When Reviewing Notice Pile, Don't Forget Medicare Part D

April 15, 2008

How deep and wide is your notice pile? It seems as though employers are inundated with an abundance of notice rules. Consider some of the laws that require employer notices: COBRA, HIPAA portability, HIPAA privacy, FMLA, wage and hour laws and summary plan descriptions.

Employers should not forget about two relatively recent additions to the notice pile. These notices relate to Medicare Part D, the prescription drug benefit. Employers must first determine whether their group health plan offers prescription drug coverage that is creditable, i.e., as good as or better than the standard Medicare Part D benefit. Health FSAs and Health Savings Accounts are exempt from the requirement. Thus, an employer that offers an HMO and a high-deductible health plan (HDHP) along with a Health Reimbursement Arrangement must make the creditable coverage determination on all three plans.

The first notice that employers should be concerned about is the participant notice. This needs to go to all Medicare Part D-eligible participants, which could include covered spouses and dependents. Because employers may not know who is Medicare Part D eligible, it is generally recommended that they send the notices to all participants by first class mail. A single notice will suffice for all participants living at the same residence.

There are three types of participant notices: creditable coverage, non-creditable coverage and an optional personalized notice, which includes coverage dates. The participant notice must be sent at the following times:

• Before November 15 of each year
• Before a participant's Initial Enrollment Period (IEP) for Medicare Part D
• When the participant first joins the employer's plan
• If the employer no longer offers prescription drug coverage or the coverage changes its creditable status
• Upon request

Employers who provide the notice before November 15 each year do not have to worry about sending another notice before the IEP.

The second notice is the Notice to the Centers for Medicare and Medicaid Services (CMS). Employers must submit the CMS Notice annually by completing an online form that can be found at www.cms.hhs.gov/creditablecoverage.

At a minimum, the Disclosure to CMS Form must be provided at the following times:

• Within 60 days after the start of each plan year (for calendar plan years, it was February 29, 2008)
• Within 30 days of prescription drug coverage termination
• Within 30 days of any change in creditable status

Infinisource can help reduce your notice pile. In the case of Medicare Part D, we can handle your participant notices. Simply contact our Blanket Notice Mailing Team at 800-300-3838 or review more information on our website at www.infinisource.net.