Send Medicare Part D by October 15, 2019

As the sponsor of your group’s health and prescription plan, businesses must notify each employee who is participating in your plan whether their prescription coverage is credible or non-credible for Medicare Part D, according to the Centers for Medicare & Medicaid Services (CMS).

Notification must be made by October 15, 2019.

  • Click Medicare Part D info, or copy and paste the link below to a Model Disclosure form for Credible and Non-Credible Coverage. Use the model disclosure form as a template for notifying your covered employees.

  • Your current renewal package will contain information about the credibility of your prescription benefit with your health insurance plan.

About Medicare Part D – Prescription Drug plans

Open Enrollment for the Medicare Part D prescription drug plan begins October 15, 2019 and runs through December 7, 2019.  Employees and their dependents that are over age 65 or on Medicare due to a disability may defer enrollment in the Medicare Part D drug plan if they have credible coverage under the group’s health and prescription plan.  Coverage is considered credible if the actuarial value of the plans coverage equals or exceeds the actuarial value of the standard prescription drug coverage under Medicare Part D.

At a minimum, disclosure to CMS must be made at the following times:

1)     For plan years that end in 2007 and beyond, disclosure of credible coverage status must be provided within sixty (60) days after the beginning date of the plan year for which the entity is providing the disclosure to CMS.

2)     Within thirty (30) days after the termination of the prescription drug plan; and

3)     Within thirty (30) days after any change in the credible coverage status of the prescription drug plan.

The CMS provisions ALSO REQUIRE that employers who provide group health plans with prescription coverage to eligible employees must disclose to CMS if the coverage is ‘credible prescription drug coverage’. The disclosure must be submitted via an electronic form on the CMS website at:

Should you have any questions, please feel free to contact your Starr Group representative: (414) 421-3800