COVID-19 (Coronavirus) Updates: CobraHelp will continue to deliver service excellence and compliance support to our Clients and their Employees during these challenging times. We appreciate your patience as we are working to provide Employers and Agents with the latest legislative updates on a national level. We encourage Employers, Benefits Administration partners and Insurance Agents to learn more about the most recent COVID-19 DISASTER RELIEF updates here.
  • Home
  • About
    • Testimonials
  • Services
    • COBRA Administration
    • State Continuation Administration
    • Retiree (Direct) Billing
    • Leave Management (FMLA & LOA)
  • Resources
    • How COBRA Works
    • How Brokers Benefit with CobraHelp
    • Employer FAQ
    • Broker FAQ/Help
    • Blog
    • COVID-19 & COBRA
    • HR Tools
  • Contact
800.398.2946​
LOGIN Request a Proposal​
  • Home
  • About
    • Testimonials
  • Services
    • COBRA Administration
    • State Continuation Administration
    • Retiree (Direct) Billing
    • Leave Management (FMLA & LOA)
  • Resources
    • How COBRA Works
    • How Brokers Benefit with CobraHelp
    • Employer FAQ
    • Broker FAQ/Help
    • Blog
    • COVID-19 & COBRA
    • HR Tools
  • Contact

THE HR, BENEFITS, & COMPLIANCE BLOG

READ: How Brokers Can Cultivate Lasting Client Relationships

Subscribe to The COBRA Advisor newsletter for fresh HR insights, law updates, and more.

Subscribe

Medicare Part D Notices Due Before Oct 15th!

10/11/2018

0 Comments

 
Picture
Medicare requires annual notifications from health plan sponsors (Employers like you) which disclose important facts to individuals who are eligible for Medicare Part D. 
This annual disclosure requirement is important because it impacts Medicare beneficiaries who are not covered by prescription (RX) coverage and who do not elect Medicare Part D will likely pay higher insurance premiums down the road. Employers and Plan Administrators should determine if their prescription drug coverage is considered "creditable" or "non-creditable" in preparation for the meeting the notification requirement. Persuant to Medicare Part D rules, the notice is due before October 15th, 2018.

What Is Creditable and Non-Creditable?

 The GPH's prescription drug plan would be considered "creditable" if its value is equal to or greater than the actual value of the standard Medicare D RX coverage. The official determination can be made through actuarial measures. As an example of how this directly works with the prescription drug benefits, ABC company needs to determine if the plan's prescription coverage is equal to or greater than the projected amount of claims paid out under the Medicare Part D prescription drug benefit.
Medicare does require that a notice be issued for creditable and non-creditable prescription drug benefit plans. There are model notices for each.

Does Medicare Provide Notice Information?

The Centers for Medicare and Medicaid Services (CMS) does provide model notices in both English and Spanish for the Employer's use in fulfilling the mandatory notice requirements.
Model Notice Creditable Coverage   | Model Notice Non-Creditable Coverage 
These model notices can be bypassed by an Employer group that wishes to obtain a similar notice from an attorney as long as the verbiage requirements are met.

How Do I Know Who Should Receive the Notices and When?

Per Federal mandate, there is a general timeframe during which the notices must be provided:
  • Prior to the Medicare Part D annual coordinated election period—Oct. 15 through Dec. 7 of each year
  • Prior to an individual’s initial enrollment period for Medicare Part D
  • Prior to the effective date of coverage for any Medicare-eligible individual who joins the plan
  • Whenever prescription drug coverage ends or changes so that it is no longer creditable or becomes creditable
  • Upon a beneficiary’s request
The disclosure notices must be provided to individuals who are eligible for Medicare Part D who are covered by, or apply for the group health plan's RX coverage. Individuals who are eligible for Medicare Part D could include active employees, leave of absence employees (or individuals who have become disabled), retiree beneficiaries, and COBRA participants. That being said, a good best practice approach for plan administrators is to simply provide the notices to anyone who is participating in the plan.

Experts say that while the method of delivering notices can vary, best practice is to have the notice sent via regular first class mail with proof of mail to the employee and participating spouse at the last known address on file. Proof of mailing (certificate of mail) provides sufficient documentation with little overhead and administrative burden and satisfies notification requirements.

Legal Disclaimer:
The information in this FAQ is provided for general informational purposes only, and may not reflect the current law in your jurisdiction. No information contained in this post should be construed as legal advice from CobraHelp. or the individual author, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this Post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction


Was this article helpful?
Receive more helpful HR compliance info by subscribing and life, follow, and share!
Subscribe to Newsletter
0 Comments

Your comment will be posted after it is approved.


Leave a Reply.

    Categories

    All
    2016 Cobra Reporting Deadlines
    ACA Benefits
    ACA Compliance
    Affordable Care Act
    Benefit Admin Solutions
    Cobra Administration
    Cobra Administration Companies
    Cobra Benefits
    Cobra Compliance
    Cobra Compliance 2016
    Cobra Compliance Audit
    Cobra Customer Service
    Cobra Eligibility
    Cobra Employer Requirements
    Cobra For Retirees
    Cobra Guidelines For Employers
    Cobra Non Compliance Penalties
    Cobra Retiree Coverage
    Cobra Rights
    Cobra Services
    Compliance Outsourcing
    Federal COBRA Regulations
    Health Savings Account
    Medicare Compliance Regulations
    Medicare Modernization Act
    Open Enrollment 2017

    HR Outsourcing Services Blog RSS Feed

    Archives

    March 2021
    February 2021
    November 2020
    September 2020
    August 2020
    July 2020
    May 2020
    April 2020
    March 2020
    February 2020
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    March 2018
    January 2018
    October 2017
    August 2017
    July 2017
    April 2017
    February 2017
    November 2016
    October 2016
    September 2016
    September 2015
    February 2015
    January 2015
    April 2014
    March 2014
    February 2014

CONTACT

COBRA Help
1620 N High St 
Denver, CO 80218

Toll Free: (800) 398-2946 
Local: (303) 322-2043
​© Copyright 1986-2019 CobraHelp.  All Rights Reserved
Sitemap | Sitemap 
Terms & Conditions | Privacy

RESOURCES

​US Department of Labor
Electronic Code of Federal Regulations
Quick Checklist
​For Insurance Agents
​
Career Opportunities

​RESOURCES

HR Compliance Tools
FAQ/HELP Brokers
FAQ/HELP Employers
Request Demo
Request Media Kit
​How COBRA Works
​COVID19 Support

​RESOURCES

​Sign up to get invites for our free webinars!
Sign Up!