Health & Welfare



Health & Welfare Information (UPDATED OCTOBER 2017)

Medicare Part D & Creditable Coverage: What you should know

As Medicare's annual open enrollment period approaches later this year, Medicare-eligible members and dependents can expect to see a flurry of marketing materials from insurance companies advertising their Medicare Part D prescription Plans. Retired New York City employees are also eligible to participate in the City of New York Health Benefits Program transfer period later this year, and may transfer between plans offered through the City's Health Plan.

When deciding whether to join a Medicare Part D drug plan, it is important to understand the impact of having "creditable coverage" through the Retired Health & Welfare Fund of the PBA (The Fund). Here are the key points you should know:

* Medicare Part D drug coverage is available as part of most Medicare Advantage plans which are also provide Part A (hospital) and Part B (medical) coverage through a private insurer

* Medicare Part D drug coverage is also available through stand-alone Prescription Drug plans (PDP) for those who have opted for through original Medicare. In most cases, you cannot simultaneously be enrolled in both a Medicare Advantage plan and a PDP

* Although Medicare Part D drug coverage is optional, people who do not enroll in Part D coverage when they first become eligible are generally subject to a late enrollment penalty if they decide to enroll in Part D coverage at a later time

* The late enrollment penalty mentioned above does not apply to periods while you are covered by a prescription drug plan that is deemed "creditable coverage". "Creditable Coverage" is prescription drug coverage that is, on average for all plan participants, expected to pay at least as much as the standard Medicare Part D benefit.

* The prescription drug coverage provided by the Retiree Health & Welfare Fund Of the PBA has been deemed to be "creditable coverage" which means that you will not be subject to the Part D late enrollment penalty for the periods during which you are covered by the Fund. The Fund will mail Creditable Coverage Notices to retired members later this year.

* Although coverage provided through the Fund is creditable coverage, you may elect to enroll in a Part D plan. Possible reasons for joining a Part D plan may include:

• You expect to have significant prescription utilization and enroll in a Part D plan that has lower co-payments and is not subject to annual benefits maximums

• You wish to join a Medicare Advantage plan that covers prescription drugs for reasons not related to prescription drug coverage (i.e. lower out of pocket costs for Part A and Part B

• If you decide to join a Medicare Part D plan, you will not lose your PBA coverage. You Part D plan will be your primary coverage and the Fund will be secondary

Source: PBA Retiree Bulletin June 2014 John P. Young

 


 

MAY 2016 - NOTICE: Click here to see a copy of the notification that was mailed out to all non-Medicare enrollees in GHI about the changes in co-payments effective July 1.

 

Medicare Part D & Creditable Coverage: What you should Know


(Added September 2014)

As Medicare's annual open enrollment period approaches later this year, Medicare-eligible members and dependents can expect to see a flurry of marketing materials from insurance companies advertising their Medicare Part D prescription Plans. Retired New York City employees are also eligible to participate in the City of New York Health Benefits Program transfer period later this year, and may transfer between plans offered through the City's Health Plan.

When deciding whether to join a Medicare Part D drug plan, it is important to understand the impact of having "creditable coverage"through the Retired Health & Welfare Fund of the PBA (The Fund). Here are the key points you should know:

* Medicare Part D drug coverage is available as part of most Medicare Advantage plans which are also provide Part A (hospital) and Part B (medical) coverage through a private insurer

* Medicare Part D drug coverage is also available through stand-alone Prescription Drug plans (PDP) for those who have opted for through original Medicare. In most cases, you cannot simultaneously be enrolled in both a Medicare Advantage plan and a PDP

* Although Medicare Part D drug coverage is optional, people who do not enroll in Part D coverage when they first become eligible are generally subject to a late enrollment penalty if they decide to enroll in Part D coverage at a later time

* The late enrollment penalty mentioned above does not apply to periods whic you are covered by a prescription drug plan that is deemed "creditable coverage.""Creditable Coverage"is prescription drug coverage that is, on average for all plan participants, expected to pay at least as much as the standard Medicare Part D benefit.

* The prescription drug coverage provided by the Retiree Health & Welfare Fund Of the PBA has been deemed to be "creditable coverage"which means that you will not be subject to the Part D late enrollment penalty for the periods during which you are covered by the Fund. The Fund will mail Creditable Coverage Notices to retired members later this year.

* Although coverage provided through the Fund is creditable coverage, you may elect to enroll in a Part D plan. Possible reasons for joining a Part D plan may include:

You expect to have significant prescription utilization and enroll in a Part D plan that has lower co-payments and is not subject to annual benefits maximums

You wish to join a Medicare Advantage plan that covers prescription drugs for reasons not related to prescription drug coverage (i.e. lower out of pocket costs for Part A and Part B

If you decide to join a Medicare Part D plan, you will not lose your PBA coverage. You Part D plan will be your primary coverage and the Fund will be secondary

Source: PBA Retiree Bulletin June 2014

 



NYPD Operations Division (646) 610-6100 should be notified. When immediately notified, they may be able to supply police officers in dress uniform as pallbearers for a funeral. In the event of the death of a member, a spouse or beneficiary should be prepared to obtain copies of documents which will be needed to straighten out the deceased estate. Here is a list of documents that each member's spouse or beneficiary will need:

Death Certificates: Cost approximately $4.00 for each copy.
You will need one copy of the death certificate for the Heath Benefit office. Two copies for the City (Employee Section & Pension Section) that's three! If the deceased is a VET, you need two copies for the Veteran's Administration. One for Social Security and one for the Department of Motor Vehicles. A copy is needed for your insurance company and a copy will be needed for the deceased's lawyer in order to execute the will. Additionally, the spouse may want to keep a copy of the death certificate for future use.

Marriage Certificate with official raised seal: Cost approximately $10.00 for first copy & $5.00 for each additional copy and are available from the City Hall where married. If deceased was a veteran, one copy for Veterans Administration and another copy for the Social Security Administration.

Last Will & Testament: You will need one copy for the State's Department of Taxation in order to obtain a tax waiver for pension monies and you will need one copy for the IRS.

Surrogates' Certificate: Usually takes about 3 ¬Ĺ months after a person's death to obtain In the event that the Will calls for a transfer of ownership of property, you will need the following Surrogates' certificates supplied by Surrogates' Court:

  • Department of Motor Vehicles- in order to transfer car ownership
  • City Department of Finances- in order to collect deceased final pay check
  • State Department of Taxation- tax wavier to collect pension monies
  • City Comptrollers Office- in some cases to collect pension monies


  • Discharge Papers (DD 214)
    If the deceased was a veteran, a copy may be need by the Veterans Administration and a copy my be needed by the Social Security Administration

    Veterans Administration: You can phone (800) 827-1000, a toll free number for the New York regional office of the Veterans Admin to inquire about any sort of dependency and Indemnity Compensation (DIC) to which certain veteran's spouses may be entitled. The VA requires the following documents: two copies of death certificates, one copy of the marriage certificate, one copy of the deceased's birth certificate, one copy of discharged papers and one copy of government insurance papers.

    Please note that VA sometimes supplies gravestones plus a stipend of about $250 for burial and for benefits for a spouse and for dependent children.

    Social Security Administration: your nearest Social Security office is listed under the government section of your phone book and they require one copy of the deceased's death certificate and one copy of the deceased's marriage certificate with seal. They (SSA) also require one copy of the deceased's birth certificate (with seal) that can be obtained by contacting the Department of Health in the city that the deceased was born. Copies of birth certificates cost approximately $3.50 each.

    If the deceased was a military veteran, one copy of the member's discharge papers (DD 214) must go the SSA, along with one copy of the paid funeral bill, one copy of the deceased's Social Security card, and one copy of the survivor's Social Security card.

    Please note that Social Security payments for widows and dependent children take about two months

    State Department of Motor Vehicles: For transfer of automobile ownership, DMV require One copy of the death certificate and one copy of the surrogate's certificate (if there is a Will involved)

    Health Insurance: To purchase the COBRA coverage, survivor should contact the deceased member's Health Benefits Office:
  • PBA (212) 349-7560
  • SBA (212) 431-6555
  • DEA (212) 587-9120
  • SOC (212) 964-7500


  • Keep Cash Readily Available
    You should keep enough cash readily available to sustain the family for several months while you're waiting for payments from some of the agencies or until the settlement of the estate. Banks will put a hold on savings or checking accounts and any safety deposit boxes as soon as an obituary is published. New York State taxes, as well as any federal inheritances taxes may be due.

    Identification will be needed at most places to get information or application forms. The Social Security cards of both the deceased and the beneficiary (or survivor) will be required at most of the offices that need to be contacted.

    You may want to contact the New York State Department of Taxation. You can receive a tax wavier to fill out and be notarized. You must list all deceased's assets i.e. real estate, bank accounts, insurance, union benefits, veteran's benefits, city pension benefits, etc. They will require a copy of the Will and possibly a Surrogate's certificate.

    You may also want to contact the City Comptroller's Office and they may require a copy of the Surrogate's certificate before paying out any monies that were due from the pension system. If you have any questions, it's always a good idea to consult with your attorney and accountant as tax and legal issues are constantly subject to change.

    Courtesy of Detective's Endowment Association

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