Plan sponsors of group health plans providing prescription drug coverage to individuals who are eligible for Medicare Part D prescription drug coverage are required to satisfy certain notice requirements.

Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the prescription drug coverage is creditable.

The creditable coverage disclosure notice alerts individuals as to whether their plan’s prescription drug coverage is at least as good as the Medicare Part D coverage (in other words, whether their prescription drug coverage is “creditable”). Medicare beneficiaries who are not covered by creditable prescription drug coverage and who choose not to enroll in Medicare Part D before the end of their initial enrollment period will likely pay higher premiums if they enroll in Medicare Part D at a later date.

CMS has provided two model notices for employers to use:

• A Model Creditable Coverage Disclosure Notice for when the health plan’s prescription drug coverage is creditable; an
• A Model Non-creditable Coverage Disclosure Notice for when the health plan’s prescription drug coverage is not creditable.

Please click here to continue reading our AHERN Benefits Brief. This Benefits brief covers how to determine whether a prescription drug plan is creditable, notice requirements, whether there is a penalty for noncompliance, as well as CMS reporting.