NOTE:  If you are receiving extra help paying for your drug coverage, the premium amount that you pay as a member of our Plan is listed in your Evidence of Coverage Rider. Or, if you are a member of a State Pharmacy Assistance Program (SPAP), you may get help paying your premiums. Please contact your SPAP to determine what benefits are available to you.

How much is your monthly plan premium and how do you pay it?
2011 UPREHS Prime Medicare Secondary Plan, and Prime Medicare Part D Prescription Plan members pay a combined premium for all Medicare Plans of $220 each month.

There are two ways to pay your monthly plan premium.

• Option one – pay quarterly: Pay your Plan premium quarterly (3 months at a time) by check, money order, or automatic premium deduction from your checking or savings account. If you pay by check or money order, we must receive your payment by the first of the month of every January, April, July, and October beginning with January 1, 2011. If you choose automatic deductions, we will debit your bank account on the second Monday of every December, March, June, and September.
  
  UPREHS charges a $20 service fee for checks returned or automatic premium payments rejected because of insufficient funds.
  
  If you have any questions about signing up for the automatic premium payment option, to receive an authorization form, your Plan premiums or the different ways to pay them, please call our Customer Services at 1-800-547-0421.

• Option two – pay monthly: You can pay your Plan premium monthly through automatic premium deduction from your checking or savings account. We cannot accept monthly payments sent directly to UPREHS. We offer payment of your combined UPREHS Medicare Plans premiums monthly only if you have the amount automatically deducted from your bank account. If you do not have a checking account you can use your savings account. Monthly payments must be made through automatic bank account withdrawals. We cannot accept monthly payments sent directly to us.

What happens if you don’t pay your Plan premiums, or don’t pay them
on time?If your Plan premiums are past due, we will tell you in writing when a 30-day grace period begins. Failure to pay your past-due plan premiums within the 30-day grace period will result in your disenrollment. Disenrollment ends your membership in our Plan. If you are disenrolled from UPREHS for any reason including nonpayment of your premium, you may not have another opportunity to enroll again. Also, if you are disenrolled, you will not be able to enroll in another Medicare Prescription Drug Plan until the next Annual Coordinated Enrollment Period, unless you qualify for a Special Enrollment Period. If you do not qualify for a Special Enrollment Period or have another source of creditable prescription drug coverage, you may have to pay a late enrollment penalty the next time you enroll in a Medicare Prescription Drug Plan or a Medicare Advantage Plan with prescription drug coverage. Please see Section 8 for more about enrollment periods.

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Can your Plan premiums change during the year?
Generally, your Plan premium cannot change during the calendar year. We will tell you in advance if there will be any changes for the next calendar year in your Plan premiums or in the amounts you will have to pay when you get your prescriptions covered. If there are any changes for the next calendar year, they will take effect on January 1, 2011.

In limited circumstances, your Plan premium may change during the calendar year. If you aren’t currently receiving extra help but you qualify for it during the year, your monthly premium amount would go down. Or, if you currently get extra help paying your Plan premium, the amount of help you qualify for may change during the year. Your eligibility for extra help might change if there is a change in your income, resources, if you get married, or become single during the year. If the amount of extra help you get changes, your monthly premium would also change. For example, if you qualify for extra help, your monthly premium amount would be lower. The Social Security Administration or State Medical Assistance Office can tell you if there is a change in your eligibility for extra help.

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Do you have to continue to pay your Part A or Part B premiums?
To be a member of our Plan, you must be entitled to Medicare Part A and enrolled in Medicare Part B. You must pay your Part B premiums. If you currently pay a premium for Medicare Part A (most people don’t) and/or Medicare Part B, you must continue paying your premium in order to keep your Medicare Part A and/or Medicare Part B and to remain a member of our UPREHS Medicare Plans.

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What is the late enrollment penalty?
You will have to pay a late enrollment penalty in addition to your monthly plan premium if both of the following two factors are present:

1. You were eligible to enroll in a Medicare Prescription Drug Plan; and
   
   
2. After the end of your initial enrollment period, there was a continuous period of 63 days or longer in which you were not enrolled in a Medicare Prescription Drug Plan or other creditable prescription drug coverage.
   
   
3. Creditable prescription drug coverage is coverage that is at least as good as the standard Medicare Prescription Drug coverage that expects to pay, on average, at least as much as the Medicare Prescription Drug benefit expects to pay.

You pay this late enrollment penalty for as long as you have Medicare Prescription Drug coverage. The amount of the late enrollment penalty may increase every year.

The late enrollment penalty does not apply to individuals who qualify for extra help with their drug plan costs.

NOTE: Many Medicare-eligible UPREHS members are still active workers with the Union Pacific Railroad. You will NOT be assessed the late enrollment penalty when you decide to retire and enroll in Medicare because you have creditable prescription drug coverage under the UPREHS Active Health Plan coverage.

Last Updated: 01/11/2011