As a reminder, the Medicare fall Open Enrollment Period now begins on October 15 and ends December 7. This means that plan sponsors of group health plans (including employers) that provide prescription drug coverage must distribute required creditable coverage disclosure notices to Medicare eligible participants prior to October 15

 

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:

  • 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 specified times, 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 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.

For further information regarding Medicare Open Enrollment, please click here. You can also visit our section on Medicare to learn more about the program and the employer notice requirements under Part D (including model notices).

Topics: Health Care Reform, Employee Safety

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