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Medicare & Medicare Part D


Medicare Part D

The Medicare Modernization Act (MMA) mandates that certain entities offering prescription drug coverage, including group health plan sponsors, must disclose to all Medicare eligible individuals with prescription drug coverage under the plan whether such coverage is creditable. The MMA also imposes a late enrollment penalty on individuals who do not maintain creditable coverage for any period of 63 days or longer following their initial enrollment period for the Medicare prescription drug benefit. This information is a key factor in retirees’ decision about whether to enroll in a Part D plan. Therefore, it is important that plan sponsors provide this information and communicate effectively with retirees to ensure that the retirees make informed and timely enrollment decisions.  Read more

CMS Issues Revised Guidance and Model Disclosure Notices for Part D Eligible Individuals for Use After January 1, 2009

[Creditable Coverage Guidance and Model Disclosure Notices to be used after January 1, 2009 (Jan. 5, 2009)] For copies:

http://www.cms.hhs.gov/CreditableCoverage/08_CCafterJanuary1.asp#TopOfPage

CMS has posted on its website revised guidance and model disclosure notices that are to be provided to Medicare Part D eligible individuals after January 1, 2009. The revisions reflect CMS's decision to eliminate one of the three model disclosure notices that previously had been made available--the model personalized disclosure notice--and to move the personalized information from this notice into the model creditable and non-creditable coverage disclosure notices. The revised guidance replaces an earlier document that was issued in 2007 .

While no other changes have been made to the substance of the remaining two model notices, they each now include an optional insert that can be completed in order to provide a personalized disclosure notice.

(Individuals may use personalized disclosure notices to demonstrate proof of prior creditable coverage when enrolling in a Part D plan.) The revised guidance recommends that this insert be completed if an individual requests a copy of a disclosure notice. In the alternative, however, a personalized statement of creditable coverage can be provided that contains the elements specified in the revised guidance.

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