Medicare
Part D Notice Due November 15, 2005
If
your group health plan offers prescription drug coverage to active employees or
retirees who are also entitled to Medicare coverage, you must provide them a
notice stating whether or not your plan’s coverage is “creditable
coverage.” The deadline for this
notice is November 15, 2005. The
notice will help Medicare eligible individuals who now have an option to elect
Medicare’s new voluntary prescription drug coverage (Medicare “Part D”
coverage) starting January 1, 2006. The
notice must be provided to all Part D eligible individuals (including
dependents) covered by the group health plan, which would include individuals
over age 65 and those under age 65 who are disabled for Social Security
purposes. Additional creditable
coverage notice requirements, some of which may be satisfied by a general notice
to all group health participants included in the annual open enrollment package,
apply at other times. The Centers
for Medicare and Medicaid Services (“CMS”) also must receive a disclosure of
your plan’s creditable coverage status on an annual basis (details about this
disclosure and the CMS model form are not yet available).
Recommendations:
Determine whether or not your group plan provides “creditable”
prescription drug coverage, which is coverage the “actuarial value” of which
equals or exceeds the actuarial value of Part D prescription drug coverage.
Contact your insurer or third party administrator to see if they will
assist in this determination (many do not want to be involved in this process).
Although you may have to engage an actuary, there are alternative “safe
harbor” rules that will make it easier for most group health plans to
determine whether their drug coverage is “creditable.”
The creditable coverage notice itself can be based on model notices
issued by CMS that are posted at www.cms.hhs.gov/medicarereform/CredCov-BeneDsclsreNtc.pdf
(for plans with creditable coverage) and www.cms.hhs.gov/medicarereform/Non-CredCov-BeneDsclsreNtc.pdf
(for plans that do not provide creditable prescription drug coverage).
Dated:
September 20, 2005
Andrew
S. Williams
Aronberg Goldgehn Davis & Garmisa
One IBM Plaza, Suite 3000
Chicago, Illinois 60611
312/755-3145
awilliams@agdglaw.com
|