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Important Notices:Medicare Part D Notice of CreditableCoveragePlease read this notice carefully and keep it where youcan find it. This notice has information about yourcurrent prescription drug coverage with DM Bowman,Inc. and about your options under Medicare’sprescription drug coverage. This information can helpyou decide whether or not you want to join aMedicare drug plan. If you are considering joining, youshould compare your current coverage, includingwhich drugs are covered at what cost, with thecoverage and costs of the plans offering Medicareprescription drug coverage in your area. Informationabout where you can get help to make decisions aboutyour prescription drug coverage is at the end of thisnotice.There are two important things you need to knowabout your current coverage and Medicare’sprescription drug coverage:1. Medicare prescription drug coverage becameavailable in 2006 to everyone with Medicare. You canget this coverage if you join a Medicare PrescriptionDrug Plan or join a Medicare Advantage Plan (like anHMO or PPO) that offers prescription drug coverage.All Medicare drug plans provide at least a standardlevel of coverage set by Medicare. Some plans mayalso offer more coverage for a higher monthlypremium.2. DM Bowman, Inc. has determined that theprescription drug coverage offered by the DMBMedical Plan is, on average for all plan participants,expected to pay out as much as standard Medicareprescription drug coverage pays and is thereforeconsidered Creditable Coverage. Because your existingcoverage is Creditable Coverage, you can keep thiscoverage and not pay a higher premium (a penalty) ifyou later decide to join a Medicare drug plan.When Can You Join A Medicare Drug Plan?You can join a Medicare drug plan when you firstbecome eligible for Medicare and each year fromOctober 15th to December 7th. However, if you loseyour current creditable prescription drug coverage,through no fault of your own, you will also be eligiblefor a two (2) month Special Enrollment Period (SEP) tojoin a Medicare drug plan.What Happens To Your Current Coverage If You Decideto Join A Medicare Drug Plan?If you decide to join a Medicare drug plan, your currentDMB coverage will not be affected. If you do decide tojoin a Medicare drug plan and drop your current DMBcoverage, be aware that you and your dependents maynot be able to get this coverage back.When Will You Pay A Higher Premium (Penalty) To JoinA Medicare Drug Plan?You should also know that if you drop or lose yourcurrent coverage with DMB and don’t join a Medicaredrug plan within 63 continuous days after your currentcoverage ends, you may pay a higher premium (apenalty) to join a Medicare drug plan later.If you go 63 continuous days or longer withoutcreditable prescription drug coverage, your monthlypremium may go up by at least 1% of the Medicare basebeneficiary premium per month for every month thatyou did not have that coverage. For example, if you gonineteen months without creditable coverage, yourpremium may consistently be at least 19% higher thanthe Medicare base beneficiary premium. You may haveto pay this higher premium (a penalty) as long as youhave Medicare prescription drug coverage. In addition,you may have to wait until the following October tojoin.For More Information About This Notice Or YourCurrent Prescription Drug Coverage Contact the person listed below for further informationor contact the customer service number on the back ofyour Medical Plan ID Card. NOTE: You’ll get this noticeeach year. You will also get it before the next period youcan join a Medicare drug plan, and if this coveragethrough DMB changes. You also may request a copy ofthis notice at any time.For More Information About Your Options UnderMedicare Prescription Drug Coverage More detailed information about Medicare plans thatoffer prescription drug coverage is in the “Medicare &You” handbook. You’ll get a copy of the handbook inthe mail every year from Medicare. You may also becontacted directly by Medicare drug plans.For more information about Medicare prescription drugcoverage: Visit www.medicare.gov Call your State Health Insurance Assistance Program(see the inside back cover of your copy of the“Medicare & You” handbook for their telephonenumber) for personalized help Call 1-800-MEDICARE (1-800-633-4227). TTY usersshould call 1-877-486-2048.
If you have limited income and resources, extra helppaying for Medicare prescription drug coverage isavailable. For information about this extra help, visitSocial Security on the web at www.socialsecurity.gov, orcall them at 1-800-772-1213 (TTY 1-800-325-0778).Remember: Keep this Creditable Coverage notice. Ifyou decide to join one of the Medicare drug plans, youmay be required to provide a copy of this notice whenyou join to show whether or not you have maintainedcreditable coverage and, therefore, whether or notyou are required to pay a higher premium (a penalty).Date: 10/2017Name of Entity/Sender: DM Bowman, Inc.Contact: Benefits DepartmentAddress: 10038 Governor Lane Blvd., Williamsport MD21795Phone Number: (301) 223-1092Summary Annual ReportFor D M Bowman Inc. Health and Benefits PlanThis is a summary of the annual report of the D M BowmanInc. Health and Benefits Plan (Employer IdentificationNumber 52-0972610, Plan Number 501) for the plan year01/01/2016 through 12/31/2016. The annual report has beenfiled with the Employee Benefits Security Administration, asrequired under the Employee Retirement Income Security Actof 1974 (ERISA).D M Bowman, Inc. has committed itself to pay certainmedical claims incurred under the terms of the plan.Insurance InformationThe plan has insurance contracts with Life InsuranceCompany of North America, Fidelity Security Life InsuranceCompany, Colonial Life & Accident Insurance Company andMetropolitan Life Insurance Company to pay certain life,accidental death and dismemberment, dental, vision,temporary disability, and long-term disability claims incurredunder the terms of the plan. The total premiums paid for theplan year ending 12/31/2016 were 776,640.Your Rights to Additional InformationYou have the right to receive a copy of the full annual report,or any part thereof, on request. The items listed below areincluded in that report: Insurance information, including sales commissions paidby insurance carriers.To obtain a copy of the full annual report, or any part thereof,write or call the plan administrator, at 10228 Governor LaneBlvd Suite 3006, Williamsport, MD 21795 and phone number,301-223-1003.You also have the legally protected right to examine theannual report at the main office of the plan: 10228 GovernorLane Blvd Suite 3006, Williamsport, MD 21795, and at theU.S. Department of Labor in Washington, D.C., or to obtain acopy from the U.S. Department of Labor upon payment ofcopying costs. Requests to the Department should beaddressed to: Public Disclosure Room, Room N-1513,Employee Benefits Security Administration, U.S. Departmentof Labor, 200 Constitution Avenue, N.W., Washington, D.C.20210.
Premium Assistance Under Medicaid and theChildren’s Health Insurance Program (CHIP)If you or your children are eligible for Medicaid or CHIP andyou’re eligible for health coverage from your employer, yourstate may have a premium assistance program that can helppay for coverage, using funds from their Medicaid or CHIPprograms. If you or your children aren’t eligible for Medicaidor CHIP, you won’t be eligible for these premium assistanceprograms but you may be able to buy individual insurancecoverage through the Health Insurance Marketplace. Formore information, visit www.healthcare.gov.If you or your dependents are already enrolled in Medicaid orCHIP and you live in a State listed below, contact your StateMedicaid or CHIP office to find out if premium assistance isavailable.If you or your dependents are NOT currently enrolled inMedicaid or CHIP, and you think you or any of yourdependents might be eligible for either of these programs,contact your State Medicaid or CHIP office or dial 1-877-KIDSNOW or www.insurekidsnow.gov to find out how to apply. Ifyou qualify, ask your state if it has a program that might helpyou pay the premiums for an employer-sponsored plan.If you or your dependents are eligible for premium assistanceunder Medicaid or CHIP, as well as eligible under youremployer plan, your employer must allow you to enroll inyour employer plan if you aren’t already enrolled. This iscalled a “special enrollment” opportunity, and you mustrequest coverage within 60 days of being determinedeligible for premium assistance. If you have questions aboutenrolling in your employer plan, contact the Department ofLabor at www.askebsa.dol.gov or call 1-866-444-EBSA(3272).If you live in one of the following states, you may be eligiblefor assistance paying your employer health plan premiums.The following list of states is current as of August 10, 2017.Contact your State for more information on eligibility:ALABAMA – MedicaidWebsite: http://myalhipp.com/Phone: 1-855-692-5447ALASKA – MedicaidThe AK Health Insurance Premium Payment ProgramWebsite: http://myakhipp.com/Phone: 1-866-251-4861Email: CustomerService@MyAKHIPP.comMedicaid aid/default.aspxARKANSAS – MedicaidWebsite: http://myarhipp.com/Phone: 1-855-MyARHIPP (855-692-7447)COLORADO – Health First Colorado (Colorado’s Medicaid Program)& Child Health Plan Plus (CHP )Health First Colorado Website:https://www.healthfirstcolorado.com/Health First Colorado Member Contact Center:1-800-221-3943/ State Relay 711CHP : Colorado.gov/HCPF/Child-Health-Plan-PlusCHP Customer Service: 1-800-359-1991/State Relay 711FLORIDA – MedicaidWebsite: http://flmedicaidtplrecovery.com/hipp/Phone: 1-877-357-3268GEORGIA – MedicaidWebsite: http://dch.georgia.gov/medicaid- Click on Health Insurance Premium Payment (HIPP)Phone: 404-656-4507INDIANA – MedicaidHealthy Indiana Plan for low-income adults 19-64Website: http://www.in.gov/fssa/hip/Phone: 1-877-438-4479All other MedicaidWebsite: http://www.indianamedicaid.comPhone 1-800-403-0864IOWA – MedicaidWebsite: ppPhone: 1-888-346-9562KANSAS – MedicaidWebsite: http://www.kdheks.gov/hcf/Phone: 1-785-296-3512KENTUCKY – MedicaidWebsite: http://chfs.ky.gov/dms/default.htmPhone: 1-800-635-2570LOUISIANA – MedicaidWebsite: Phone: 1-888-695-2447MAINE – MedicaidWebsite: ex.htmlPhone: 1-800-442-6003TTY: Maine relay 711MASSACHUSETTS – Medicaid and nts/masshealth/Phone: 1-800-862-4840MINNESOTA – MedicaidWebsite: calassistance.jspPhone: 1-800-657-3739MISSOURI – MedicaidWebsite: htmPhone: 573-751-2005MONTANA – MedicaidWebsite: Phone: 1-800-694-3084
NEBRASKA – MedicaidWebsite: http://www.ACCESSNebraska.ne.govPhone: (855) 632-7633Lincoln: (402) 473-7000Omaha: (402) 595-1178NEVADA – MedicaidMedicaid Website: https://dwss.nv.gov/Medicaid Phone: 1-800-992-0900NEW HAMPSHIRE – MedicaidWebsite: one: 603-271-5218NEW JERSEY – Medicaid and CHIPMedicaid /clients/medicaid/Medicaid Phone: 609-631-2392CHIP Website: http://www.njfamilycare.org/index.htmlCHIP Phone: 1-800-701-0710NEW YORK – MedicaidWebsite: https://www.health.ny.gov/health care/medicaid/Phone: 1-800-541-2831NORTH CAROLINA – MedicaidWebsite: https://dma.ncdhhs.gov/Phone: 919-855-4100NORTH DAKOTA – MedicaidWebsite: d/Phone: 1-844-854-4825OKLAHOMA – Medicaid and CHIPWebsite: http://www.insureoklahoma.orgPhone: 1-888-365-3742OREGON – MedicaidWebsite: //www.oregonhealthcare.gov/index-es.htmlPhone: 1-800-699-9075PENNSYLVANIA – ogram/index.htmPhone: 1-800-692-7462RHODE ISLAND – MedicaidWebsite: http://www.eohhs.ri.gov/Phone: 855-697-4347SOUTH CAROLINA – MedicaidWebsite: https://www.scdhhs.govPhone: 1-888-549-0820SOUTH DAKOTA - MedicaidWebsite: http://dss.sd.govPhone: 1-888-828-0059TEXAS – MedicaidWebsite: http://gethipptexas.com/Phone: 1-800-440-0493UTAH – Medicaid and CHIPMedicaid Website: https://medicaid.utah.gov/CHIP Website: http://health.utah.gov/chipPhone: 1-877-543-7669VERMONT– MedicaidWebsite: http://www.greenmountaincare.org/Phone: 1-800-250-8427VIRGINIA – Medicaid and CHIPMedicaid Website:http://www.coverva.org/programs premium assistance.cfmMedicaid Phone: 1-800-432-5924CHIP Website:http://www.coverva.org/programs premium assistance.cfmCHIP Phone: 1-855-242-8282WASHINGTON – MedicaidWebsite: e: 1-800-562-3022 ext. 15473WEST VIRGINIA – MedicaidWebsite: http://mywvhipp.com/Toll-free phone: 1-855-MyWVHIPP (1-855-699-8447)WISCONSIN – Medicaid and ions/p1/p10095.pdfPhone: 1-800-362-3002WYOMING – MedicaidWebsite: https://wyequalitycare.acs-inc.com/Phone: 307-777-7531To see if any other states have added a premium assistanceprogram since August 10, 2017, or for more information onspecial enrollment rights, contact either:U.S. Department of LaborEmployee Benefits Security BSA (3272)U.S. Department of Health and Human ServicesCenters for Medicare & Medicaid Serviceswww.cms.hhs.gov1-877-267-2323, Menu Option 4, Ext. 61565Paperwork Reduction Act StatementAccording to the Paperwork Reduction Act of 1995 (Pub. L.104-13) (PRA), no persons are required to respond to acollection of information unless such collection displays avalid Office of Management and Budget (OMB) controlnumber. The Department notes that a Federal agency cannotconduct or sponsor a collection of information unless it isapproved by OMB under the PRA, and displays a currentlyvalid OMB control number, and the public is not required to
respond to a collection of information unless it displays acurrently valid OMB control number. See 44 U.S.C. 3507.Also, notwithstanding any other provisions of law, no personshall be subject to penalty for failing to comply with acollection of information if the collection of information doesnot display a currently valid OMB control number. See 44U.S.C. 3512.The public reporting burden for this collection of informationis estimated to average approximately seven minutes perrespondent. Interested parties are encouraged to sendcomments regarding the burden estimate or any other aspectof this collection of information, including suggestions forreducing this burden, to the U.S. Department of Labor,Employee Benefits Security Administration, Office of Policyand Research, Attention: PRA Clearance Officer, 200Constitution Avenue, N.W., Room N-5718, Washington, DC20210 or email ebsa.opr@dol.gov and reference the OMBControl Number 1210-0137.OMB Control Number 1210-0137 (expires 12/31/2019)Summary of Benefits and Coverage (SBC)Choosing a health plan is an important decision. To assist youwith this process, and in accordance with the Affordable CareAct, the DM Bowman, Inc. health plan has produced an SBC.The SBC provides important information in a standard formatto help you better understand your health benefit coverageand easily compare health plan options. You may view yourSBC online. To request a free hard copy of the SBC, contactthe Benefits Department.Your HIPAA Privacy RightsKeeping your personal health information private is yourright. That’s why the U.S. government passed the “PrivacyRule” – part of the Health Insurance Portability andAccountability Act of 1996 (HIPAA). The Privacy Rule, passedin 2003, protects your health information and makes it illegalfor healthcare providers to reveal information and makes itillegal for health care providers to reveal information aboutyour health without your permission unless needed to treatyour condition. It also prevents the improper use of healthinformation by health care benefits insurers andadministrator, Doctors’ offices and health care facilities arerequired by law to obtain your written permission toappropriately reveal information about your health. A copyof the DM Bowman, Inc. Notice of Privacy Practices may berequested from the Benefits Department.HIPAA Notice of Special Enrollment RightsIf you are declining enrollment for yourself or yourdependents (including your spouse) because of other healthinsurance or group health plan coverage, you may be able toenroll yourself and your dependents in this plan if you or yourdependents lose eligibility for that other coverage (or if theemployer stops contributing towards your or yourdependents' other coverage). However, you must requestenrollment within 30 days after your or your dependents'other coverage ends (or after the employer stopscontributing toward the other coverage).If you have a new dependent as a result of marriage, birth,adoption, or placement for adoption, you may be able toenroll yourself and your dependents. However, you mustrequest enrollment within 30 days after the marriage, birth,adoption, or placement for adoption.To request special enrollment or obtain more information,contact the Benefits Department.Women’s Health & Cancer Rights Act of 1998If you have had or are going to have a mastectomy, you maybe entitled to certain benefits under the Women’s Health andCancer Rights Act of 1998 (WHCRA). For individuals receivingmastectomy-related benefits, coverage will be provided in amanner determined in consultation with the attendingphysician and the patient, for: All stages of reconstruction of the breast on whichthe mastectomy was performed;Surgery and reconstruction of the other breast toproduce a symmetrical appearance;Prostheses; andTreatment of physical complications of themastectomy, including lymphedema.These benefits will be provided subject to the samedeductibles and coinsurance applicable to other medical andsurgical benefits provided under this plan. If you would likemore information on WHCRA benefits, you may contactUnited Healthcare or the Benefits Department.Newborns’ and Mothers’ Health Protection ActGroup health plans and health insurance issuers generallymay not, under federal law, restrict benefits for any hospitallength of stay in connection with childbirth for the mother ornewborn child to less than 48 hours following a vaginaldelivery, or less than 96 hours following a cesarean section.However, federal law generally does not prohibit themother's or newborn's attending provider, after consulting
with the mother, from discharging the mother or hernewborn earlier than 48 hours (or 96 hours as applicable). Inany case, plans and issuers may not, under federal law,require that a provider obtain authorization from the plan orthe issuer for prescribing a length of stay not in excess of 48hours (or 96 hours).Wellness Program DisclosureYour health plan is committed to helping you achieve yourbest health. Rewards for participating in a wellnessprogram are available to all employees. If you think youmight be unable to meet a standard for a reward under thiswellness program, you might qualify for an opportunity toearn the same reward by different means. Contact theBenefits Department and we will work with you (and, if youwish, with your doctor) to find a wellness program with thesame reward that is right for you in light of your healthstatus.USERRAYour right to continued participation in the Plan duringleaves of absence for active military duty is protected bythe Uniformed Services Employment and ReemploymentRights Act (USERRA). Accordingly, if you are absent fromwork due to a period of active duty in the military for lessthan 31 days, your Plan participation will not be interrupted.If the absence is for more than 31 days and not more than 12weeks, you may continue to maintain your coverage underthe Plan by paying premiums.If you do not elect to continue to participate in the Planduring an absence for military duty that is more than 31 daysor if you revoke a prior election to continue to participate forup to 12 weeks after your military leave began, you and yourcovered family members will have the opportunity to electCOBRA Continuation Coverage only under the medicalinsurance policy for the 24 month period (18 month period ifyou elected coverage prior to December 10, 2004) that beginson the first day of your leave of absence. You must pay thepremiums for Continuation Coverage with after-tax funds,subject to the rules that are set out in the plan.Termination of Benefits – COBRA RightsBenefit coverage for you and your family will terminate onthe day you terminate your employment or the day on whichyou and/or any dependents cease to be eligible. If youbecome ineligible for coverage, you and your eligibledependent may have continuation rights for medical, dental,and vision benefits under the federal law known as COBRA. Ifyou terminate your employment or are in an ineligible benefitstatus, you will be notified about any continuation rights youmay have. You will also receive a Certificate.Pre-Tax Payroll DeductionsTo help offset your contributions for the medical, dental,vision, and disability plans, DM Bowman, Inc. offers thesebenefits on a pre-tax basis through the Section 125 (or“cafeteria”) plan. By making pre-tax contributions, yourpremium is withheld from your pay before federal, state (ifapplicable), and FICA taxes are calculated. This can reduce theamount of taxes you pay per paycheck. Pre-tax premiums areautomatic unless you waive them in writing.About This GuideThis guide highlights your benefits. Official plan andinsurance documents govern your rights and benefits undereach plan. For more details about your benefits, includingcovered expenses, exclusions, and limitations, please refer tothe individual summary plan descriptions (SPDs), plandocument, or certificate of coverage for each plan. If anydiscrepancy exists between this guide and the officialdocuments, the official documents will prevail. DM Bowman,Inc. reserves the right to make changes at any time to thebenefits, costs, and other provisions relative to benefits.
New Health Insurance Marketplace CoverageOptions and Your Health CoverageForm ApprovedOMB No. 1210-0149H[SLUHV 5 31 2020PART A: General �Ι͑ΚΟΤΦΣΒΟΔΖ:͑ΥΙΖ͑ ΔΖ͑͟ Ε͑ΓΪ͑ΪΠΦΣ͑ΖΞΡΝΠΪΖΣ͑͑͟What is the Health Insurance Marketplace? ΘΖΥ͑͟ ΡΣΖΞΚΦΞ͑ΣΚΘΙΥ͑ΒΨΒΪ͑͟ ͑ΚΟ͑ ΒΣΪ͑͑ͣͥ͑͢͢͟͝͡Can I Save Money on my Health Insurance Premiums in the Marketplace?ΊΠΦ͑ΞΒΪ͑ ΥΒΟΕΒΣΕΤ͑͟ ΝΕ͑ΚΟΔΠΞΖ͑͟Does Employer Health Coverage Affect Eligibility for Premium Savings through the ΝΠΪΖΣ͘Τ͑ΙΖΒΝΥΙ͑ΡΝΒΟ͑͟ ΒΝ͑ΒΟΕ͑ Ω͑ΓΒΤΚΤ͑͑͟How Can I Get More ͑͑͑͑͑͟Benefits Department 800-789-5163͑ ΟΕ͑ΚΥΤ͑ΔΠΤΥ͑͟ ΝΖΒΤΖ͑ΧΚΤΚΥ͑ ͑Β͑ ΔΖ͑ΚΟ͑ΪΠΦΣ͑ΒΣΖΒ͑͑͟͢ͲΟ͑ ΖΞΡΝΠΪΖΣ͞ΤΡΠΟΤΠΣΖΕ͑ ΙΖΒΝΥΙ͑ΡΝΒΟ͑ΞΖΖΥΤ͑ΥΙΖ͑ ͓ΞΚΟΚΞΦΞ͑ ΧΒΝΦΖ͑ΤΥΒΟΕΒΣΕ͓͑ ΚΗ͑ ΥΙΖ͑ΡΝΒΟ͘Τ͑ΤΙΒΣΖ͑ΠΗ͑ ͑ΔΠΤΥΤ͑ΔΠΧΖΣΖΕ͑ΓΪ͑ ΥΙΖ͑ΡΝΒΟ͑ΚΤ͑ ΟΠ͑ ΝΖΤΤ͑ΥΙΒΟ͑ͧ͑͡ΡΖΣΔΖΟΥ͑ΠΗ͑ ΤΦΔΙ͑ΔΠΤΥΤ͑͟
PART B: Information About Health Coverage Offered by Your Employer ΥΚΠΟ͑͟ ΒΣΜΖΥΡΝΒΔΖ͑ΒΡΡΝΚΔΒΥΚΠΟ͑͟3. Employer name4. Employer Identification Number (EIN)D.M. Bowman, Inc.52-09726105. Employer address6. Employer phone number10228 Governor Lane Blvd., Ste 3006800-789-51637. CityWilliamsport8. State9. ZIP codeMD2179510. Who can we contact about employee health coverage at this job?Employee Benefits Department11. Phone number (if different from above)͑800-789-516312. Email addressHR@dmbowman.com Σͫ͑x ΪΖΖΤ͑ΒΣΖͫ͑͑͑͑͑͑ ΞΡΝΠΪΖΖΤ͑ΒΣΖͫ͑͑͑Active, Full Time Employees working 30 or more hours per week͑͑͑͑x ͑The subscriber's legal spouse and/or dependent child of the subscriber or subscriber's spouse under 26 years of͑age. ΒΘΖΤ͑͑͛͛͑͟ ΣΜΖΥΡΝΒΔΖ͑͟ ΝΠΤΤΖΤ͑͝ΪΠΦ͑ΞΒΪ͑ΤΥΚΝΝ͑ ΒΣΜΖΥΡΝΒΔΖ͑͝ ΖΒΝΥΙʹΒΣΖ͟ΘΠΧ Ζ ΡΣΠΔΖΤΤ͑͟ ΠΦ͑ΧΚΤΚΥ͑ ͑ΡΣΖΞΚΦΞΤ͑͑͟
Ζ͑ͶΞΡΝΠΪΖΣ͑ʹΠΧΖΣΒΘΖ͑ . Is the employee currently eligible for coverage offered by this employer, or will the employee be eligible inthe next 3 months? Yes (Continue)13a. If the employee is not eligible today, including as a result of a waiting or probationary period, when is theemployee eligible for coverage? First of the mo after 60 waiting period (mm/dd/yyyy) (Continue)No (STOP and return this form to employee)͑14. Does the employer offer a health plan that meets the minimum value standard*? Yes (Go to question 15)No (STOP and return form to employee)15. For the lowest-cost plan that meets the minimum value standard* offered only to the employee (don't includefamily plans): If the employer has wellness programs, provide the premium that the employee would pay if he/ shereceived the maximum discount for any tobacco cessation programs, and didn't receive any other discounts based onwellness programs.a. How much would the employee have to pay in premiums for this plan? 28.75b. How often? WeeklyEvery 2 weeksTwice a �ΘΠ͑ΥΠ͑ ΜΟΠΨ͑͝ ΪΖΖ͑͑͟16. What change will the employer make for the new plan year?Employer won't offer health coverageEmployer will start offering health coverage to employees or change the premium for the lowest-cost planavailable only to the employee that meets the minimum value standard.* (Premium should reflect thediscount for wellness programs. See question 15.)a. How much would the employee have to pay in premiums for th
coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare's prescription drug coverage: 1.
