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Monday, 18 September 2017 18:51

Mandatory Compliance Notice Due October 15th

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Do you know if your employer prescription benefits are creditable when compared Medicare Part D benefits? Are you informing your plan participants of the plan’s status on an annual basis? 
 
The Medicare Part D Notice is just one of the many compliance responsibilities to which most employer health plans are subject. 

The Notice informs participants of the creditability status of their health plans compared to Medicare Part D (prescription) benefits. Anyone eligible for Medicare needs to know the status of their employer’s prescription plan, helping them determine whether they need a Part D plan, and also allowing them to avoid late enrollment penalties. Since the Medicare open enrollment window starts on October 15th each year, the Part D Notices need to go out to employees by then.
 
When we audit employers on ERISA and other compliance responsibilities for the first time, they often say, “I don’t have any employees over 65 so I don’t need to send the Medicare Part D Notices.” We quickly point out that’s not where their responsibility ends. Remember, a person under 65 can be Medicare-eligible if they are disabled, or in end stage renal failure. While you may know the status of all your employees, you may not know the status or even age of all the spouses or children on your plan, and these notices need to be provided to them as well.
 
As a good practice, Fall River recommends to our clients that employers send out the Notice annually to all employees, to make sure you’re capturing anyone in the family that might be Medicare-eligible. We also recommend that the Notice be included in the new hire package.
 
In addition to sending employees the Notice, employers must also certify whether their plan is creditable or non-creditable on the CMS website, within 60 days of the beginning of each plan year. This allows CMS to look up the status of a participant’s plan, and helps to make the Medicare process simpler and faster. Just let us know if you would like instructions for this requirement as well!
 
All Fall River clients will be receiving their fully customized Medicare Notices shortly! For those who aren’t (yet) part of the Fall River family, click here to download the latest templates for the Medicare Part D creditable and non-creditable Model Notices.
 
Read 210 times Last modified on Wednesday, 27 September 2017 09:09
Tonya Kimrey

Tonya is our Senior Account Manager and brings eleven years of prior insurance company expertise to Fall River, having worked at Anthem Blue Cross and Great-West Healthcare (now part of CIGNA). Tonya holds a Bachelor of Science in Psychology from Texas A&M University. Originally from Minnesota, she loves the Colorado outdoors and enjoys family time with her young daughter.

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