Medicare D Annual Notification Requirements

Centers for Medicare & Medicaid Services (CMS) under the Medicare Modernization Act (MMA) requires employers to notify CMS and Medicare eligible individuals (employee or dependents) annually whether their prescription drug coverage is creditable or not.

Notification of Creditability to Covered Individuals¹

Notices must be provided to Medicare-eligible active working, COBRA, retiree or disabled individuals and their dependents that are covered under the prescription drug plan.

¹Power Kunkle issued Custom/Distribution Ready Medicare D Disclosure Notices annually to our clients, as well as any additional guidance, last week.  If you do not receive the notice or have additional questions please contact your Client Manager or our compliance department at pkcompliance@pkbenefits.com.

Notices must be provided annually, prior to the October 15th to December 7th election period for Medicare Part D (the deadline change is due to health care reform) prior to an individual’s initial enrollment period for Medicare Part D (the employer is considered compliant if a notice is sent to all plan participants annually) prior to the effective date of coverage for any Medicare Part D eligible individual who enrolls in the employer’s prescription drug coverage if the employer no longer offers prescription drug coverage, changes it so it is no longer creditable or becomes creditable upon request by any Medicare Part D-eligible individual.

Notification to CMS

Separate from the Notice to Covered Individuals, employers must disclose creditable coverage status to CMS using the online Disclosure to CMS Form no later than 60 days following the beginning of the plan year (i.e. if the prescription drug plan renews/starts January 1st, the disclosure online form should be completed by March 1st). For details on completing the form, including screen shots, visit the Disclosure to CMS Guidance and Instructions webpage.

 

DISCLOSURE

The information provided herein is intended solely for the use of our clients. You may not display, reproduce, copy, modify, license, sell or disseminate in any manner any information included herein, without the express permission of the Publisher or Publishers of articles within.

The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.