Deadline Coming Up for Calendar Year Plans to Submit Medicare Part D Notice to CMS
As you know, group health plans offering prescription drug coverage are required to disclose to all Part D-eligible individuals who are enrolled in or were seeking to enroll in the group health plan coverage whether such coverage was “actuarially equivalent,” i.e., creditable. (Coverage is creditable if its actuarial value equals or exceeds the actuarial value of standard prescription drug coverage under Part D.) This notice is required to be provided to all Part D eligible persons, including active employees, retirees, spouses, dependents and COBRA qualified beneficiaries.
The regulations also require group health plan sponsors with Part D eligible individuals to submit a similar notice to the Centers for Medicare and Medicaid Services (“CMS”). Specifically, employers must electronically file these notices each year through the form supplied on the CMS website.
The filing deadline is 60 days following the first day of the plan year. If you operate a calendar year plan, the deadline is the end of February.
At a minimum, the Disclosure to CMS Form must be provided to CMS annually and upon the occurrence of certain other events including:
1) Within 60 days after the beginning date of the plan year for which disclosure is provided;
2) Within 30 days after termination of the prescription drug plan; and
3) Within 30 days after any change in creditable status of the prescription drug plan.
The Disclosure to CMS Form must be completed online at the CMS Creditable Coverage Disclosure to CMS Form web page at: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosureForm.html
The online process is composed of the following three step process: (1) Enter the Disclosure Information; (2) Verify and Submit Disclosure Information; and (3) Receive Submission Confirmation.
The Disclosure to CMS Form requires employers to provide detailed information to CMS including but not limited to, the name of the entity offering coverage, whether the entity has any subsidiaries, the number of benefit options offered, the creditable coverage status of the options offered, the period covered by the Disclosure to CMS Form, the number of Part D eligible individuals, the date of the notice of creditable coverage, and any change in creditable coverage status.
For more information about this disclosure requirement (instructions for submitting the notice), please see the CMS website for updated guidance at: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosure.html
As with the Part D Notices to Part D Medicare-eligible individuals, while nothing in the regulations prevents a third-party from submitting the notices (such as a TPA or insurer), ultimate responsibility falls on the plan sponsor.
Reminder: Form W-2 Reporting on Aggregate Cost of Employer Sponsored Coverage
Unless subject to an exemption, employers must report the aggregate cost of employer-sponsored coverage provided in 2012 on their employees’ Form W-2 (Code DD in Box 12) issued in January 2013. Please see IRS Notice 2012-9. See also our previous e-mail alerts dated September 22, 2011 as updated on April 13, 2012 for more information. If you did not receive or cannot locate these alerts or memoranda, please advise.
Alert: Employer Notice of Exchanges (Delayed)
The Affordable Care Act requires that employers must provide employees a notice regarding the upcoming availability of state insurance exchanges in their state for 2014. This new notice requirement falls under the Fair Labor Standards Act provisions, specifically FLSA section 18B, and until yesterday, the deadline imposed for this notice requirements was March 1, 2013.
However, yesterday FAQs were released stating that the exchange notice deadline is delayed. While these FAQs are located on the Department of Labor’s website, they state they were jointly prepared by the Departments of Labor, Health and Human Services (HHS), and the Treasury.
The FAQs are Q1 provide, in part, as follows: “The Department of Labor has concluded that the notice requirement under FLSA section 18B will not take effect on March 1, 2013 for several reasons. First, this notice should be coordinated with HHS’s educational efforts and Internal Revenue Service (IRS) guidance on minimum value. Second, we are committed to a smooth implementation process including providing employers with sufficient time to comply and selecting an applicability date that ensures that employees receive the information at a meaningful time. The Department of Labor expects that the timing for distribution of notices will be the late summer or fall of 2013, which will coordinate with the open enrollment period for Exchanges.”
The FAQs also address matters such as HRAs, fixed indemnity insurance and PCORI fees. Please see http://www.dol.gov/ebsa/faqs/faq-aca11.html for more information.
If you would like further information regarding the above matters, health care reform, or employee benefits in general, please feel free to contact our office. You can reach attorney Elizabeth Latchana at firstname.lastname@example.org or 517-377-0826.
Elizabeth H. Latchana specializes in employee health and welfare benefits. Recognized for her outstanding legal work, in both 2018 and 2015, Beth was selected as “Lawyer of the Year” in Lansing for Employee Benefits (ERISA) Law by Best Lawyers, and in 2017 as one of the Top 30 “Women in the Law” by Michigan Lawyers Weekly. Contact her for more information on this reminder or other matters at 517.377.0826 or email@example.com.