Sarah Borders, CEBS February 2, 2024 3 min read

Medicare Part D Coverage Disclosures Due February 29th for January 1 Plan Years

Date:  February 29, 2024 – Any sized employer who sponsors a group health plan is required to notify CMS of the plan’s Medicare Part D creditable coverage status.

Who this applies to:

  • Large employers with fully insured and self-funded health plans
  • Small employers with fully insured and level-funded health plans

Go Deeper:
This must be done through an online form available on the CMS website. Hard copies are typically not allowed, unless the company has no internet access.

The form is relatively straightforward, but the employer needs to determine whether the prescription drug plan covers any Medicare-eligible individuals at the start of the plan year, including active employees, retirees, disabled individuals or anyone on COBRA. However, any retiree drug subsidy participants should be excluded.

Employers may not be able to give an exact number of Part D eligible individuals, but should instead estimate the number of covered Part D eligible individuals under the options offered under the type of coverage for which they are providing the Disclosure Notice to CMS. This estimate should be the total number of Medicare eligible individuals, less any Medicare eligible individuals being claimed under the retiree drug subsidy program. This includes actives, disables, individuals on COBRA, and retired individuals (best estimate of those over 65).

The Disclosure to CMS Form must be submitted annually within 60 days from the start of the plan year. Thus, for plans that begin on Jan 1, the deadline to submit the CMS disclosure is February 29, 2024. CMS must also be notified within 30 days after termination of the prescription drug plan or a change in creditable coverage status of the drug plan.

Lastly, there is no specific penalty for failure to complete the Disclosure to CMS Form, but ERISA plan fiduciaries must administer the plan in accordance with ERISA and other federal laws. Therefore, employers should determine if the plan is creditable or non-creditable, and disclose that information to CMS within the appropriate timeframes.


Sarah Borders, CEBS

Principal, Benefits Compliance Solutions. Sarah has spent the last 15 years in the employee benefits industry, has numerous designations and serves on NAHU’s Employer Working Group Subcommittee and is an active board member of Austin AHU. She recently stepped down as Vice President of Benefits Compliance at one of the nation's largest brokerage firms to start her own compliance consulting practice. Her designations include an active license with the Texas Department of Insurance, CEBS (Certified Employee Benefits Specialist), Certified Health Care Reform Professional, HIPAA certification and Health Care Service Associate. She holds an MBA from Texas A&M Corpus Christi and a BA from University of Incarnate Word. Her consulting firm, Benefits Compliance Solutions, partners with employers to identify unknown risks and avoid hundreds of thousands of dollars in fines and lawsuits from failure to comply with their healthplan obligations.