coverage. This information can help you decide whether you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
There are two 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 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. Capital City Tree Experts has determined that the prescription drug coverage offered by the Dean Health Plan is, on average for all plan participants, expected to pay out as much as standard Medicare 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.
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 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.
What Happens to Your Current Coverage if You Decide to Join a Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current Capital City Tree Experts group plan could be affected. Please contact Angie for more information about what happens to your Capital City Tree Experts coverage if you enroll in a Medicare prescription drug plan.
When Will You Pay a Higher Premium (Penalty) to Join a Medicare Drug Plan?
You should also know that if you drop or lose your current coverage with Dean Health Plan and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, 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 19 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 (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
Where Can You Obtain More Information About This Notice or Your Current Prescription Drug Coverage?
Feel free to contact Angie for more information. NOTE: You will get this notice each year. You will also receive this notice before the next period you can join a Medicare drug plan, and if this coverage through Capital City Tree Experts changes, you also may request a copy of this notice at any time.
Where Can You Obtain 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 will receive 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 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 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether you have maintained creditable coverage and, therefore, whether you are required to pay a higher premium (a penalty).
Date of Notice: October 2, 2020
Name of Entity/Sender: Capital City Tree Experts
Contact: Angie Addison – Human Resources Consultant
Address: 4702 Ellestad Drive; Madison, WI 53716
Phone Number: 608.370.4642 | e-mail: email@example.com