Medicare Part D: what employers need to know about this voluntary program.Medicare Part D is a voluntary program that provides prescription drug prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, coverage to Medicare beneficiaries. This program is administered through the Centers for Medicare and Medicaid Services The Centers for Medicare and Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and (CMS (1) See content management system and color management system. (2) (Conversational Monitor System) Software that provides interactive communications for IBM's VM operating system. ) and will become effective on Jan. 1, 2006. What does it mean for participants? The drug coverage will be offered like other Medigap policies. It is estimated that participants can expect to pay around $35 in monthly premiums, after meeting a $250 deductible. What groups are affected? Medicare Part D affects employer groups employer group Association of employers Managed care An entity with a current group benefits agreement in effect with a health plan to provide covered health care services to its employee-subscribers and eligible dependents. who currently offer retirees prescription drug coverage and groups who currently have active employees that are Medicare-eligible and are covered for prescription drugs (including their Medicare eligible dependents.) What are the general employer requirements? 1. Determine whether their prescription drug plan provides "creditable cred·it·a·ble adj. 1. Deserving of often limited praise or commendation: The student made a creditable effort on the essay. 2. Worthy of belief: a creditable story. coverage." Creditable coverage means that "the employer-sponsored plan employer-sponsored plan, n a program supported totally or in part by an employer or group of employers to provide dental benefits for employees. The plan may be administered directly by the employer or another person or group under a contractual would pay at least as much as the Part D program for all of their Medicare eligible employees." More information on Creditable Coverage Guidance can be found at: www.cms.hhs.gov/medicarereform/CCguidances.asp. 2. Provide notices to individuals before Nov. 15, 2005 or prior to the effective date of enrollment in the employer's plan. Model notices that sponsors may use to meet the initial notice obligation may be found at the same Website. Q: What should employers be doing now? 1. Analyze and document the entire retiree population: coverage options, contribution rate, subsidy caps, etc. 2. Determine which retiree groups would be likely to qualify for the subsidy based upon creditable coverage standard. 3. Identify which retirees fit into each retiree group and verify complete indicative data on retirees and their dependents. [ILLUSTRATION OMITTED] Key dates for Medicare Part D Nov. 15, 2005 -- Retirees can begin enrolling in Part D; Medicare will start sending materials related to prescription drug plans and enrollment in October. Nov. 15, 2005 to May 15, 2006 -- Initial enrollment period for the new Part D benefit. Jan. 1, 2006 -- Part D coverage becomes effective. Joe DiCresce is a shareholder and employee benefits specialist at ALCOS in Sterling Heights Sterling Heights, city (1990 pop. 117,810), Macomb co., SE Mich., on the Clinton River; platted 1835 as Jefferson Township, renamed 1838, inc. 1968. Largely rural until the mid-20th cent., the city grew as a suburb of Detroit, 19 mi (31 km) to the northeast. , a member of the Detroit Regional Chamber. [ILLUSTRATION OMITTED] This page is brought to you by the Detroit Regional Chamber's Health Care Central ... the hub for all business related health-care issues. For learn more about this initiative, visit www.detroitchamber.com or call (866) MBR-LINE. The Detroit Regional Chamber sponsors a wide range of special health insurance options. Packages are designed exclusively for small and mid-sized employers and self-employed entrepreneurs. Through Blue Cross Blue Shield Blue Shield A US not-for-profit health care insurer that is a reimbursement intermediary for physicians. Cf Blue Cross. of Michigan and Blue Care Network, many plans are available including traditional, Preferred Provider Organization pre·ferred provider organization n. Abbr. PPO A medical insurance plan in which members receive more coverage if they choose health care providers approved by or affiliated with the plan. , Point of Service and Health Maintenance Organization. These plans may include extensive benefits normally available only to large firms. Visit the Health Care Central section of our Website at www.detroitchamber.com for more details. |
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