The CMS requires employers to provide annual creditable coverage notices to all Medicare Part D-eligible individuals covered on your plan. Individuals are Medicare Part D-eligible if they are enrolled in Medicare Part A or Part B.

These notices inform eligible employees of whether their group prescription drug coverage is “creditable,” which means the coverage is expected to pay out as much as a standard Medicare Part D prescription drug plan. As explained in our article Medicare Part D Changes: Considerations for 2025 and Beyond, due to cost-sharing changes to Medicare Part D for 2025, some group health plans that have been creditable in the past might not be going forward.

Part D-eligible individuals can delay enrollment in a Part D plan, without a premium penalty, if they are enrolled in creditable prescription drug coverage through a group health plan.

All employers must provide the applicable creditable or non-creditable notice to all Medicare Part D-eligible group health plan participants – including current employees, dependents, COBRA beneficiaries, and retirees – at least once a year prior to the Medicare Part D open enrollment period, which begins on October 15th. You must also distribute this Notice during the year to any plan participant upon request or if there are changes to the creditable coverage status of the plan (i.e. no longer creditable or becomes creditable).

If you are unsure if your group prescription drug plan is creditable, please contact your OneDigital account team. Once you confirm if your prescription drug coverage is creditable, complete either or both the Model Creditable Coverage Notice or the Model Non-Creditable Coverage Notice, which are linked below. Also linked is a guide that can assist you in filling out the model notice prior to distribution.

Model Creditable Coverage Disclosure Notice

Model Non-Creditable Coverage Disclosure Notice

CMS Guidance on Creditable Coverage Disclosure Notices

Here are some details about the delivery of this Notice:

• This notice does not need to be sent as a separate mailing. It may be provided with other plan participant information materials (including enrollment and/or renewal materials). If you decide to include it with other materials, the first page of the materials should include this statement prominently (e.g., at least 14-point font and bolded, boxed, or offset):

“If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices about your prescription drug coverage. Please see page __ for more details.”

• You can provide a single notice to all family members covered under the same plan. However, separate notice is required if it is known that any spouse or dependent that is Part D-eligible resides at a different address than where you are mailing it to the employee or former employee.

• You can disclose the notice electronically to plan participants who can access electronic documents on a regular basis as part of their work duties. If electronic disclosure is used, you must tell the plan participant that the participant is responsible for providing a copy to their Part D-eligible dependents covered under the group health plan. We have included this statement on the Model Notices.

• Since former employees do not have access to the employer’s electronic system, you should mail hard copies to these individuals. If you wish to provide it electronically, please contact your OneDigital account team for consent procedures.

• CMS does not require the notices to be personalized for each recipient, unless a participant requests a personalized one. The personalized language is still included in the attached Model Notices as an optional insert.

Again, the notice should be distributed to all Part D-eligible individuals by October 15th. It is recommended to send this Notice to all health plan enrollees so that you do not have to identify who is Part D-eligible or separately provide to an enrollee who enrolls in Medicare during the year. Be sure to keep a record of when you distribute the Notice, as this date is reported in your online disclosure to the CMS after the start of the plan year.