Organizations that offer group prescription drug plans must notify their Medicare-eligible members each year with either a Notice of Creditable Coverage or a Notice of Non-Creditable Coverage.
Letters must be sent this year by October 15, 2012, a month earlier than required last year.
Federal Requirement
- The federal Medicare Modernization Act requires entities to let Medicare-eligible policyholders know wether their prescription drug coverage is considered “creditable coverage,” meaning it is expected to pay out as much as standard medicare prescription coverage, or is not creditable. Complete details are in the Creditable Coverage section of the federal Centers for Medicare and Medicaid Services.
Model Notice Letters: You can download the PDF templates with sample text. As an AFG client, these letters are provided in each open enrollment kit that goes to your employees. If you’re renewal is after October 15, 2012, you must provide these letters to employees
Creditable Coverage Standards: To determine if the 2012 and 2013 prescription plans offered meet the creditable coverage standards established by CMS, check out the documents available on the group and agent areas of bcbsm.com. The documents provide a rating of “pass” or “fail” for most benefit packages
Individual Members: CMS also requires notices for individual members. Blue Cross® Blue Shield® of Michigan will mail a Notice of Creditable Coverage to each direct billed subscriber before Oct. 15, 2012. The letter instructs subscribers to contact Customer Service with their questions.
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