Creditable Coverage Notice for Medicare-eligible Individuals
Employers who sponsor group health plans should be aware that the annual deadline to provide notice of Creditable Coverage to Medicare-eligible employees is October 15.
WHAT IS CREDITABLE COVERAGE?
The actuarial value of the coverage determines whether it is defined as "Creditable" or not. According to the Centers for Medicare & Medicaid Services (CMS), "in general, [the] actuarial equivalence test measures whether the expected amount of paid claims under the plan sponsor's prescription drug coverage is at least equal to the expected amount of paid claims under standard prescription drug coverage under Medicare."
Distribution of this notice has been required since January of 2006, when Medicare beneficiaries first received subsidized prescription drug coverage through the Medicare Part D program.
WHAT CREDITABLE COVERAGE NOTICES ARE REQUIRED?
Per CMS guidelines, two notices related to Creditable Coverage are required every year. More information is in the table below.
WHERE CAN I FIND SAMPLE CREDITABLE COVERAGE NOTICES?
Find sample Creditable and Non-Creditable Notices in both English and Spanish at http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverag...
FOR MORE INFORMATION
If you have any questions, please reach out to our Employee Benefits teamat 210-640-1789 or via email at [email protected].
*Source: Centers for Medicare & Medicaid Services (CMS)
This bulletin should not be considere legal advice or tax advice. Please consult legal or tax professionals for those services.