Medicare Part D Notice Due Before October 15th

This is a reminder to employers who are required to provide an annual Medicare Part D Notice. Sponsors of group health plans that provide prescription drug coverage generally must provide the Notice to all participants who are eligible for Medicare. The Notice must be distributed prior to the start of the election period (which runs from October 15 to December 7), so you may want to include the Notice in your open enrollment packages. You must send the Notice out no later than October 14, 2013.
You must provide the Notice to all Part D eligible individuals enrolled in or seeking to enroll in your plan, including spouses and dependents. Because employers may not know which individuals are Part D eligible (some individuals might be eligible because of a disability, some might be eligible due to age, etc.) many employers distribute the Notice to all individuals eligible to enroll in the plan to ensure that no Part D eligible individual is missed.
Here are some basic rules for the Notice:
  • You have flexibility in the form and manner of providing the Notice
  • You may use the model notice form published by the Centers for Medicare & Medicaid Services (CMS) (although you are not required to do so).
  • You are not required to send the Notice as a separate mailing. You can provide it with other participant information materials (although note that certain formatting requirements may apply)
  • A separate disclosure must be provided if you know that the spouse or dependent resides at a different address than the participant.
  • You may distribute the Notice electronically if you follow the same electronic disclosure requirements that apply to summary plan descriptions (SPDs), except you should inform the participant that he/she is responsible for providing a copy of the disclosure to his/her Medicare-eligible spouse and/or dependents eligible for coverage under the plan (otherwise, you will need to separately send them a hard copy notice) And you must post the Notice on your website (if you have one) with a link on your home page to the Notice.
  • If you have not yet finished your 2013 offerings, the Notice should still be provided now based on your current 2012 offerings. If the status of those offerings changes from creditable to non-creditable (or vice versa), you will need to provide an additional Notice within a reasonable period of time (maximum 60 days) after the change occurs. You should indicate on your Notice that it will not be updated if coverage changes but it remains creditable or non-creditable (as applicable)
In addition to the Notice, you must annually disclose to CMS the creditable coverage status of your prescription drug plan, using the online Disclosure to CMS Form (available here). The Form is due no later than 60 days after 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 coverage status.
For further information or if you have any questions about Medicare Part D and notices of creditable coverage, visit the Medicare section on the CMS website at https://www.cms.hhs.gov/CreditableCoverage
or call our office at (423) 266-8306.

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