Employer Benefits Compliance – October 15th Deadline
Medicare D Creditable Coverage Notification
If you are an employer who provides prescription drug coverage as part of your benefit package, you are required under the Medicare Modernization Act to annually disclose to your Medicare-eligible population whether the pharmacy plan is “creditable” or “non-creditable”. “Creditable” means the prescription drug coverage provided meets or exceeds the Medicare Part D standards for the year. In addition, you are required to complete an annual disclosure to the Centers for Medicare & Medicaid Services (CMS). The notice must be distributed before October 15.
HOW DO I DETERMINE IF MY RX PLANS ARE CREDITABLE OR NON-CREDITABLE
Your insurance carrier should conduct the testing and make the determination as to whether or not your plan(s) are creditable. If you haven’t already done so, contact your carrier representative and request that a determination be made on your plans. Once the determination is made, you must then create and distribute the appropriate notice to benefit participants.
WHAT DOES THE NOTICE STATE AND HOW DO I DRAFT THE NOTICE
CMS provides a template for the notices. Click on the link below to find the Creditable and Non-creditable Coverage Notice Templates. Simply insert your plan specific information in the document.
http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/Model-Notice-Letters.html
WHO SHOULD GET THE NOTICE
Since it is almost impossible to determine which participants under your plan are Medicare-eligible individuals, we recommend sending the notice to all covered participants.
WHEN MUST THE NOTICE BE SENT
The notice must be sent prior to the Medicare Part D Annual Coordinated Election Period which runs from October 15th through December 7th of each year.
HOW SHOULD THE NOTICE BE SENT
The notice does not need to be sent as a separate mailing. The Disclosure Notice may be included with other plan information including enrollment and/or renewal materials. You can provide one notice to an employee and all covered dependents, unless you know that a dependent resides at a different address than where the employee resides. The notice may also be sent electronically.
HOW TO DISCLOSE CREDITALBE COVERAGE TO CMS
In addition to distributing the Notice to employees, employers are also required to complete an on-line disclosure form notifying CMS of the plans determination. The form can be found at the web address below.
http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosure.html
This disclosure must be completed on an annual basis and within 60 days after the beginning date of the plan year for which the entity is providing the disclosure to CMS. So, for example, plans with effective dates of 1/1/2013 must complete the online filing to CMS by February 29, 2013.
The instructions for completing this form, including screen shots, can be downloaded from this same page.