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Communicating Your Plan's Creditable
Coverage Status To Medicare

Under the new Medicare Part D regulations, all employers that currently provide prescription drug coverage to Medicare eligible individuals must disclose their Creditable Coverage status to the Centers for Medicare & Medicaid Services (CMS). Until recently, there has been no guidance on how to do this. CMS has now provided an on-line form that will enable employers to communicate their creditable coverage status. The disclosure form is located on the CMS web page. This method of transmission is the sole method for compliance with the requirement.

Who Must Provide the Disclosure Notice to CMS?

The Disclosure Notice must be provided to CMS by all employer group health plans, including federal, state and local government plans. However, there are some limited cases where an employer would not provide a report to CMS.

1. Part D plans, such as those included in a Medicare Advantage Plan, are exempt from this disclosure requirement. Any other plans offered to employees or retirees by the same employer would need to be disclosed.
   
   
2. Employers that have been approved for the Retiree Drug Subsidy are exempt from filing the Disclosure Notice with CMS with respect to those retirees. Any plans covering employees not included in the retiree drug subsidy would need to be disclosed.

When Must the Notice be Provided to CMS?

The initial Disclosure Notice must be provided by March 31, 2006. Additionally, the Disclosure Notice must be made to CMS on an annual basis and upon any change that affects whether the drug coverage is creditable as follows:

1. For plan years that end in 2007 and beyond, disclosure of creditable coverage
   status must be provided within 60 days after the beginning date of the plan year; and
   
   
2. Within 30 days after the termination of the prescription drug plan; and
   
   
3. Within 30 days after any change in the creditable coverage status of the
   prescription drug plan.
   
   

What Information Must be Included in the Notice?

Listed below are the fields that must be completed in order to generate the Disclosure Notice:

1. Name of Employer
   
   
2. Federal Tax Identification Number of the Employer
   
   
3. Street Address, City, State and Zip Code of the Employer
   
   
4. Phone Number of the Employer
   
   
5. Type of Coverage (e.g., Employer Sponsored Plan, Medicaid, VA)
   
   
6. Number of Options offered by the Employer (such as HMO, POS and PPO)
   
   
7. Creditable Coverage Status of Options offered by the Employer
   (Creditable or Non-Creditable)
   
   
8. Period covered by Disclosure Notice (Your Plan Year based on your renewal)
   
   
9. Number of Part D Eligible Individuals expected to be covered under these
   Plan(s) as of the Beginning Date of the Plan Year
   
   
10. Estimate Number of individuals expected to be covered through an
    Employer/Union group health Retiree Plan
    
    
11. Date of Notice of Creditable Coverage provided to Part D Eligible Individuals
    
    
12. Change in Creditable Coverage status of previously disclosed information to CMS
    
    
13. Name, Title and Email of the Entity's Authorized Individual
    
    
14. Date of Disclosure to CMS

Please note that most employers will be able to complete one on-line submission which will include all plans that are offered. CMS requires a separate submission for each "type of coverage", however an employer sponsored plan is considered one "type" even if that coverage involves numerous options such as an HMO, POS and PPO plans. Even if some plans offered by one employer are creditable while others are not creditable, the employer can provide data for each within the same submission.