ALERT – Benefits Compliance Deadline October 15

 

 

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.

 

 

 

 

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Author: Millennium Benefits Consulting

Millennium Benefits Consulting (MBC) is an Atlanta-based employee benefit and consulting brokerage firm that was incorporated in 1988. As a privately held, family-oriented organization, MBC stands apart from other consulting houses and brokerage firms because of our passion and talent for creating customized benefit solutions. The MBC team is comprised of associates with a variety of professional backgrounds and related areas of expertise, ranging from large national health insurance carriers to human resource departments. Having dealt extensively with both sides of the healthcare/benefits equation, MBC is uniquely qualified to develop benefit solutions that are valuable for employees, while making the most efficient use of the employer’s resources. Learn more about MBC at www.mbcllc.com. View all posts by Millennium Benefits Consulting →

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