The eligibility and enrollment rules for the U

Retiree Health Care SPD Effective January 1, 2012
termination date. You can initiate the enrollment process online at
www.yourbenefitsresources.com/usbank or by calling the U.S. Bank Employee Service Center.
Once you initiate your enrollment you will be sent an enrollment kit, which will include an
enrollment form. You must be enrolled in Medicare Parts A and B in order to enroll in the
Program. If you are not enrolled in Medicare Parts A and B, your application for enrollment will
not be accepted. Once the U.S. Bank Employee Service Center receives your completed and
signed enrollment application, this information is submitted to CMS for verification of
eligibility. If CMS rejects your enrollment application, the U.S. Bank Employee Service Center
will contact you for additional information in order to resubmit your application. The effective
date of coverage in the insured UnitedHealthcare or Medica Plan option will be the first of the
month following the date when your application is received and processed or the date you are
first eligible to enroll in the Program, whichever is later. The effective date of coverage for your
dependent(s) enrolling in one of the pre-65 options, will be the same date as your coverage is
effective, if you enroll them by the enrollment deadline.
Your Prescription Drug Coverage under the Program and Medicare Part D
Beginning January 1, 2006, Medicare Part D prescription drug coverage became available. This
coverage is available if you enroll in Medicare Part D and pay an additional Part D premium.
However, the U.S. Bank option will continue to provide primary prescription drug coverage at
NO ADDITIONAL cost, except for prescriptions covered under Medicare Parts A and B. In
fact, the prescription drug coverage under the Program provides more cost effective coverage
than what is offered under standard Medicare Part D. Because prescription coverage is already
available under the Program, we strongly recommend that you DO NOT ENROLL IN
MEDICARE PART D.
If you are enrolled in the Medica or Comprehensive option and you enroll in Medicare Part D
coverage, you will no longer receive prescription drug coverage under the U.S. Bank option, and
your monthly U.S. Bank option premium will not be reduced. Your monthly premium covers
both medical and pharmacy benefits, and it will not be changed. If you decide to enroll in
Medicare Part D, you will end up paying additional unnecessary premiums, as you will be
paying a premium for both Medicare Part D and the U.S. Bank option.
If you are enrolled in the Medica or Comprehensive option and you enroll in Medicare Part D
prescription drug coverage, and later decide to drop your Medicare Part D coverage, you will be
eligible to reenroll for U.S. Bank prescription drug coverage, as long as you are actively enrolled
in a U.S. Bank Retiree Health Care Program option (except for the Kaiser health care option).
Your U.S. Bank prescription drug coverage will be effective on the first of the month following
the date that your Medicare Part D prescription drug coverage is dropped and you contact the
U.S. Bank Employee Service Center, unless you contact the service center on the first of the
month. In this case, your coverage will become effective on that day.
If your coverage option is the UHC plan and you enroll in a Medicare Part D prescription drug
plan, Medicare will automatically terminate your UHC coverage and you will no longer be
enrolled in the U.S. Bank Retiree Health Care Program. In addition, your dependent’s coverage
will be terminated, as dependents are not eligible to be enrolled in the Program if the retiree is
not enrolled.
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