Small Group Creditable Coverage Status Report

2021-2022 small group creditable coverage status report: If your plan year straddles 2021–2022, reference this report. It shows 2021 small group creditable coverage tested against 2022 Medicare Part D threshold amounts.

 

2021 small group creditable coverage status report

 

2020 small group creditable coverage status report

 

The CMS website offers general information about Medicare Part D.

 

Important Reminder

Premera no longer sends creditable coverage status notices to members on behalf of groups with pharmacy plans.

 

Employers will need to provide the notifications as required by the Medicare Modernization Act (MMA) to their Medicare-eligible employees and dependents. This act requires employers to let their Medicare-eligible employees and dependents know whether the prescription drug coverage pays on average as much as the standard Medicare prescription drug coverage.

 

Additional information is found at the following pages of the Centers for Medicare & Medicaid Services:

 

Submission of CMS Medicare Part D Disclosure Form

Federal law requires employer groups to notify the Centers for Medicare and Medicaid Services (CMS) if their prescription drug coverage for Medicare beneficiaries is creditable. CMS requires employer groups to submit a creditable coverage disclosure form each year or upon any change that could affect whether the drug coverage offered is creditable. 

Medicare Secondary Payer

Employers offering group health plans must comply with the Medicare Secondary Payer (MSP) statute and regulations (the MSP laws). These laws establish Medicare as the secondary payer to group health plan coverage in certain instances of dual healthcare coverage. The MSP laws are complex and can be confusing even to a seasoned healthcare administrator.

 

This section has been designed to provide a general overview of what your group clients need to know about MSP and related issues. It's purely informational, does not modify their policy or coverage in any way, and should not be construed as legal advice or opinion.

 

MSP change form - Form used for employer groups to report group size and Medicare beneficiary changes to Premera that may impact MSP rules.