ÿþ<html> <head> <title>10611</title> </head> <body bgcolor=white lang=EN-US link=blue vlink=purple jquery1317837134640=58 jquery1317062045656=51 jquery1314040676640=38 jquery1310673821218=38 jquery1302820379546=34 jquery1295466635843=45 jquery1290026324917=48 jquery1285362686734=41 jquery1285355562531=42 jquery1287180298468=43 jquery1283467321765=46 jquery1283454571968=29 jquery1279907695906=94 jquery1278710090671=46 jquery1277855881984=43 jquery1277837058312=44 jquery1276109412499=37 jquery1276106122452=40 jquery1276023222312=44 jquery1276120003093=39 jquery1277853670078=46 jquery1278092017339=46 jquery1278101410153=47 jquery1279048986906=42 jquery1279058487281=43 jquery1279832665046=83 jquery1280173031435=41 jquery1280180957357=40 jquery1275513481312=43 jquery1273189794953=40 jquery1273181562968=47 jquery1272922427796=64 jquery1271878266375=39 jquery1271447667000=66 jquery1261593501593=61 jquery1270058053997=51 jquery1269462703295=55 jquery1268864184934=49 jquery1267818517168=48 jquery1267730564015=74 jquery1267126806318=59 jquery1267053178125=70 jquery1263241996750=71 jquery1262647041828=49 jquery1262636384500=63 jquery1262646079953=42 jquery1262647495031=52 jquery1266957598484=70 jquery1267126181836=51 jquery1267655479656=79 jquery1267659345703=83 jquery1267750940390=47 jquery1268678464562=68 jquery1268691448015=48 jquery1269041411250=73 jquery1269980722062=67 jquery1270074073937=48 jquery1271710387984=49 jquery1271963664478=38 jquery1272999021031=40 jquery1273017484000=41 jquery1274476354343=69 jquery1274478900015=38 jquery1274479164140=46 jquery1275520110640=48 jquery1275604639968=39 jquery1291316496938=43 jquery1297366994578=42 jquery1307665027140=33 jquery1307665642203=32 jquery1310679188718=35 jquery1316632767687=52 jquery1317404600125=47 jquery1317925627460=36 jquery1317925627460=36> <body bgcolor="#FFFFFF" class="Normal"> <div class=WordSection1> <div align=center> <table border=0 cellpadding=0 width=740> <tr> <td width=800 class="Normal"><p><b><i><span style='font-size:18.0pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'><img width=731 height=100 id="_x0000_i1025" src="http://www.rbgsocal.com/rogersreport/rrbanner.gif" title="" complete=complete></span></i></b></p> <p align=center style='text-align:center'><span style='font-size:18.0pt;font-family:"Arial","sans-serif";"Times New Roman";color:red'>MEDICARE PART D DISCLOSURE REQUIREMENTS <br> Starting in 2011 for the 2012 Plan year, the <br> Annual Election Period (AEP) will begin on <br> October 15, 2011 and end on December 7, 2011</span><span style='font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;color:black'> </span></p> <p><span style='font-size:13.5pt;font-family:"Arial","sans-serif";color:black'>The following is from the Centers for Medicare and Medicaid Services. <br> Source: <a href="http://www.cms.gov/CreditableCoverage/01_Overview.asp#TopOfPage">www.cms.gov/CreditableCoverage/01_Overview.asp#TopOfPage</a></span></p> <p><span style='font-size:13.5pt;font-family:"Arial","sans-serif";color:black'>The Medicare Modernization Act (MMA) requires entities (whose policies include prescription drug coverage) to notify Medicare eligible policyholders whether their prescription drug coverage is creditable coverage, which means that the coverage is expected to pay on average as much as the standard Medicare prescription drug coverage. For these entities, there are two disclosure requirements:</span></p> <ul type=disc> <li style='color:black;'><span style='font-size:13.5pt;font-family:"Arial","sans-serif";"Times New Roman"'>The first disclosure requirement is to provide a written disclosure notice to all Medicare eligible individuals annually who are covered under its prescription drug plan, prior to October 15th each year and at various times as stated in the regulations, including to a Medicare eligible individual when he/she joins the plan. This disclosure must be provided to Medicare eligible active working individuals and their dependents, Medicare eligible COBRA individuals and their dependents, Medicare eligible disabled individuals covered under your prescription drug plan and any retirees and their dependents. The MMA imposes a late enrollment penalty on individuals who do not maintain creditable coverage for a period of 63 days or longer following their initial enrollment period for the Medicare prescription drug benefit. Accordingly, this information is essential to an individual's decision whether to enroll in a Medicare Part D prescription drug plan. For more information go to the &quot;Creditable Coverage Guidance and Model Disclosure Notices to be used after January 1, 2009&quot; <a href="http://www.cms.gov/CreditableCoverage/Model%20Notice%20Letters.asp#TopOfPage">https://www.cms.gov/CreditableCoverage/Model%20Notice%20Letters.asp#TopOfPage</a></span></li> </ul> <ul type=disc> <li style='color:black;'><span style='font-size:13.5pt;font-family:"Arial","sans-serif";"Times New Roman"'>The second disclosure requirement is for entities to complete the Online Disclosure to CMS Form to report the creditable coverage status of their prescription drug plan. The Disclosure should be completed annually no later than 60 days from the beginning of a plan year (contract year, renewal year), within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status. <br> For more information go to <a href="http://www.cms.gov/CreditableCoverage/40_CCDisclosure.asp#TopOfPage">https://www.cms.gov/CreditableCoverage/40_CCDisclosure.asp#TopOfPage</a>.&nbsp; <br> For CMS disclosure form go to <a href="http://www.cms.gov/CreditableCoverage/45_CCDisclosureForm.asp#TopOfPage">https://www.cms.gov/CreditableCoverage/45_CCDisclosureForm.asp#TopOfPage</a>.<br> -- This requirement does not pertain to the Medicare beneficiaries for whom entities are receiving the Retiree Drug Subsidy (RDS).</span></li> </ul> <p><span style='font-size:13.5pt;font-family:"Arial","sans-serif";color:black'>Source: <a href="http://www.cms.gov/CreditableCoverage/01_Overview.asp#TopOfPage">www.cms.gov/CreditableCoverage/01_Overview.asp#TopOfPage</a></span></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Note from RBG:</span></strong></p> <p><span style='font-size:13.5pt;font-family:"Arial","sans-serif";color:black'>If the employer tracks Medicare eligibility, it is only necessary for them to notify all currently Medicare eligible individuals and those who will become Medicare eligible in 2011 or 2012.</span></p> <p><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Many employers may not track the Medicare eligibility of their employees, dependents, COBRA eligible former employees and their dependents, covered disabled individuals or retirees and their dependents. If they do not track Medicare eligibility, the employer might consider notifying ALL of these individuals to ensure compliance with this Federal law.&nbsp; <br> &nbsp;<br> Employers notifying all potentially eligible Medicare individuals, can simply add this item at the top of the disclosure:<br> &nbsp; <br>  This notice does not apply to you if you or your dependents are not currently Medicare eligible or will not become Medicare eligible in 2011 or 2012. </span></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Carrier Notices and Creditable or Not Creditable Small group plans:</span></strong></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Aetna</span></strong><span style='font-size:13.5pt;font-family: &quot;Arial&quot;,&quot;sans-serif&quot;;color:black'><br> The following plans are not considered&nbsp;Medicare Creditable for 2011:<br> Vitalidad HMO $10<br> Vitalidad Plus HMO $10/$5<br> Vitalidad Plus HMO $30/$10<br> MC HRA $5000 80/50</span></p> <p><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'><br> <strong><span style='font-family:"Arial","sans-serif"'>Blue Shield</span></strong><br> The following plans are not considered&nbsp;Medicare Creditable for 2011: <br> Shield Spectrum PPO Plan 1000 Value<br> Shield Spectrum PPO Plan 1500 Value <br> Shield Spectrum PPO Plan 2000 Value*</span></p> <p><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Shield Spectrum PPO Plan 3000*<br> Shield Savings 3000/6000*<br> Shield Savings QS 3000/6000*<br> Shield Savings 4800 <br> Shield Savings QS 4800<br> Simple Savings 4500/9000 <br> Simple Savings 5500/11000 <br> Active Choice Plan 500* SG<br> Active Choice Plan 750* SG<br> CalChoice Active Choice Plan 500<br> *</span><span style='font-family:"Arial","sans-serif";"Times New Roman";color:black'>Underwritten by Blue Shield Life and Health</span></p> <p><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>The following plans are not considered&nbsp;Medicare Creditable for 2012:<br> Medicare Part D <u>Non-Creditable</u> plans as of Jan. 1, 2012 <br> Shield Spectrum PPO Plan 1000 Value <br> Shield Spectrum PPO Plan 1500 Value <br> Shield Spectrum PPO Plan 2500 Value </span></p> <p><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Simple Savings 4500/9000 <br> Simple Savings 5500/11000 </span></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>California Choice</span></strong><br> <span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'><a href="http://www.rbgsocal.com/forms/CC%20Medicare%20Part%20D%20eff%207-1-11.pdf">Click here for&nbsp;2011 creditable coverage chart</a>&nbsp;</span></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Health Net</span></strong><span style='font-size:13.5pt; font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;color:black'> <br> <a href="http://www.rbgsocal.com/forms/HN%20SBG%20May%202011%20Plan%20Codes%20with%20RX%20Status_032811.xls">Click here for 2011 creditable coverage chart</a> </span></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Sharp Healthplans</span></strong><br> <span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>All plans are creditable.</span></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>United Healthcare</span></strong><br> <span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>All 2-50 plans are creditable with the exception of the HSA plans:&nbsp; All HSA plans in the portfolio are non-creditable.</span></p> <p><strong><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'>Downloads:</span></strong></p> <p><span style='font-size:13.5pt;font-family:"Arial","sans-serif";color:black'><a href="http://www.cms.gov/CreditableCoverage/downloads/ModelCreditableCoverageDisclosureNotice051711.pdf">Model Creditable Coverage Disclosure Notice [PDF, 107KB]</a> </span></p> <p><span style='font-size:13.5pt;font-family:"Arial","sans-serif";color:black'><a href="http://www.cms.gov/CreditableCoverage/downloads/ModelNonCreditableCoverageDisclosureNotice051711.pdf">Model Non-Creditable Coverage Disclosure Notice [PDF, 100KB]</a> </span></p> <p><span style='font-size:13.5pt;font-family:"Arial","sans-serif";color:black'><a href="http://www.cms.gov/CreditableCoverage/downloads/ModelCreditableCoverageDisclosureNotice051711Spanishedits.pdf">Model Creditable Coverage Disclosure Notice (Spanish) [PDF, 188KB]</a> </span></p> <p><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'><a href="http://www.cms.gov/CreditableCoverage/downloads/ModelNonCreditableCoverageDisclosureNotice051711Spanishedits.pdf">Model Non-Creditable Coverage Disclosure Notice (Spanish) [PDF, 180KB]</a> </span></p> <p><span style='font-size:13.5pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; color:black'><a href="http://www.cms.gov/CreditableCoverage/downloads/WHATISCREDITABLECOVERAGE.PDF">What is Creditable Coverage (PDF, 14KB)</a>&nbsp;<br> &nbsp;<br> Source: <a href="http://www.cms.gov/CreditableCoverage/Model%20Notice%20Letters.asp#TopOfPage">www.cms.gov/CreditableCoverage/Model%20Notice%20Letters.asp#TopOfPage</a><br> &nbsp;<br> &nbsp;</span></p></td> </tr> <tr> <td valign=top class="Normal"><div align=center style='text-align:center'><span style='font-family:"Arial","sans-serif";"Times New Roman"'> <hr size=2 width="100%" align=center> </span></div> <p align=center style='text-align:center'><span style='font-family:"Arial","sans-serif"'>&nbsp;<img border=0 width=514 height=29 id="_x0000_i1027" src="https://app.icontact.com/icp/loadimage.php/mogile/150263/0851081d0583caf0f6637202ebc48b94/image/gif" title="" complete=complete></span></p> <div align=center style='text-align:center'><span style='font-family:"Arial","sans-serif";"Times New Roman"'> <hr size=2 width="100%" align=center> </span></div></td> </tr> <tr> <td class="Normal"><p align=center style='text-align:center'><span style='font-family:&quot;Arial&quot;,&quot;sans-serif&quot;; 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