TO: FUSD Retirees and Spouses Enrolled in EnvisionRx Plus Silver (a Medicare Part D plan)
RE: Eligibility for Medicare Prescription Drug (Part D) Subsidy as a Result of IRMAA Premium Rules
DATE: October 23, 2014
As a Medicare-eligible retiree (or spouse of a retiree) currently enrolled in the EnvisionRx Plus Silver Medicare Part D plan, you may be eligible for subsidies from the District’s Joint Health Management Board (JHMB) for your 2015 Medicare Part D prescription drug premiums. You may recall that effective February 1, 2012, the Fresno Unified School District (the District) converted their EnvisionRx drug plan to the EnvisionRx Plus drug plan for all Medicare-eligible retirees and spouses. As a result, you and/or your spouse were enrolled in EnvisionRx Plus Silver, a Medicare Part D prescription drug plan.
Due to this plan change and a federal regulation that also went into effect in 2012, certain higher-income Medicare beneficiaries are subject to additional Medicare prescription drug premiums. This additional premium is known as the Income-related Monthly Adjustment Amount (IRMAA). The amount is calculated based on your federal income taxes filed two years prior to the plan year. In 2015, you are subject to the IRMAA premium if you are a Medicare beneficiary whose modified adjusted gross income (AGI) on your most recent Federal tax return fell into either of the following categories:
- AGI of $85,000 or more – Individuals
- AGI of $170,000 or more – Married Couples Filing Jointly
However, there is no need to worry. The District’s JHMB will provide subsidies in the 2015 plan year to any eligible plan participants enrolled in EnvisionRx Plus Silver who receive an IRMAA statement from the Social Security Administration or a bill from Medicare indicating Part D or prescription drug IRMAA premiums. Though the Joint Health Management Board has agreed to subsidize your IRMAA premiums, it is still up to you to pay the premiums to Medicare.
What You Need to Do: If you received a notice/bill from the Social Security Administration or Medicare that your monthly Part D prescription drug premiums include an income-related monthly adjustment amount (IRMAA), simply follow the instructions below.
Instructions
Delta Fund Administrators, the JHMB’s Administrator, is responsible for reviewing and processing the IRMAA premium subsidies. To receive your subsidy, send Delta Fund Administrators a copy of your statement/bill from the Social Security Administration or Medicare. Make sure the statement/bill clearly indicates your monthly Part D or prescription drug IRMAA premium. Delta Fund Administrators will annualize your IRMAA premium based on the monthly amount and provide you a subsidy for the entire plan year. Be sure to include your phone number or email address, should they need to follow up with you for additional information. You are not required to submit this information monthly – only one time during the plan year.
Please scan/email, fax, or mail the copy of your statement/bill to Delta Fund Administrators at the information provided below:
Delta Fund Administrators
Franceen Hanley, Account Executive
PO Box 2330
Stockton CA 95201
Fax: (209) 940-5141
Email: fhanley@deltafund.com
Pay Your Premiums: Though the Joint Health Management Board has agreed to subsidize your IRMAA premiums, it is still up to you to pay the premiums to Medicare. Delta Fund Administrators is not sending the money to Medicare on your behalf. If you fail to pay the premiums, Medicare will disenroll you from the EnvisionRx Plus Part D prescription drug plan and you will not be allowed to re-enroll in the District’s prescription drug plan at any time in the future. So, be sure to continue to make your payments throughout the year.
2014 IRMAA Reimbursements: The Joint Health Management Board also provided IRMAA subsidies for the 2012, 2013 and 2014 plan years. Reimbursement for 2012 and 2013 is now closed, but if you still need to submit documentation to receive your 2014 reimbursement, please follow the instructions provided in the “What You Need to Do” section above.
If You Have Questions: Please contact Delta Fund Administrators if you have any additional questions. You may reach them at the following contact information:
Delta Fund Administrators
Franceen Hanley, Account Executive
P: (209) 940-5140
E: fhanley@deltafund.com