Does an employer with Medicare-eligible individuals have a creditable coverage disclosure obligation?

Yes, there are two reporting obligations:

• The employer must annually (or when a plan’s prescription drug benefit changes) notify Medicare-eligible individuals as to whether the prescription drug benefit in the plans it offers are creditable or non-creditable.
• The employer must annually disclose to the Centers for Medicare and Medicaid Services (CMS) the creditable status of the plans offered to Medicare-eligible individuals.

There is a potential financial cost to Medicare-eligible individuals covered by non-creditable plans for longer than 63 days, so it is important for employers to disclose the creditable status to affected individuals.

Resources – This CMS Creditable Coverage web page provides information on the employer’s requirement, describes who is considered a Medicare-eligible individual, and includes links to forms and disclosure model notices that can be used by employers.

The Society of Human Resource Management (SHRM) provides an excellent summary of an employer’s responsibility for disclosing their creditable/non-creditable coverage to CMS and to Medicare-eligible individuals.