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HEALTH PLAN NOTICES FOR BENEFITS ELIGIBLE EMPLOYEES IMPORTANT NOTICE ABOUT YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE (CONTINUED) What Happens to Your Current Coverage If You Decide to Join a Medicare Drug Plan? Your current coverage pays for other health expenses, in addition to prescription drugs. If you are actively employed and decide to join a Medicare drug plan, your current medical coverage will not be affected; you can keep this coverage if you elect part D and this plan will coordinate with Part D coverage. If you are actively employed and you decide to join a Medicare drug plan and drop your current medical coverage, be aware that you and your dependents may be able to get this coverage back at the next open enrollment period or upon a qualifying status change if you remain otherwise eligible to enroll in the Plan. If you are no longer actively employed and you decide to join a Medicare drug plan and drop your current coverage, be aware that you and your dependents will not be able to get this coverage back. 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 and don’t 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 creditable prescription drug coverage, your monthly premium may go up by 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 nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice or Your Current Prescription Drug Coverage… Contact the plan administrator for further information.

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