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Notice: Medicare Part D Creditable Coverage Notice

Franklin & Marshall College is required to send the enclosed Medicare Prescription Drug “Creditable Coverage” Disclosure Notice on an annual basis. Please read the enclosed Notice and retain it for your records. You are not required to take any other action.

Full-time faculty and professional staff: If you are employed by Franklin & Marshall in a full-time, benefits-eligible status, you, and your spouse or same-sex domestic partner if applicable, are not required to enroll in medical or prescription drug coverage offered through Medicare. You are eligible for medical and prescription coverage through the College’s Shared Services Health & Prescription Drug Plan.


Retired members of the College community: If you are retired and eligible for coverage through Medicare, you, and your spouse or same-sex domestic partner if he/she is Medicare-eligible, must enroll in Medicare Parts A and B to retain supplemental coverage through Franklin & Marshall College. However, you are not required to enroll in a supplemental Medicare Part D prescription drug plan. You have been provided with the enclosed Creditable Coverage Disclosure Notice so that if you ever do need to apply for a Medicare Part D prescription drug plan, the penalty fee for late enrollment will be waived.

Medicare Prescription Drug Creditable Coverage Disclosure Notice; Important Notice From Franklin & Marshall College 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 prescription drug coverage currently available through Franklin & Marshall College, and prescription drug coverage available for individuals with Medicare coverage. It also explains the options you have under Medicare prescription drug coverage and can help you decide whether or not to enroll in a Medicare prescription drug plan. If you are considering enrolling in a Medicare prescription drug plan, you should compare your current coverage through Franklin & Marshall College, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. At the end of this Notice is information about where you can get help to make decisions about your prescription drug coverage.

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 health coverage. 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.     Franklin & Marshall College has determined that the prescription drug coverage offered through the College’s Shared Services Health & Prescription Drug Plan (for those who retired prior to January 1, 2013, and faculty who signed an early retirement agreement prior to January 1, 2013) is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay and is considered “Creditable Coverage”. Emeriti Retirement Health Solutions has determined that the prescription drug coverage offered through the Emeriti Retirement Health Plan (for those who retire(d) on or after January 1, 2013), is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage will pay and is considered “Creditable Coverage”.

Because your existing coverage through a Franklin & Marshall prescription drug plan is on average at least as good as standard Medicare prescription drug coverage (“Creditable Coverage”), you can keep this coverage as long as you are eligible for coverage through Franklin & Marshall College. You will not pay a higher premium (a penalty) if you later decide to enroll in Medicare prescription drug coverage.

When Can You Join A Medicare Drug Plan?

Individuals can enroll in a Medicare prescription drug plan when they first become eligible for Medicare, and each year from October 15 through December 7. However, if you lose other creditable prescription drug coverage, through no fault of your own, you will be eligible for a two (2) month Special Enrollment Period to join a Part D Medicare prescription plan.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?

Franklin & Marshall College does not currently require you to enroll in a Medicare Part D prescription drug plan in order to retain health and prescription coverage through the College. If you are retired and do enroll in both a Franklin & Marshall health and prescription drug plan and a Medicare-approved prescription drug plan, the College-sponsored plan will be the secondary payment provider. You will pay the applicable monthly Medicare premium plus the premium required to be covered through the College’s plan. Please contact Franklin & Marshall’s Human Resources office, at (717) 291-4353, if you would like more information about what happens to your coverage if you enroll in a Medicare Part D prescription drug plan.

Important note: If you terminate your prescription drug coverage through the College’s Shared Services Health & Prescription Drug Plan (for those who retired prior to January 1, 2013), you and your dependents will no longer receive any hospitalization, medical, vision, or prescription drug coverage through a College-sponsored plan. Retirees who drop their coverage through the College’s Shared Services Health & Prescription Drug Plan may generally only re-enroll once per year during the Open Enrollment period, with coverage effective the next January 1.

College retirees and their dependents enrolled through the Emeriti Retirement Health Plan (for those who retire(d) on or after January 1, 2013) who drop this coverage are never permitted to re-enroll in the Emeriti Plan, except in limited situations due to a qualifying life event.

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 through a Franklin & Marshall College group health and prescription drug plan and do not 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 prescription drug coverage that is at least as good as Medicare’s prescription drug coverage, your monthly premium will go up 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 coverage, your premium will always be at least 19% higher than what many other people pay. You’ll have to pay this higher premium as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to enroll.

For more information about this Notice or your current prescription drug coverage:

Please contact the Franklin & Marshall Human Resources office at (717) 291-3995 if you would like more information. You will receive this Notice annually and at other times in the future such as before the next period you can enroll in Medicare prescription drug coverage, and if prescription drug coverage through Franklin & Marshall changes. You also may request a copy from the Human Resources office at any time.

For more information about your options under Medicare prescription drug coverage:

More detailed information about Medicare plans that offer prescription drug coverage is available in the Medicare & You handbook. You will receive a copy of this handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug plans:

• Visit www.medicare.gov

• Call your state Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number)

• Call 1-800-MEDICARE - (800) 633-4227. TTY users should call (877) 486-2048.

For people with limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration, (800) 772-1213 (TTY (800) 325-0778), www.socialsecurity.gov.

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 or not you have maintained Creditable Coverage and whether or not you are required to pay a higher premium (a penalty).

Rev. 7/2013