Health Benefits

If You Are Eligible for Medicare...

Annual Deductible for 2008
For participants eligible for Medicare, the annual deductible will be $1,310.
The Trust Tribune

To read about plan amendments that are effective January 1, 2008, view the Trust Tribune
Plan of Benefits and Plan Summary of Coverage
For additional details see the:

Voluntary Disease Management Programs
The Trust offers heart disease and diabetes management programs to eligible participants through Nurtur (formerly Cardium Health). Nurtur's programs are free to Trust participants who have a:
  • History of cardiovascular disease;
  • Diagnosis of diabetes; or
  • Diagnosis of congestive heart failure.

Counselors work with enrollees to develop personalized plans designed to improve the quality of their lives. The programs enhance, but do not replace, the medical care you receive from your doctor. On average, participation in the program lasts 24 months. If you have questions or would like to enroll, call toll-free 1-877-676-7700, or visit NurturHealth.com  to see if you are eligible to participate.

What We Offer and How You Benefit...

As a Trust participant who is eligible for Medicare, you can receive medical coverage under the Trust's indemnity program. This plan covers certain health care expenses for you and your eligible spouse.

Trust Indemnity Program
Your monthly contribution

$0 for retirees, $35 for eligible spouses

Plan
  • Coordinates with Medicare up to 80% on covered medical expenses after you pay the annual deductible
  • Pays additional payment of one-half of the coinsurance amount payable for covered items on which Medicare pays 80% of the allowable charge (see page 3 of your Plan of Benefits booklet for more information)
Deductible $1,310
Annual out-of-pocket maximum $3,930
Lifetime maximum benefit $170,000
Prescription Drug Benefits
  • After you meet a separate $635 deductible, generic drugs are covered at 90%, "plan-preferred" brand-name drugs are covered at 75%, and "non-plan-preferred" drugs are covered at 60%.
  • To use the discount, show your Trust I.D. card when you visit a participating pharmacy.
  • Mail-order service is mandatory on maintenence medications.

To learn more about the Trust indemnity program, see your Plan of Benefits and Plan Summary of Coverage booklets on this site or request them by calling the Trust office at (239) 936-6242.

To learn more about these programs, continue reading this page or see the More Than You Expect brochure.

Keep in mind that the Trust Tribune serves as the plan amendment, effective January 1, 2008.

What You Need To Do...

When you retire, you are automatically enrolled in the Trust's indemnity program. You are not required to do anything to participate. You do have to apply for coverage for your eligible, lawful spouse, however, and there is a $35 monthly premium.

How The Plan Works...

When you need medical care, you go to any health care provider that is approved by Medicare. Medicare is primary over the Trust indemnity program. This means Medicare must first process your medical claims, with the exception of prescription drugs. After the Trust deductible is satisfied (a separate deductible applies to you and your eligible spouse), the Trust coordinates with Medicare to pay up to 90 percent of certain covered medical expenses. You are responsible for any remaining amount not paid by Medicare or the Trust.

If you reach your annual limit — called the out-of-pocket maximum — the Plan will coordinate with Medicare to pay the rest of your covered medical expenses for that year at 100 percent.

It's important to know the level of your employer's current contributions to the Trust. The medical plan and prescription drug benefit details explained are different, depending on whether or not your employer contributes to the Trust at the highest rate per hour. To find out the level of your employer's contributions to the Trust, ask your employer's benefits specialist, call the Trust office at (239) 936-6242, or send an email through the feedback section of this website.

Copyright 2008, G.M.P. – Employers Retiree Trust, All Rights Reserved