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BENEFITS
Summary
Plan Description of all Retiree Benefits
ELIGIBILITY
Click
here for eligibility
for retired members
DIABETIC, CHEMO & INJECTABLE DRUG
COVERAGE
Click
here for changes in coverage from Active to Medicare status
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HEALTH INSURANCE COUNSELING
ASSISTANCE
The NYC Health Insurance Information Counseling Assistance Program (HIICAP)
is New York's source for free, current and impartial information about
health care coverage. Through the helpline and the volunteer counselors they
can provide you with information on all aspects of health insurance.
Click
here.
NEW
TO RETIREMENT?
Checkpoints: Click
here for a list of
important checkpoints about your retirement and continuing Welfare Fund
Benefits.
Welfare Fund FAQs.
Click
here for
answers to frequently asked questions for prospective retirees.
More
RETIREE FAQs from
City of New York Health Benefits Program
here
New!
Announcing
"The Envelope"
-- Your Personal Survivor Info
Document. Check it out!
MEDICARE HMO ENROLLMENT AND
TRANSFERS
Get must-read application info
here
LEARN ABOUT
MyMedicare.gov, a very useful
service for getting your personal Medicare information,
here.
MEDICARE BASICS RESOURCE GUIDE
THE MEDICARE RIGHTS CENTER works to ensure access to affordable health
care for older adults through counseling, educational programs and public
policy initiatives.
Sign
up here for
free electronic newsletters and alerts
designed to give consumers and professionals the latest Medicare information
right at their desktops.
MEDICARE
PART B PREMIUM REIMBURSEMENT FOR HIGH
INCOME BENEFICIARIES (IRMAA REIMBURSEMENTS)
Reimbursement form is available
here.
Get background on IRMAA here.
MEDICARE PART D
-
Notice of Creditable Coverage.
An important notice about your prescription drug coverage and
Medicare.
-
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 payss 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.
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SURVIVOR INFORMATION
Survivor Coverage
described here
Retiree Survivor
Planning
Do you have an envelope in your desk or top
dresser drawer (or a file on your PC hard drive) that tells your
spouse, your partner or adult children what to do in case you
die? If not, you should create a document that includes account
numbers, personal ID numbers, passwords and phone numbers that
are necessary to access your financial, pension and benefits
information. Many spouses are unaware of the things they need to
know.
It’s also a good
idea to collect your important documents in one place—one desk
drawer or file cabinet folder—and tell your spouse/ partner or
adult children where it is. This is the place for copies of all
insurance policies, your marriage license, children’s birth
certificates, veteran’s discharge papers, property titles and
your will.
Here are some
important phone numbers your survivors will need:
Welfare Fund Survivor
Benefits
It is the
responsibility of your spouse/domestic partner/covered dependent
to notify the Welfare Fund office of your death. They have 30
days from the date of notification to decide to purchase
benefits.
A description of the
benefit plans available for purchase by your spouse and/or
dependents of an eligible retiree who dies can be found
here.
Click
here for more
information for survivor coverage for a spouse or eligible dependent of
a retiree.
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