NEWSLETTERS
February
2011 Benefits Bulletin
May 2010 Benefits Bulletin
Fall 2009 Benefits Bulletin
Oct./Nov. 2006 Newsletter
PICA PROGRAM
(Effective 7/1/05)
PICA for Non-Medicare MEDCO
members. There are some drugs for which participants do
not use the MEDCO card, but instead use another card not issued by
the Welfare Fund.
For
non-Medicare eligible retirees,
injectable and Chemotherapy medications are available under the PICA
program. The NY City Retiree Health Program should be consulted for
further detail and updates. Eligible individuals will be issued a
drug card for PICA coverage. For retirees with Medicare, the IC
drugs are treated as any other medications which are covered by the
Fund.
MEDICARE PART D
(Effective 1/1/06)
(You may choose this
instead of MEDCO)
Basics
The Federal government recently enacted a limited, catastrophic drug
program for qualified retirees, over age 65 who are covered under
Medicare Part A (hospital) and [at least eligible for] Part B
(medical). It is commonly referred to as Medicare Part D.
The Part D program is privately administered by insurance companies
who offer a variety of policies featuring: 1) a formulary of covered
drugs, 2) a "front-end" deductible, 3) a range of annual costs where
the enrollee pays a moderate percentage co-pay, 4) a range of annual
costs where the enrollee pays all costs - 100% co-pay - also known
as the "doughnut hole" and 5) a range of annual costs where the
enrollee pays minimal percentage co-payment toward drug costs. For
this coverage, the Medicare Part D enrollee pays a premium.
The prototype on which the program is based applies a $250
deductible, a 25% co-payment on the next $2,000 of annual drug
spending, no coverage between $2,250 and $5,100 annually and a 5%
co-payment on annual expenses exceeding $5,100.
The monthly premium estimated on that model was to have been
approximately $37 in the first year (2006). Many areas around the
country had 40 to 50 competing plans in the first year of operation,
with wide variances on premium, deductibles, copayments and
formularies.
The PSC-CUNY Welfare Fund Drug Benefit
Eligible plan participants may chose a Medicare Part D plan instead
of the Welfare Fund retiree drug plan. Those who do so would
relinquish Welfare Fund drug coverage. It is often not advisable to
do so.
Analysis of average drug utilization among covered retirees has
determined that most retirees would be financially
better off with the PSC-CUNY Welfare Fund Medco program. The
exception would be those individuals who incur high annual costs. If
annual costs exceed $13,800, the Part D program might be beneficial.
The Fund actuaries have calculated that on the average the Welfare
Fund drug coverage is equal to or better than the Medicare Part D
program. This "Actuarial Equivalence" enables the Welfare Fund to
issue a
Notice of Creditable Coverage* to its eligible retired
members. This Notice assures that a future decision by a participant
to enroll directly in Part D (e.g., by a spouse if a retiree dies)
is not met with a substantial premium surcharge.
Fund office staff is unable to personally advise on choice of
coverage. More information is available on-line at
www.medicare.gov.
*The Welfare Fund
provides the first year Notice of Creditable Coverage (2005) -- and
only the first year. Carriers, such as Medco, are responsible
for subsequent years.
HIPAA
HIPAA For:
CLARION ARTICLES
Click
image
below for article in the April '08 Clarion explaining how the
Welfare Fund has initiated an improvement to the
disability insurance rider offered to full-time faculty and
professional staff through The Standard Life Insurance Company of
New York. The change has triggered a unique opportunity for covered
members to buy the optional disability rider without medical
evidence.
Click
image
below for article in the March '08 Clarion which explains options
for those who already have long-term coverage under John Hancock's
original plan for CUNY and wish to consider moving to the new plan.
Click
image
below for an overview of new long-term care program being introduced
by Welfare Fund (October '07 Clarion).
Click
image
below for an overview of dental
choices and FAQs in December '06
Clarion
Click
image
below for an article on planning for long term care in March '06 Clarion.
Click
image
below for an article on Drug Prices and Research" in the January '06
Clarion.
An article on
the Welfare Fund's new Long
Term Health Care Plan appeared the October '07 Clarion.
Click
here
for the article.
