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Aug 2006
23
August 23, 2006

New Medicare Part D Notice of Creditable Coverage Forms Available for This Year's Annual Notice Requirement

Although it's hard to believe that a year has passed since we implemented rules for Medicare Part D, it is time once again to start planning to distribute the annual notice of whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. As you begin your planning, you should be aware the Centers for Medicare and Medicaid Services ("CMS") has issued updated guidance on the notice of creditable coverage, including new notice forms.

Although it's hard to believe that a year has passed since we implemented rules for Medicare Part D, it is time once again to start planning to distribute the annual notice of whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. As you begin your planning, you should be aware the Centers for Medicare and Medicaid Services ("CMS") has issued updated guidance on the notice of creditable coverage, including new notice forms.

As you will recall from last year's roll-out, employers who sponsor a health plan offering prescription drug benefits must provide an annual notice to all Medicare-eligible participants that explains whether the prescription drug benefits offered under the plan are at least as good as the benefits offered under the Medicare Part D plan. The only employers exempt from this notice requirement are those that establish their own Part D plan or who contract with a Part D plan.

The forms you used last year included language relating to the initial enrollment period for Medicare Part D. The updated forms no longer use this language. CMS has also provided a "personalized" notice that you can use instead of the generic notice forms. The guidance and forms are available on the CMS Creditable Coverage Web site (http://www.cms.hhs.gov/CreditableCoverage).

The notice must be provided:

  • At least once a year before November 15 (the start of the annual Medicare Part D enrollment period);
  • whenever a Medicare-eligible employee enrolls in your health plan;
  • whenever there is a change in the creditable or non-creditable status of your health plan's prescription drug coverage;
  • whenever an individual requests the notice.

Because it is difficult to keep track of which employees (and their spouses or dependents) are eligible for Medicare benefits, we recommend that you make the Notice a part of your new-hire enrollment materials and your annual open enrollment materials.

If you have any questions about which notification forms to use, please contact a member of our Employee Benefits Practice Group.

 

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