4
Prescription Drug Coverage
In 2011, 76.6% of prescriptions were generic,
representing an increase of 3% from 2010. This
demonstrates the effectiveness of cost-sharing levels
and the mandatory generic substitution program.
The prescription drug program available through the
Trust does not have a “donut hole” like Medicare
Part D. For all participants whose former employer
contributes at the highest rate, mail-order maintenance
medications and short-term retail pharmacy
prescriptions are covered as follows, once a separate
annual deductible is met:
•
Generic prescription drugs at 90%;
•
“Plan-preferred” brand-name prescription drugs
at 75%;
•
“Non-plan-preferred” brand-name prescription
drugs at 60%.
Mail-order presents considerable savings for the
participants and the Trust. Participants who do not use
the mail-order program for maintenance prescription
drugs have their coverage reduced as follows:
•
Generic prescription drugs at 50%;
•
“Plan-preferred” brand-name prescription drugs
at 50%;
•
“Non-plan-preferred” brand-name prescription
drugs at 25%.
On average for all plan participants, this program is at
least as good as standard Medicare Part D coverage, so
most participants do not need to enroll in a Medicare
Part D plan and pay its monthly premium. Some
participants with limited income and resources still
choose to enroll in a Medicare Part D plan so they are
able to receive financial assistance from the government.
Participants are regularly advised to notify the Trust
immediately if they decide to enroll in a Part D plan.
Life Insurance
The Trust provides $2,000 of life insurance coverage
for eligible retirees only. There is no coverage
available for spouses.
There are many resources available to inform participants and
employers about the Trust and its benefits, with the website
serving as a repository. Examples of available materials include:
•
An overview brochure
•
Plan of Benefits and Plan Summary of Coverage booklets
•
Annual newsletters
Notification:
If the Trustees determine that any of the Trust’s benefits are no longer satisfactory for any
reason, they reserve the right, as they do with the Trust’s Plan and other programs, to
modify, change or discontinue any of them at any time and in any manner. The Trustees
strive to provide ample notice before carrying out any such action.
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