2015 Benefits Guide
10
IMPORTANT NOTICES
PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN'S HEALTH INSURANCE
PROGRAM (CHIP)
If you or your children are eligible for Medicaid or CHIP and you're eligible for our health coverage your State may have a premium assis-
tance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren't eligible for
Medicaid or CHIP, you won't be eligible for these premium assistance programs but you may be able to buy individual insurance coverage
through the Health Insurance Marketplace. For more information, visit
www.healthcare.gov.If you believe you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or
dial 1-877-KIDS NOW or go to
www.insurekidsnow.gove website to find out how to apply. If you qualify, ask your State if it has a pro-
gram that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, you will be allowed to enroll in our medical plan if
you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being de-
termined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at
www.askebsa.dol.govor call 1-866-444-3272.
Link to the latest form:
http://www.dol.gov/ebsa/pdf/chipmodelnotice.pdfFor more information on special enrollment rights, you can contact either:
U.S. Department of Labor
Employee Benefits Security Administration
www.dol.gov/ebsa1-866-444-EBSA (3272)
U.S. Department of Health and Human Services
Centers for Medicare & Medicaid Services
www.cms.hhs.gov1-877-267-2323, Ext. 61565
MEDICARE PART D CREDITABLE COVERAGE
This notice has information about your current prescription drug coverage and about your options under Medicare’s prescription drug
coverage. If you are eligible for Medicare the following information can help you decide whether or not you want to join a Medicare drug
plan. You should consider comparing your current coverage through our medical plan with the costs of plans offering Medicare prescrip-
tion drug coverage in your area. Two important things you need to know about your current coverage and Medicare prescription drug
coverage:
Medicare prescription drug coverage is available if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan. All Medi-
care drug plan provide at least a standard level of coverage set by Medicare. More coverage may be offered at a higher premium.
Coventry Healthcare has determined that the prescription drug coverage offered by 1st Financial Federal Credit Union is on average for
all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Cred-
itable Coverage for the Buy Up (C-1000-14) Plan . Because this coverage is Creditable Coverage, you can keep it and not pay a higher pre-
mium (a penalty) if you later decide to join a Medicare drug plan. The HSA plan is not considered Creditable Coverage by Coventry
Healthcare. Depending on how long you go without creditable prescription drug coverage you may pay a penalty to join a Medicare drug
plan.
If you lose your current creditable prescription drug coverage through no fault of your own, you will be eligible for a two-month Special
Enrollment Period to join a Medicare drug plan.