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Pharmacy Creditability: Employer Required Notice to Employees

Sep 28, 2016

​Pharmacy Creditability - Employer Required Notice to Employees 

Health Net is mailing an important reminder to employer groups about a CMS notice they must provide their employees by October 15, 2016: Pharmacy plan creditable coverage. 

Employers must send this notice to their employees in the coming weeks, if they haven't already. Health Net is mailing a letter to let them know about this notice requirement. Employers may use the CMS model notices referenced in the letter. To provide the details needed when meeting with clients, the notice requirement is recapped here.

Pharmacy Plan Creditable Coverage Notification 

Employer groups who provide prescription drug coverage through a group-sponsored health plan have to notify Medicare-eligible employees of the creditability status of their pharmacy plan.

Health Net has assessed its 2016-2017 pharmacy plans for creditability. Most are creditable, but some do not meet the actuarial value of the standard Medicare Part D benefit. Health Net is sending group customers a list of pharmacy plans that are not creditable so they know what to tell employees, along with details for filing the Medicare-required Online Disclosure to CMS Form

You can find more information on creditable coverage, along with the CMS Model Beneficiary Creditable Coverage Disclosure Notice and the Online Disclosure to CMS Form, in the employer section of the Centers for Medicare & Medicaid Services (CMS) website at https://www.cms.gov/Medicare/Prescription-Drug-Co...

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