Health Benefits...

If You Are Eligible For Medicare...

New Annual Deductible for 2008
For participants eligible for Medicare, the annual deductible will be $1,690. This change is reflected in the details below.
The Trust Gazette

To read about plan amendments that are effective January 1, 2008, view the Trust Gazette

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 enroll online, enter GMPTRUST as the access code.

 

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 $1,690
Annual out-of-pocket maximum $5,070
Lifetime maximum benefit $100,000
Prescription Drug Benefits
  • The prescription drug benefit covers 80% of eligible prescription drug charges after you meet the $1,690 deductible.
  • To use the discount, show your Trust I.D. card when you visit a participating pharmacy. To file a prescription drug claim with the Trust office, you must submit an itemized list from the pharmacy.

To learn more about your Trust indemnity program benefits, see your Plan of Benefits and Plan Summary of Coverage booklets on this site or request them by using the Feedback feature, or by calling the Trust office at (239) 936-6242. The Trust Gazette 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. 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 80 percent of covered medical expenses. You are responsible for any remaining amounts that are 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.

To receive benefits from the Trust indemnity program, you must submit a Notice of Claim form once every year to the Trust office. For prescription drug claims, be sure to provide an itemized list from the pharmacy.

It's important to know the level of your former employer's current contributions to the Trust. The medical plan and prescription drug benefit details are different, depending on whether your former 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