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Plan Sponsors Must Disclose Creditable Coverage Status to CMS

As we reported in our July 2005 issue of Benefits in Brief, regulations issued by the Centers for Medicare and Medicaid Services (“CMS”) require group health plans providing prescription drug coverage to Medicare Part D-eligible individuals to disclose to participants whether that coverage is “creditable.” Plan sponsors were required to send these notices by November 15, 2005. CMS has now released guidance regarding the plan sponsor’s obligation to disclose information regarding the plan’s creditable coverage status to CMS.

As we reported in our July 2005 issue of Benefits in Brief, regulations issued by the Centers for Medicare and Medicaid Services (“CMS”) require group health plans providing prescription drug coverage to Medicare Part D-eligible individuals to disclose to participants whether that coverage is “creditable.” Plan sponsors were required to send these notices by November 15, 2005. CMS has now released guidance regarding the plan sponsor’s obligation to disclose information regarding the plan’s creditable coverage status to CMS.

For plan years ending in 2006, the initial disclosure must be submitted no later than March 31, 2006. Thereafter, the disclosure form must be provided to CMS within 60 days after the first day of the plan year. Thus, sponsors of most non-calendar-year plans will have to make two disclosures during 2006. Additionally, disclosure is required within 30 days of a prescription drug plan’s termination or change in creditable coverage status.

The disclosure form requests a number of pieces of information from plan sponsors, including an estimate of the number of Part D-eligible individuals expected to be covered by the plan and the date that the annual creditable coverage notice was given to Part D-eligible individuals. This form must be completed and submitted electronically, via the CMS website, at www.cms.gov/CreditableCoverage. There are no other permissible methods for providing the notice to CMS.