NEWSLETTERS
PICA PROGRAM
(Effective 7/1/05)
PICA for Non-Medicare MEDCO
members. There are some drugs for which participants do
not use the MEDCO card, but instead use another card not issued by
the Welfare Fund.
For
non-Medicare eligible retirees,
injectable and Chemotherapy medications are available under the PICA
program. The NY City Retiree Health Program should be consulted for
further detail and updates. Eligible individuals will be issued a
drug card for PICA coverage. For retirees with Medicare, the IC
drugs are treated as any other medications which are covered by the
Fund.
MEDICARE PART D
(Effective 1/1/06)
[You may choose this
instead of MEDCO]
Basics
The Federal government recently enacted a limited, catastrophic drug
program for qualified retirees, over age 65 who are covered under
Medicare Part A (hospital) and [at least eligible for] Part B
(medical). It is commonly referred to as Medicare Part D.
The Part D program is privately administered by insurance companies
who offer a variety of policies featuring: 1) a formulary of covered
drugs, 2) a "front-end" deductible, 3) a range of annual costs where
the enrollee pays a moderate percentage co-pay, 4) a range of annual
costs where the enrollee pays all costs - 100% co-pay - also known
as the "doughnut hole" and 5) a range of annual costs where the
enrollee pays minimal percentage co-payment toward drug costs. For
this coverage, the Medicare Part D enrollee pays a premium.
The prototype on which the program is based applies a $250
deductible, a 25% co-payment on the next $2,000 of annual drug
spending, no coverage between $2,250 and $5,100 annually and a 5%
co-payment on annual expenses exceeding $5,100.
The monthly premium estimated on that model was to have been
approximately $37 in the first year (2006). Many areas around the
country had 40 to 50 competing plans in the first year of operation,
with wide variances on premium, deductibles, copayments and
formularies.
The PSC-CUNY Welfare Fund Drug Benefit
Eligible plan participants may chose a Medicare Part D plan instead
of the Welfare Fund retiree drug plan. Those who do so would
relinquish Welfare Fund drug coverage. It is often not advisable to
do so.
Analysis of average drug utilization among covered retirees has
determined that most retirees would be financially
better off with the PSC-CUNY Welfare Fund Medco program. The
exception would be those individuals who incur high annual costs. If
annual costs exceed $13,800, the Part D program might be beneficial.
The Fund actuaries have calculated that on the average the Welfare
Fund drug coverage is equal to or better than the Medicare Part D
program. This "Actuarial Equivalence" enables the Welfare Fund to
issue a
Notice of Creditable Coverage* to its eligible retired
members. This Notice assures that a future decision by a participant
to enroll directly in Part D (e.g., by a spouse if a retiree dies)
is not met with a substantial premium surcharge.
Fund office staff is unable to personally advise on choice of
coverage. More information is available on-line at
www.medicare.gov.
*The Welfare Fund
provides the first year Notice of Creditable Coverage (2005) -- and
only the first year. Carriers, such as Medco, are responsible
for subsequent years.
HIPAA
HIPAA For:
OFFICE RELOCATION
Both the Welfare Fund and the
union (PSC-CUNY) have moved from midtown to downtown.
Our new address:
61 Broadway/ 15th floor
New York, NY 10006
TEL: 212-354-5230
FAX: 212-354-5363
Click
HERE
for directions, maps, parking
and subways.
|
CITY SECURITY BREACH
On August 18, 2007
a laptop computer
being used by a consultant to the NY City Financial Services
Agency (FISA) was
stolen. The computer
contained personal identifying information on a certain
number of retirees who receive pensions through city pension
systems. It is likely that some PSC Retirees are included
in this group. The City is unable to provide us with
information about which individuals were included. Two weeks
later a notice was sent out to all retirees.
PSC-CUNY
was first made aware when
our retired members began receiving letters from FISA. The
Welfare Fund followed up to obtain copies of all
correspondence distributed as well as FAQ sheets to assist
our members.
The data of primary
concern is Name, Social
Security Number and Bank Account Number.
The affected group among
PSC members appears to be some or all of those who have a
TRS or NYCERS pension.
The letter sent by FISA includes enclosures that will help
assess the risk as well as obtain ways to monitor whether
there are consequences.
The Executive Director of
the PSC and other PSC officers have expressed their extreme
displeasure with the level of security that permitted this
breach and have called for further investigation, including
City Council hearings, to determine appropriate remedial
measures.
The
letter provides phone numbers if there are questions, and
your Welfare Fund Is available as always |
