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The Wagner Law Group Description 

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 

 

Established in 1996, The Wagner Law Group has 22 attorneys engaged exclusively in employee benefits, estate planning and employment law. Six of our attorneys are AV rated by Martindale-Hubbell as having very high to preeminent legal abilities and ethical standards. The firm is among the largest ERISA boutiques in the country. Our practice is national in scope, with clients in more than 40 states and several foreign countries.

 

 

 

 

 

Contact Info

The Wagner Law Group

 

  Integrity | Excellence

  

Massachusetts Office 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110


Florida Office 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418

   

San Francisco Office

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 904

San Francisco, CA 94104

 

www.wagnerlawgroup.com

 

 

 

 

February 11, 2015

 

 Health and Welfare Law Alert

 

 

 

Calendar Year Plans Must Submit Creditable Coverage Disclosure Notices to CMS by March 1

 

 

 

Each year, group health plan sponsors that provide prescription drug coverage to Medicare Part D-eligible individuals must disclose to the Centers for Medicare & Medicaid Services ("CMS") whether that coverage is "creditable" or "non-creditable." This disclosure requirement applies to all plan sponsors that provide prescription drug coverage, even when a plan does not offer prescription drug coverage to retirees.

 

Group health plan sponsors satisfy this obligation by submitting an electronic Disclosure Notice to CMS on an annual basis. Calendar year plans must submit this year's Disclosure Notice to CMS by March 1.

 

Background. Individuals who fail to enroll in Medicare Part D prescription drug coverage when first eligible may be subject to late enrollment penalties if they go 63 consecutive days or more without creditable coverage. Prescription drug coverage is "creditable" when it is at least actuarially equivalent to Medicare Part D Coverage.

 

Medicare Part D-eligible individuals, and CMS, must be informed whether a group health plan's prescription drug coverage is creditable or non-creditable. Accordingly, plan sponsors that provide prescription drug coverage must: (i) furnish Part D-eligible individuals with a notice disclosing the creditable or non-creditable status of their coverage, and (ii) disclose to CMS on an annual basis (and at certain other times) whether the plan's coverage is creditable.

 

Timing of Disclosure Notice. A plan sponsor subject to the disclosure requirement must submit a new Disclosure Notice to CMS no later than 60 days following the beginning of the new plan year (i.e., March 1, 2015 for calendar year plans).

 

A new Disclosure Notice must also be filed with CMS during the plan year if any prescription drug coverage change affects the plan's creditable coverage status. Specifically, a plan must file a new Disclosure Notice with CMS within 30 days following: (i) the termination of the prescription drug plan; or (ii) any change in the creditable coverage status of the prescription drug plan.

 

Information Needed to Complete the Disclosure Notice. When completing the Disclosure Notice, plan sponsors need to: 

 

  • Identify the number of prescription drug options the plan offers to Medicare-eligible individuals.
  • Determine the number of benefit options offered that are creditable coverage and non-creditable coverage.
  • Estimate the total number of Medicare-eligible individuals expected to have coverage under the plan at the start of the plan year. This includes:
    • health plan enrollees who are active employees,
    • COBRA enrollees,
    • Retirees,
    • Disabled individuals, and
    • Any Medicare-eligible dependents of the above individuals. 

How to Complete the Disclosure Notice. A plan sponsor must submit the Disclosure Notice to CMS by completing the Creditable Coverage Disclosure Form on the CMS Creditable Coverage Disclosure webpage. This is the only method available for complying with the disclosure requirement.

 

The CMS Creditable Coverage Disclosure webpage is accessible at: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosureForm.html 

 

  

 

 

 

This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.

 

This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.