This is the time of year when we like to thank you for your membership and let you know of new plan changes for the upcoming year. Our Plan benefits and cost-sharing will be exactly the same in 2009 as they are in 2008. Medicare has reviewed and approved the benefits described and/or covered drugs listed in our formulary for our Plan in 2009. Please see Section 10 of the C and O Employees’ Hospital Association Medicare Part D Prescription Drug Plan Evidence of Coverage for 2009 for more information about what you pay for coverage through our Plan

Effective January 1, 2009, your monthly premium will be $250.00. This premium includes payment for your membership in the COEHA Supplemental Plan and your enhanced COEHA Medicare Part D Plan prescription drug benefits.

We are sending this Annual Notice of Change ("ANOC") so you can review the 2009 coverage offered through this Plan. Each year from November 15 through December 31, you may make a change to your Medicare plan and Medicare prescription drug coverage, with your new plan beginning on January 1. Certain individuals, such as those with Medicaid, those who get extra help, or who move, can make changes at other times. If you want to stay in our Plan, you don’t need to do anything. You will still be a member of our Plan for the coming year.

Remember, because we are an Employer/Union Medicare Part D Prescription Drug Plan, you may leave our Plan at any time, however, you may not be able to join another plan at any time.

What do I need to know if I qualify for extra help (the low-income subsidy, or LIS) from Medicare to pay for my prescription drugs?

If you continue to qualify for the same amount of extra help next year, the table below tells you how your prescription costs will change. You will also receive an "Evidence of Coverage Rider for those who Receive Extra Help Paying for their Prescription Drugs" before October 31, 2008, that has more specific information on your premiums and cost-sharing in 2009. Read this important information carefully. If you don’t know what level of extra help you qualify for, you can call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

If you qualify for extra help, you pay $0 or a reduced monthly Part D premium. If you continue to qualify for the same amount of extra help in 2009, the table below tells how much you will pay for a monthly premium. (This doesn’t include any Medicare Part B premium you may have to pay.) If you don’t know your level of extra help, call COEHA Customer Service.

The Evidence of Coverage has more information on our Plan’s coverage, including information on how to make changes to your membership in Section 6.

Please call COEHA Customer Service if you have any questions. You can also get information about the Medicare program and other Medicare plans available by visiting www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048.

October 2008