Retiree Welfare Fund Summary Plan Description (SPD)
Medical Benefits Summary Material Modifications (SMM)
Summary Annual Report (SAR)
Notices/Letters
Retiree Welfare Fund - Pre Medicare Coverage
The Plan offers Pre-Medicare retiree health coverage to eligible Participants to provide uninterrupted basic health and welfare coverage between retirement and the time Medicare coverage begins. If you elect Pre-Medicare retiree coverage under the Plan, coverage begins the month after your eligibility under the Active Employee Health Plan terminates. Although you must elect Pre-Medicare retiree health coverage within 60 days of your retirement date, the first premium is not due until the month before coverage starts. If the first premium is not paid by the end of the calendar month after the premium is due, coverage will not begin. Coverage begins once all banked hours under the Active Employee Health Plan are exhausted following retirement.
EPIC Hearing Plan Services
Express Scripts Pre-Medicare
100% of Reasonable and Customary cost for up to a 34 day retail supply less the applicable co-payments as
follows:
$10.00 - for covered generic drugs,
$20.00 - for covered brand name drugs on Express Scripts’ formulary, and
$40.00 - for covered brand name drugs not on Express Scripts’ formulary.
100% for Express Scripts’ Prescription Drug Mail Order Program (3 month supply), less the applicable copayments
as follows:
$ 0.00 - for covered generic drugs,
$10.00 - for covered brand name drugs on Express Scripts’ formulary, and
$20.00 - for covered brand name drugs not on Express Scripts’ formulary.
For prescribed specialty and self-administered injectable drugs (except insulin), 100% of Reasonable and
Customary cost less the applicable $20.00 co-payment but only if the drug is acquired from Accredo. There is no
coverage for specialty and self-administered drugs that are not acquired from Accredo.
Express Scripts Medicare
Medicare Advantage Plan
Effective January 1, 2023, Retirees, Spouses, and surviving Spouses who are at least 65, and enrolled in Medicare Parts A and B are eligible for a Medicare Advantage Plan provided through Humana. Unless you have affirmatively chosen not to receive this benefit under the Plan, all eligible Retirees and Spouses will be automatically enrolled in the new Medicare Advantage Plan. If you are not enrolled in Medicare Parts A and B, you will not be eligible for this benefit.
The new Medicare Advantage Plan provides 100% coverage for a number of Medicare-approved services.
The following services are including in the Medicare Advantage benefit so long as such services are Medicare-approved: office visits, specialist visits, diagnostic procedures/tests, lab services, preventive services, therapy (occupational/physical/speech), inpatient and outpatient services, skilled nursing facility ($0 paid for the first 100 days), urgent care services, ambulance services, routine chiropractic services, routine acupuncture services, and emergency services for foreign travel. Additionally, a $50 allowance is provided every three months for select over-the-counter health and wellness products through the Medicare Advantage benefit. Please note that benefits not otherwise covered by the Humana Medicare Advantage Plan will be denied. Any denied claims may be appealed pursuant to the Plan’s claim and appeal procedures set forth in Article XIII of your Plan/SPD.
For more information about your Medicare Advantage benefits provided through Humana, please contact Retiree First at 312-248-9922 (TTY 711) or toll-free at 855-433-1672. Retiree First is a company which specializes in the ongoing member support of retiree health and drug programs and has been retained by the Fund to provide you with a dedicated team of professionals to answer your questions about the Medicare Advantage benefit. You may also contact Humana directly at 1-800-733-9064.
Silver Sneakers and One-Pass Gym Plan