Group Health Plan Compliance | Annual CMS Disclosure

Group Health Plan Compliance
Annual CMS Disclosure of Prescription Drug Coverage Status to Medicare-Eligible Employees

SUMMARY

  • IF employers offer prescription drug benefits within Group Health Plans, Medicare Part D regulations require employers to distribute a notice of Creditable or Non-Creditable prescription drug coverage to Medicare-eligible employees and retirees by October 14 each year.
  • In addition to the annual notice of creditable or non-creditable coverage to Medicare-eligible employees by October 14 annually, employers must also report to the Centers for Medicare and Medicaid Services (CMS) Online as to the plan(s)’ Creditable or Non-Creditable prescription drug status. This CMS reporting requirement applies to all employers offering medical benefit plans that include prescription drugs.
  • Reporting is due to CMS within 60 days of the beginning of the plan year; within 30 days after termination of a prescription drug plan; or within 30 days after any change in Creditable or Non-Creditable coverage status.
  • Creditable means the coverage is “as good as” and comparable to Medicare Part D coverage.
  • Links to the Model Creditable and Non-Creditable Coverage Disclosure Notices:
    Model Creditable Coverage Disclosure Notice
    Model Non-Creditable Coverage Disclosure Notice
  • Link to Complete the Online Disclosure Notice via the CMS Website: Click HERE
  • NOTE: If uncertain as to the coverage status of the RX plan, please contact your Oswald representative, or your carrier for assistance.

ACTION ITEMS

  • Send the creditable or non-credible coverage notice to all Medicare-eligible employees by October 14, annually
  • Complete the online disclosure, as to the creditable or non-creditable status of the RX plan, within 60 days of the beginning of the plan year
  • Click HERE for an Oswald Advisory: CMS Reporting Reference Chart and Step-by-Step Guideline

Oswald Companies | Health Care Reform 2015
Andrea Esselstein, J.D. | aesselstein@oswaldcompanies.com; 216.658.5012
Luke Clark, Sr Benefits Consultant | lclark@oswaldcompanies.com; 216.367.8758
Disclaimer: Materials are solely for informational purposes as an educational resource. Please contact counsel to obtain advice with respect to any specific issue.