Page 22 - Think Goodness Enrollment Guide

HCR NOTICES

COBRA

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) provides for continued coverage for a certain period of time
at applicable monthly COBRA rates if you, your spouse, or your dependents lose group medical, dental, or vision coverage because
you terminate employment (for reason other than gross misconduct); your work hours are reduced below the eligible status for
these benefits; you die, divorce, or are legally separated; or a child ceases to be an eligible dependent.

ACA 1557

[Name of covered entity] complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color,
national origin, age, disability, or sex.

Important Notice from Think Goodness About Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug
coverage with Think Goodness and about your options under Medicare’s prescription drug coverage. This information can help
you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current
coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription
drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is
at the end of this notice.
There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you
join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug
coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer
more coverage for a higher monthly premium.
2. Think Goodness has determined that the prescription drug coverage offered by Cigna is, on average for all plan participants,
expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable
Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium
(a penalty) if you later decide to join a Medicare drug plan.
Note: The 60-day period for requesting enrollment applies only in these last two listed circumstances relating to Medicaid and
state CHIP. As described above, a 30-day period applies to most special enrollments.

When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.
However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a
two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?
If you decide to join a Medicare drug plan, your current Think Goodness coverage will not be affected.
You can keep this coverage if you elect part D and this plan will coordinate with Part D coverage. See pages 7- 9 of the CMS
Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance (available at
http://www.cms.hhs.gov/CreditableCoverage/), which outlines the prescription drug plan provisions/options that Medicare
eligible individuals may have available to them when they become eligible for Medicare Part D.

If you do decide to join a Medicare drug plan and drop your current Think Goodness coverage, be aware that you and your
dependents may or may not be able to get this coverage back.

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