CMS Online Disclosure Form   
W ho is required to provide an annual online disclosure?

Employers providing prescription drug coverage to Part-D eligible individuals at the beginning of the plan year are required to provide an annual  online disclosure
to the Centers for Medicare & Medicaid Services (CMS) to report the creditable coverage status of their prescription drug plans. 

Information brought to you by:
DRA Employee Benefits Dept.

Send questions to:
T: 510.465.3090
License# 0020739
Due 60 Days After Effective Date

The disclosure form is due no later than 60 days after the beginning of a plan year-for calendar year plans beginning on January 1, 2019, this date would be March 1, 2019.

Additional CMS Disclosure Deadlines

In addition to the annual disclosure requirement, the CMS disclosure form is required within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status.

Disclosure Submission Process
The disclosure submission process is composed of the following steps:
  1. Enter the Disclosure Information
  2. Verify and Submit Disclosure Information
  3. Receive Submission Confirmation
To determine the creditable status of all offered plans, you may refer to our Creditable Coverage plan list for all carriers. The Disclosure to CMS Guidance and Instructions web page is available to further assist with completing the online disclosure form.

For questions, please contact a member of your DRA Employee Benefits Team or call us at 1-800-545-3090.