Any sized employer who sponsors a group health plan is required to notify CMS of the plan’s Medicare Part D creditable coverage status.
Applies To:
All employers with a fully insured, level-funded, or self-funded group medical plan or an ICHRA
Go Deeper:
Disclosure 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, if the employer sponsors a Medicare retiree drug subsidy, participants of that plan 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 described above.
The disclosure to CMS must be submitted annually within 60 days from the start of the plan year, or within 30 days if creditable status has changed for one or more plan options (or if all prescription drug plans have terminated). Thus, for plans that begin on January 1, the deadline to submit the CMS disclosure is either February 28, 2025, or January 31, 2025.
Lastly, there is no specific penalty for failure to complete the disclosure to CMS, but this filing requirement is one of the easiest and on average takes less than five minutes.

COMMENTS