Page 18 - Quarles

You must provide this notice to Quarles Petroleum, Inc. month that you did not have that coverage. You’ll have to
Human Resources Department. Once Human Resources is pay this higher premium as long as you have Medicare
coverage. In addition, you may have to wait until the next
notified that one of the qualifying events has occurred, they enrollment period to enroll.
will in turn, notify the qualified beneficiaries of their right to

elect continuation coverage under COBRA. More detailed information about Medicare plans that offer

Notice of Prescription Drug Options for Medicare prescription drug coverage is in the Medicare & You
Members: This notice is important to you if you or one handbook. Medicare participants will get a copy of the
of your covered dependents currently have Medicare handbook in the mail every year from Medicare. You may
coverage or if you expect to begin Medicare coverage also be contacted directly by Medicare prescription drug
within the next 14 months. If you or your family members plans. Here’s how to get more information about Medicare
aren’t currently covered by Medicare and won’t become prescription drug plans: Visit medicare.gov for personalized
covered by Medicare in the next 12 months, this notice help. Call your State Health Insurance Assistance Program
doesn’t apply to you. (see a copy of the Medicare & You handbook for the
telephone number) or Call 800-MEDICARE (800-633-
4227). TTY users should call 877-486-2048.
Quarles Petroleum, Inc. has determined that the
prescription drug coverage offered by Quarles Petroleum, Health Insurance Options through the Public Health
Inc. is, on average for all plan participants, expected to pay Insurance Exchanges: Health insurance is available to
out as much as the standard Medicare prescription drug you through public health insurance exchanges (often
coverage will pay. All Medicare prescription drug plans will referred to as the “Marketplace”) as an alternative to the
provide at least a standard level of coverage set by medical plans available to you from Quarles Petroleum,
Medicare. Some plans might also offer more coverage for a Inc. For some people, especially those eligible for a
higher monthly premium. If you or a covered dependent are subsidy to help pay the cost of their insurance, the
currently covered under the Quarles Petroleum, Inc. Marketplace may offer the right option for their healthcare.
prescription drug plan, your coverage is on average at least With this in mind, it will be helpful for you to understand
as good as standard Medicare prescription drug coverage. your options and make your own decision. Please be
As a result, you will not pay extra if you later decide to aware, however, that our medical plan options meet the
enroll in Medicare coverage. federal minimum value standard for medical coverage.

People with Medicare can enroll in a Medicare prescription Therefore, if you elect coverage through the Marketplace,
drug plan from October 15 through December 7 of each you may not qualify to receive a subsidy. The Marketplace
year. However, if you have existing prescription drug can help you evaluate your coverage options, including
coverage through the Quarles Petroleum, Inc. prescription your eligibility for coverage through the Marketplace and its
drug plan, it is, on average, as good as Medicare coverage cost. Please visit healthcare.gov for more information,
and you can choose to join a Medicare prescription drug including an online application for health insurance
plan later. coverage and contact information for a Health Insurance
Marketplace in your area.

If you decide to enroll in a Medicare prescription drug plan Physician Designation Notice
and you are an active associate or family member of an Quarles Petroleum, Inc. generally allows the designation of
active associate, you may also continue your Quarles a primary care provider. You have the right to designate
Petroleum, Inc. coverage. In this case, the plan will any primary care provider who participates in the medical
continue to pay primary or secondary as it had before you plan’s network and who is available to accept you or your
enrolled in a Medicare prescription drug plan. If you waive family members. For children, you may designate a
or drop coverage, Medicare will be your only payer. You pediatrician as the primary care provider. You do not need
can re-enroll in the employer plan at annual enrollment or if prior authorization from Quarles Petroleum, Inc. or from
you have a special enrollment event for the Quarles any other person (including a primary care provider) in
Petroleum, Inc. plan. order to obtain access to obstetrical or gynecological care

You should compare your current coverage, including from a health care professional in our medical plan’s
network who specializes in obstetrics or gynecology.
which drugs are covered, with the coverage and cost of the
plans offering Medicare prescription drug coverage in your The health care professional, however, may be required to
area. Your current coverage pays for other health comply with certain procedures, including obtaining prior
expenses, in addition to prescription drugs, and you will still authorization for certain services, following a pre-approved
be eligible to receive all of your current health and treatment plan, or procedures for making referrals. For a
list of participating health care professionals who
prescription drug benefits if you choose to enroll in a
Medicare prescription drug plan. You should also know that specialize in obstetrics or gynecology, contact Anthem.
if you drop or lose your coverage with the medical/ For other questions, please contact Human Resources.

prescription drug plan and don’t enroll in Medicare
prescription drug coverage after your prescription drug
coverage ends, you may pay more to enroll in Medicare
prescription drug coverage later. If, you go 63 days or
longer without prescription drug coverage that’s at least as
good as Medicare’s prescription drug coverage; your
monthly premium will go up at least 1% per month for every

17 2016-2017 Benefits Guide