Employers sponsoring group health plans that provide prescription drug coverage to employees or dependents who are Medicare eligible (e.g., age 65 or older, disabled under Social Security or who have end stage renal disease) are required to issue a Medicare Part D Creditable Coverage Notice to such individuals. Beginning in 2011, the annual deadline for providing this notice is October 15, instead of November 15 corresponding with the new Medicare Part D annual enrollment period, which now runs from October 15 to December 7.
Delivery of the notice can be made via hand delivery, first‐class mail or electronically. Electronic delivery must be made in accordance with Department of Labor rules, including the requirement to get prior consent for electronic delivery from participants who either do not have access to the electronic delivery system at their work location or are not expected to access the system as part of their regular work duties. The notice can be issued separately or combined with other plan participant communications. If combined with other communications, the notice must be set forth in a prominent and conspicuous manner (at least 14‐point font in a separate box, bolded, or offset on the first page). The plan may provide a single notice to a Medicare‐eligible participant and all of his or her Medicare‐eligible dependents covered under the plan. However, separate notices must be provided if it is known that the Medicare‐eligible spouse or dependent lives at an address different from the participant’s address.
The Centers for Medicare & Medicaid Services (CMS) has issued a set of updated model creditable coverage notices in English and Spanish. These notices, which should be ustomized for your plan, can be found at the CMS website.
Report to CMS
Plan sponsors are required to file online the Disclosure to CMS Form, reporting the creditable coverage status of their prescription drug plan, no later than 60 days after the beginning of a plan year, within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status. This requirement does not pertain to Medicare beneficiaries for whom the plan sponsor receives the retiree drug subsidy.