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October 8, 2012

Medicare Disclosures Due Prior to October 15!

Filed under: Benefits,COBRA,Compliance,Insurance — Tags: 6:00 am

The Medicare Modernization Act requires certain disclosures be distributed annually regarding prescription drug coverage to Medicare eligible individuals.  This annual disclosure must be made prior to October 15.

If a group health plan offers prescription drug coverage, it must notify all Medicare eligible participants covered by the plan whether the prescription drug coverage offered is deemed, “creditable coverage,” meaning it is as good or better than what the standard Medicare prescription benefit (Part D) would cover.  Besides the active employee, notice would also have to be provided to the following individuals covered by the prescription drug coverage of the group plan:

  • Dependents of the actively working employee
  • Medicare eligible individuals covered under the COBRA provision and their dependents
  • Medicare eligible disabled employees
  • Medicare eligible retirees and their dependents

Besides the annual distribution of such disclosures, notice must also be given when the Medicare eligible individual joins the plan.

A second annual disclosure must be made to The Centers for Medicare & Medicaid Services (CMS) using the Online Disclosure to CMS Form to keep the government agency abreast of the status of the creditable coverage of their prescription drug plan.  This disclosure notice is to be made no later than 60 days from the beginning of the renewal date of the plan year, within 30 days of the termination of a prescription drug plan or within 30 days after a change in the creditable coverage status.


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