Offer of Services

Medicare Part D Notice of Creditable Service.

1. This document notifies all self-funded health care plan practitioners of the services now offered by Self-Funding Actuarial Services, Inc. with regards creditable service. A companion offer is available for subsidy election.

2. The reader is invited to visit www.rxplanning.com which Web Site is devoted to assisting practitioners and their clients in using these new Medicare benefits in a useful and proper way.

3. The work flow is in two steps:

Step 1

The Named Entity sends to Self-Funding Actuarial Services, Inc. these items;

· Options Checklist (Exhibit A)

· Description of 2006 Rx benefits and participant contributions thereto (Attachments I and II)

Step 2

Self-Funding Actuarial Services, Inc. returns bye-mail or otherwise the following two documents:

· Notice of Creditable Service (Exhibit B)

· Actuarial Opinion (Exhibit C)

4. The fees are as follows:

$200 per Notice of Creditable Service.

EXHIBIT A

Options Checklist for

Notice of Creditable Service

Every covered person with a Medicare Card must be given a Notice of Creditable Service which assists such person in making a rational choice of accepting or rejecting Medicare Part D. The two major parts of information in the Notice are A and B:

1. Are the Plan Rx benefits comparable with Medicare Part D? See 1 or 2.

1. Yes. Then covered person is free to take a pass on electing Medicare Part D without risking the 1 %/month penalty when electing as a late entrant.

2. No. Then the covered person is not free to take a pass on electing Medicare Part D without risking the 1 %/month penalty when electing as a late entrant.

Benefit comparability is based upon the actuarially-certified value of the Medicare and Plan Rx Benefits.

2. In what way do plan benefits coordinate with Medicare Rx benefits? Group One and Group Two must be considered:

1. Group 1. Group One. Working aged, disabled and ESRD

These covered persons are not eligible for the subsidy. The Plan may be amended in any of ways a, b, or c:

a. Eliminate Plan Rx benefits entirely.

b. Provide only limited Rx benefits (i.e., 100% submitted expenses in the $2,250- $5,100 range)

c. Offer Plan Rx benefits without regard to Medicare Part D. (not recommended).

2. Group Two. Retirees over age 65

These covered persons may be eligible for the subsidy. The Plan may be amended in any of ways a or b:

a. Offer only Plan Rx benefits (no Medicare Part D) and claim the subsidy.

b. Provide Plan Rx benefits only as a wraparound to Medicare Part D.

EXHIBIT B

Important Notice

About Your Rx Coverage and Medicare

Named Plan _____________________________________________________________
Named Entity ____________________________________________________________
Named Sender ___________________________________________________________
	Address ____________________________________________
	Contact Person ______________________________________
	Telephone __________________________________________

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the Named Plan and new prescription drug coverage available soon for people with Medicare. It also tells you where to find more information to help you make decisions about your prescription drug coverage.

1. Starting January 1, 2006, new Medicare prescription drug coverage will be available to everyone with Medicare.

2. The Named Entity has determined that the prescription drug coverage offered by The Named Plan is, on average for all plan participants is expected to payout as much as the Standard Medicare Prescription Drug Coverage will pay.

3. Read this notice carefully; it explains the options you have under Medicare prescription drug coverage, and can help you decide whether or not you want to enroll.

You have heard about Medicare's new prescription drug coverage, and wondered how it would affect you. The Named Entity has determined that your prescription drug plan will provide at least standard level of coverage set by Medicare. Some plans might also offer more coverage for a higher monthly premium.

Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay extra if you later decide to enroll in Medicare Coverage.

People with Medicare can enroll in a Medicare Prescription Drug Plan from November 15, 2005 through May 15, 2006. However, because you have existing prescription drug coverage that, on average, is as good as Medicare coverage, you can choose to join a Medicare Prescription Drug Plan later. Each year after that, you will have the opportunity to enroll in a Medicare Prescription Drug Plan between November 15th through December 31st.

If you do decide to enroll in a Medicare Prescription Drug Plan and drop your Named Plan's prescription drug coverage, be aware that you may not be able to regain such plan coverage.

If you drop your coverage with The Named Plan and enroll in a Medicare Prescription Drug Plan, you may not be able to get this coverage back later. You should compare your current coverage, including which drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area.

In making your decision to accept or not accept Medicare Part D Rx benefits, you should review the Attachment which sets forth the benefits and required contributions of both The Named Plan and Medicare Part D.

You should also know that if you drop' or lose your coverage with The Named Plan and do not enroll in Medicare prescription drug coverage after your present coverage ends, outlay pay more to enroll in Medicare prescription drug coverage later. If after May 15, 2006, you go 63 days or longer without prescription drug coverage that is at least as good as Medicare's prescription drug coverage; your monthly premium will go up at least 1% per month for every month after May 15, 2006, that you did not have that coverage. For example: if you go nineteen months without coverage, your premium will always be at least 19% higher than what most other people pay. You will have to pay this higher premium as long as you have Medicare coverage. In addition, you may have to wait until the next November to enroll.

For more information about this notice or your current prescription drug coverage...

For more information, contact the Named Sender above shown. You may receive this notice at other times in the future such as before the next period you can enroll in Medicare prescription drug coverage, and if this coverage changes. You also may request a copy.

For information about your options under

Medicare prescription drug coverage....

More detailed information about Medicare's plans that offer prescription drug coverage will be available in October 2005 in the ''Medicare & You 2006", handbook. You will get a copy of the handbook in the mail from Medicare. You may also be contacted directly by Medicare prescription drug plans. You can also get more information about Medicare prescription drug plans from these places:

· Visit www.medicare.gov for personalized help,

· Call your State Health Insurance Assistance Program (see your copy of the Medicare & You handbook for their telephone number),

· Call 1-800-MIEDICARE (1-800-325-0778).

***********************************************************************Remember: Keep this notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage after May 15, 2006, you may need to give a copy of this notice when you join to show that you are not required to pay a higher premium amount.

***********************************************************************

EXHIBIT C

Self-Funding Actuarial Services, Inc.
	8025 North Point Blvd., Suite 207W	Carlton Harker, FSA, MAAA
	Winston-Salem, NC 27106	Principal
	Tel. (336) 759-2035	e-mail: harker2@earthlink.net
	Fax (336) 896-0392	www.self-fundhealth.com
		www.ifebp.org/harker

Actuarial Opinion

For Medicare Rx Benefits for

Purpose of Creditable Service

For Calendar Year 2006 working Aged

Named Plan ___________________________________________________________

It is the opinion of the certifying actuary that the Rx benefits which are provided to covered person eligible for Medicare Part D Rx benefits for the above-cited health care plan [meet] [fail to meet] the Creditable Service Standards for the Medicare Part D Safe Harbor Regulations.

Based upon the Rx benefits set forth In Attachment I, the relative cost sharing thereof is as follows:

· Medicare _________%

· Plan _________

· Participant              _________

· Total 100%

_____________________________	__________________________
Date	Carlton Harker, FSA, MAAA

EXHIBIT C

Self-Funding Actuarial Services, Inc.
	8025 North Point Blvd., Suite 207W	Carlton Harker, FSA, MAAA
	Winston-Salem, NC 27106	Principal
	Tel. (336) 759-2035	e-mail: harker2@earthlink.net
	Fax (336) 896-0392	www.self-fundhealth.com
		www.ifebp.org/harker

Actuarial Opinion

For Medicare Benefits for

Purpose of Creditable Service

For Calendar Year 2006 Retired

Named Plan ___________________________________________________________

It is the opinion of the c' ertifying actuary that the Rx benefits which are provided to covered person eligible for Medicare Part D Rx benefits for the above-cited health care plan meet the Creditable Service Standards for the Medicare Part D Safe Harbor Regulations when the Plan is primary and do not meet such Safe Harbor Regulations when the Plan if secondary. See Attachment II.

_____________________________	__________________________
Date	Carlton Harker, FSA, MAAA

ATTACHMENT I

Medicare Part D and Plan Rx Benefits

Calendar Year 2006 - Working Aged

Named Plan ___________________________________________________________

The Medicare Part D and Plan Rx benefits for 2006 are as follows:

Annual Submitted Rx Charges	Medicare Medicare Beneficiary Share Share		Plan Plan Participant Share Share		Plan Plan or Covered Medicare Person
0-100	0%	100%	0%	0%	0%	100%
100-250	0	0	50	50	50	50
250-1400	75	25	0	0	75	25
1400-2250	75	25	0	0	75	25
2250-3500	0	0	100	0	100	0
2500-5100	0	0	100	0	100	0
Over 5100	95	5	0	0	95	5

Requisite annual contributions are as follows:

a. Medicare (per beneficiary) $ _______________

b. b. Rx Plan (per covered person) $ _______________

ATTACHMENT II

Medicare Part D and Plan Rx Benefits

Calendar Year 2006 – Retired

Named Plan ___________________________________________________________

The Medicare Part D and Plan Rx benefits for 2006 are as follows:

Annual Submitted Rx Charges		Primary Payer	Secondary Payer	Is Subsidy Claimed
	$0-100	Plan	None	No
	100-250	Plan	None	No
	250-1400	Plan	None	Yes
	1400-2250	Medicare	Plan	N/A
	2250-3700	Medicare	Plan	N/A
	3700-5100	Plan	None	Yes
	Over 5100	Medicare	Plan	N/A

Requisite annual contributions are as follows:

a. Medicare (per beneficiary) $ _______________

b. Plan (per covered person) $ _______________