Medicare Part D Creditable Coverage Notices are Due and Mandatory Insurer Reporting is Forthcoming

Creditable Coverage Notices

Employers who provide prescription drug coverage to Medicare eligible individuals must provide notice annually regarding whether the offered coverage is “creditable.” (Coverage is deemed creditable when the actuarial value of the coverage is equal to or exceeds the coverage provided under Medicare Part D.) If notice is provided to all plan participants annually prior to November 15 each year, CMS will consider this notice requirement met.

The Centers for Medicare & Medicaid Services (CMS) recently issued updated model creditable coverage notices containing minor organizational changes and substantive modifications relating to re-enrollment and the Medicare special enrollment period. Although employers are not required to utilize the CMS model notices, they are required to disclose the information in a manner that meets standards set forth by CMS. Our experience has shown that it is also important to include language regarding an employer’s right to modify or amend benefits at any time.