Horizon BCBSNJ Creditable Coverage Notices, Applies to All Markets
Posted on September 25, 2019
As defined by the Centers for Medicare & Medicaid Services (CMS), prescription drug coverage is creditable if the actuarial value of the coverage is equivalent to, or better than, the actuarial value of standard Medicare Part D prescription drug coverage. A non-creditable prescription drug plan has an actuarial value that is less than the standard Medicare Part D coverage.
- Group Creditable Coverage Email
- Group Non-Creditable Coverage Email
- Individual Creditable Coverage Letter
- Individual Non-Creditable Coverage Letter
Once your groups receive this information, they must disclose to their employees whether their prescription plan is creditable or non-creditable. CMS-approved models for creditable and non-creditable disclosure notices are available at cms.hhs.gov/creditablecoverage.
Your groups are also required to disclose, directly to CMS, whether or not the coverage that is offered to Medicare-eligible employees and their dependents is creditable prescription drug coverage.
This disclosure must be made to CMS annually and upon any change in the creditable coverage status of the prescription drug plan. The Disclosure to CMS form can also be found on the CMS website cms.hhs.gov/creditablecoverage.
If your groups do not have any Medicare-eligible employees, they will not receive a letter and no disclosure is required.