| In General | Retiree health coverage is very similar to coverage for active participants. The following will summarize the main differences in the area of deductibles, out-of-pocket maximums, and Medicare rules. |
|---|---|
| Annual Deductible | Each Participant with Medicare - $200 Each Participant without Medicare - $2,000 |
| Lifetime Maximum | $500,000 |
| Annual Out-of-Pocket Maximum | Each Participant with Medicare - $1,500 Each Participant without Medicare - $6,000 |
| Life Insurance Benefit | $5,000 |
| Medicare Enrollment Required | You must enroll for Medicare parts A and B as soon as you are eligible to do so in order to get full benefits from this Plan. |
|---|---|
| Medicare Primary | Medicare is considered "Primary" for retirees and their families. This means that all medical bills are first submitted to Medicare for payment. |
| Plan Payment Calculation | The Plan is considered "secondary" to Medicare. After Medicare pays its portion and sends you an Explanation of Medical Benefits (EOMB) you will submit this with your claim to the Plan. First, the Plan will calculate what it would have paid in the absence of Medicare coverage. Then, the Plan will subtract the amount paid by Medicare and pay any remaining amount. |
| Non-Medicare Eligible (*) | $968.00 |
|---|---|
| Medicare Eligible - Tier 6 less than 10,000 hours worked |
$344.00 |
| Medicare Eligible - Tier 5 10,000 to 14,999 hours worked |
$310.00 |
| Medicare Eligible - Tier 4 15,000 to 19,999 hours worked |
$275.00 |
| Medicare Eligible - Tier 3 20,000 to 29,999 hours worked |
$241.00 |
| Medicare Eligible - Tier 2 30,000 to 39,999 hours worked |
$206.00 |
| Medicare Eligible - Tier 1 over 40,000 hours worked |
$172.00 |
| Children | $529.00 |
(*) This non-Medicare self-payment rate is effective March 1, 2010.