The Medicare Modernization Act (MMA) established annual notification requirements for employer-sponsored group health plans with prescription drug coverage. Per the MMA, employers sponsoring these plans are required to disclose annually the creditable status of the plan to The Centers for Medicare and Medicaid Services (CMS). This disclosure is due to CMS no later than 60 days after the start of each plan year, so for group plans started or renewed as of January 1, 2024, the submission is due by March 1, 2024. In the event there is a mid-year change to the creditable status of the prescription drug coverage, employers will need to upload a new disclosure to CMS within 30 days of the change. The same deadline applies when a plan is terminated.
To make the disclosure, employers will need to complete and submit CMS’s online form utilizing the confirmation of the creditability status of their plan, which they likely received from their carrier or third-party administrator. Prescription coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard Medicare prescription drug coverage. If this is not the case, the coverage is deemed non-creditable.
To complete the online disclosure form, employers should have the following information:
- The name, address, phone number, and Federal Tax ID of the entity providing coverage.
- The type of coverage (e.g., state or local government plan, group health plan, union plan, etc.) and the number of prescription drug options offered by the entity.
- Creditable coverage status of the prescription drug plans offered, and the period covered by the disclosure.
- Estimated number of Part D eligible individuals covered under the plan as of the beginning of the plan year.
- If the entity completing the form is a group health plan, the estimated number of individuals expected to be covered through an employer/union group health retiree plan.
- The date of the Notice of Creditable/Non-Creditable Coverage was provided to Part D eligible individuals. Note: Employers are required to distribute this notice to individuals by October 15th of each year.
- If the creditability status of the plan changed from the previous year and the effective date of the change, if applicable.
- The name, title, and email address of the entity’s authorized individual (i.e., the individual completing the disclosure form).
While the disclosure requirement is not new, employers should be mindful of the deadline and information needed to comply. Instructions for the disclosure can be found here.
