If you are eligible for Medicare and you, or a family member, is still working in Outside Construction, Shop Employement, or for the City of
New York, this notice does not accurately describe how the New York City District Council of Carpenters Welfare Fund's prescription drug
coverage will work with Medicare prescription drug coverage. Please call the Fund office for information about how your Active Employee
coverage will work with Medicare prescription drug coverage.
Notice of Creditable Coverage
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage
with the New York City District Council of Carpenters Welfare Fund and new prescription drug coverage available January 1, 2006 for people
with Medicare. It also tells you where to find more information to help you make decisions about your prescription drug coverage.
1. Starting January 1, 2006, new Medicare prescription drug coverage will be available to everyone with Medicare.
2. The prescription drug coverage offered by the New York City District Council of Carpenters Welfare Fund is, on average for all plan
participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay.
3. Read this notice carefully - it explains the options you have under Medicare prescription drug coverage, and can help you decide
whether or not you want to enroll.
You may have heard about Medicare's new prescription drug coverage, and wondered how it would affect you. The actuary retained by the
Board of Trustees has determined that your prescription drug coverage with the New York City District Council of Carpenters Welfare Fund is,
on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay.
Starting January 1, 2006, prescription drug coverage will be available to everyone with Medicare through Medicare prescription drug plans. All
Medicare prescription drug plans will provide at least a standard level of coverage set by Medicare. Some plans might also offer more coverage
for a higher monthly premium.
Because your existing coverage is on average at least as good as standard Medicare prescription drug coverage, you can keep this coverage
and not pay extra if you later decide to enroll in Medicare coverage.
People with Medicare can enroll in a Medicare prescription drug plan from November 15, 2005 through May 15, 2006. However, because you
have existing prescription drug coverage that, on average, is as good as Medicare coverage, you can choose to join a Medicare prescription
drug plan later. Each year after that, you will have the opportunity to enroll in a Medicare prescription drug plan between November 15th
through December 31st.
You should also know that if you drop or lose your coverage with the New York City District Council of Carpenters Welfare Fund and don't
enroll in Medicare prescription drug coverage after your current coverage ends, you may pay more to enroll in 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 good as Medicare's
prescription drug coverage, your monthly premium will go up at least 1% per month for every month after May 15, 2006 that you did not have
that coverage. For example, if you go nineteen months without coverage, your premium will always be at least 19% higher than what most other
people pay. You'll have to pay this higher premium as long as you have Medicare coverage. In addition, you may have to wait until next
November to enroll.
If you do decide to enroll in a Medicare prescription drug plan, you will lose your prescription drug coverage with the New York City District
Council of Carpenters Welfare Fund.
You have two options to consider. The first option is to simply keep your current New York City District Council of Carpenters Welfare Fund
prescription drug coverage and not enroll in a Medicare prescription drug plan. You are not required to notify the Fund office if you decide to
keep your Welfare Fund prescription drug coverage. Your second option is to enroll in a Medicare prescription drug plan; however, you will
forfeit your prescription drug coverage with the New York City District Council of Carpenters Welfare Fund if you choose to enroll in a
Medicare prescription drug plan.
You should compare your current coverage, including the drugs you take now, with the coverage and cost of the plans offering Medicare
prescription drug coverage in your area. Your current prescription drug coverage with the New York City District Council of Carpenters Welfare
Fund is summarized below. In addition to prescription drug coverage, the New York City District Council of Carpenters Welfare Fund
provides other health benefits including hospital/medical, dental, vision and life insurance coverage. You will still be eligible to receive all
of your other Welfare Fund health benefits if you choose to enroll in a Medicare prescription drug plan.
Please consider your choices carefully before making any decision. Once you are enrolled in a Medicare prescription drug plan, Medicare has
their own rules concerning when you can change from one Medicare plan to another and when you can drop your Medicare prescription drug
coverage entirely. We will continue your New York City District Council of Carpenters Welfare Fund prescription drug coverage until we hear
from Medicare or from you that you have joined a Medicare prescription drug plan.
Prescriptions from a
Retail pharmacy
(up to a 34-day supply) | Continuation
of Coverage
during Total Disability
(Disability Waiver) | Regular
Retirees &
Survivors |
| Generic drugs | Welfare Fund pays 100%
(no copay required) |
$5 copay |
"Single source" brand-name
drugs (no generic equivalent) | $6 copay |
$10 copay |
Brand-name drugs with
generic equivalents | Difference between the
brand-name cost and
generic cost | Difference between the
brand-name cost and
generic cost |
Prescriptions from the
Mail-order pharmacy
(up to a 90-day supply) |
Continuation of Coverage
during Total Disability
(Disability Waiver) | Regular
Retirees &
Survivors |
| Generic drugs | Welfare Fund pays 100%
(no copay required) | $5 copay |
| All brand-name drugs | $6 copay | $10 copay |
Please notify the Fund office in writing if you decide to join a Medicare prescription drug plan.
If you do decide to join a Medicare prescription drug plan, please send a written notice of your choice to the Fund office. This notice should
include your name, your social security number and the effective date of your Medicare drug coverage. Send this notice to: New York City
District Council of Carpenters Welfare Fund, 395 Hudson Street, New York, NY 10014, Attention: Medicare Drug Benefits.
If you do join a Medicare prescription drug plan but, at a later date, decide you want your New York City District Council of Carpenters
Welfare Fund drug coverage back, this coverage can be reinstated.
If you join a Medicare prescription drug plan and decide later on that you prefer your New York City District Council of Carpenters Welfare
Fund prescription drug coverage, the Fund office will reinstate your coverage once you submit acceptable proof that your Medicare prescription
drug coverage has ended, and provided that you still meet the New York City District Council of Carpenters Welfare Fund's eligibility
requirements. Acceptable proof that your Medicare prescription drug coverage has ended will be a signed document from the Medicare
prescription drug plan administrator indicating that you have dropped or will drop your Medicare prescription drug coverage. Such written
proof must include your name, your social security number, the date your Medicare prescription drug coverage ended or will end, the name of
the Medicare prescription drug plan, and a contact at the Medicare prescription drug plan. Send this proof to: New York City
District Council of Carpenters Welfare Fund, 395 Hudson Street, New York, NY 10014, Attention: Medicare Drug Benefits.
You do not need to notify the Fund office if you are changing from one Medicare prescription drug plan to another.
For more information about this notice or your current prescription drug coverage...
Contact the Fund office for further information at 1-800-529-3863. NOTE: You may receive this notice at other times in the future such as before
the next period you can enroll in Medicare prescription drug coverage, and if this coverage changes. You also may request a copy.
For more information about your options under Medicare prescription drug coverage...
More detailed information about Medicare plans that offer prescription drug coverage will be available in October 2005 in the "Medicare & You
2006" handbook. You'll get a copy of the handbook in the mail from Medicare. You may also be contacted directly by Medicare prescription
drug plans. You can also get more information about Medicare prescription drug plans from these places:
• Visit www.medicare.gov for personalized help,
• Call your State Health Insurance Assistance Program
(see your copy of the Medicare & You handbook for their telephone number)
• 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 plan is available. Information about this extra
help is available from the Social Security Administration (SSA). For more information about this extra help, visit SSA online at
www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage after
May 15, 2006, you may need to give a copy of this notice when you join to show that you are not required to pay a higher premium amount.
| Date of this notice: | October 24, 2005 |
| Name of Entity/Sender: |
New York City District Council of Carpenters Welfare Fund |
| Contact: | John Pirrone |
| Address: | 395 Hudson Street, New York, NY 10014 |
| Phone Number: | (800) 529-3863 or (212) 366-7300 |
