Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 3822 SilverScript Prescription Drug Coverage for Medicare-eligible UnitedHealthcare Members Effective January 1, 2017, Medicare-eligible Washington Suburban Sanitary Commission (WSSC) retirees, and/or their Medicare-eligible dependents who are enrolled in UnitedHealthcare, will have their prescription drug coverage provided under the SilverScript Prescription Drug Plan (PDP) sponsored by WSSC and administered by SilverScript® Insurance Company (SilverScript), a CVS/caremark™ company. Medicare-eligible Kaiser Permanente Health Plan members receive their prescription coverage through Kaiser Permanente. About SilverScript Q. How does SilverScript work? A. There are two plan components working together as a single plan administered by SilverScript: 1. A component that provides Federal government-approved standard Medicare Part D prescription benefits (known as an “Employer Group Waiver Plan” or “EGWP”), and 2. A second component (often referred to as a “Wrap” or “Wraparound”) that will help maintain pre-Medicare current coverage levels. Eligibility Q. Who is eligible for Silverscript? A. Individuals that: • Have prescription drug coverage through the CVS/caremark Commercial plan, and • become Medicare-eligible (retirees, dependents of retirees, or eligible survivors), and • are enrolled in Medicare Parts A and/or B. Note: The current CVS/caremark Commercial plan will continue to be offered to non-Medicare eligible plan participants. Q. Who is not eligible to enroll in SilverScript? A. Individuals who are: • Active WSSC employees and their enrolled dependents; • WSSC retirees, dependents or survivors who are not yet eligible for Medicare; • Medicare-eligible WSSC retirees, dependents, or survivors who are not enrolled in Medicare Parts A and/or B; • Retirees, dependents or survivors who do not have prescription coverage provided by WSSC, or who are covered under an active WSSC employee’s plan; • Enrolled in the Kaiser Permanente Health Plan, regardless of Medicare eligibility; and • Retirees and dependents residing outside the United States (i.e., those not residing in the fifty federated states, District Of Columbia, American Samoa, Guam, the Northern Mariana Islands, or Puerto Rico), or who are incarcerated. Q. Must I be age 65 and over to enroll in SilverScript? A. No. Enrollment is based on Medicare eligibility, not age. This means that retirees and their covered dependents under age 65 who are eligible for Medicare (and are enrolled in Medicare Parts A and/or B) will be enrolled in SilverScript. Q. My family has “split coverage,” meaning that one or more of my covered family members are Medicare-eligible and one or more is not eligible for Medicare. Will the SilverScript plan apply to all of us, or just to those who are Medicare-eligible? A. SilverScript will apply only to those individuals who are eligible for Medicare and enrolled in Medicare Parts A and/or B. Individuals who are not eligible for Medicare will continue to have their benefits administered by CVS/caremark under the current Commercial plan. Q. I will be turning age 65 in 2017 and will become eligible for Medicare; what will happen to my prescription plan coverage? A. Prior to becoming eligible for Medicare, you will receive information from WSSC about your benefits and how they will coordinate with Medicare. You must enroll in Medicare Parts A and B when eligible, and you must provide WSSC with your Medicare ID card as soon as you receive it. At that point, WSSC will begin the process of enrolling you in SilverScript. What You Need to Do (or Not Do) If you are eligible for Medicare, but not currently enrolled in Medicare Parts A and Part B, you must enroll in both parts (call 1-800- MEDICARE) immediately. You must be enrolled in Medicare Parts A and/or B before becoming eligible for coverage under SilverScript. Failure to enroll in Medicare could result in the loss of both WSSC sponsored Medical and Prescription Drug coverage.