Is your prescription drug coverage creditable?

Posted October 9, 2014 Company News

All Part D Eligible Individuals working for the company must be notified by October 15 as to whether the prescription drug coverage the company offers to employees and former employees (including spouses and dependents) qualifies as creditable. Plan sponsors should also annually disclose this information to the Centers for Medicare and Medicaid Services (CMS).

Who are Part D Eligible Individuals?

Employees, spouses and dependents of employees, and retirees eligible for Medicare.

What is a creditable prescription plan?

Creditable prescription plans, on average, pay out at least as much as standard Medicare Part D coverage.

Is the plan I offer creditable?

Most insurers provide guidance on whether an employer’s Rx benefits are considered creditable

What happens if the plan is not creditable?

The notification must explain when an individual may enroll in a Part D plan, and that he or she may be subject to a lifetime late enrollment penalty under Part D.

How do I disclose creditable coverage to Part D Eligible Individuals and CMS?

Henderson Brothers has distributed the 2015 prescription benefit parameters, model notices, and detailed instructions on how to properly disclose creditable and non-creditable coverage. Feel free to contact your HBI Consultant or Analyst if you have questions regarding your Medicare Part D disclosure obligations.



Please note that the information contained in this document is designed to provide authoritative and accurate information, in regard to the subject matter covered. However, it is not provided as legal or tax advice and no representation is made as to the sufficiency for your specific company’s needs. This document should be reviewed by your legal counsel or tax consultant before use.

Additionally, the messages and content within the Pittsburgh Health Care Reform group do not reflect the advisory services of Henderson Brothers, Inc.