Employer Notice Requirements under Medicare Part D

The Medicare Modernization Act (MMA) requires Plan Sponsors whose health plans include prescription drug coverage to notify Medicare-eligible individuals of the Medicare creditable coverage status of such coverage. Coverage is considered creditable if it is expected to pay, on average, as much as the standard Medicare prescription drug coverage.  Plan Sponsors are subject to two disclosure requirements:

  • Annually, the Sponsor must provide a written disclosure notice to all Medicare-eligible individuals who are covered under its prescription drug plan. You are required to distribute these Notices are required on or before October 15, 2012 (and at other times stated in the regulations). The disclosure must be provided to Medicare-eligible
    1. active working individuals and their dependents,
    2. COBRA individuals and their dependents,
    3. disabled individuals covered under the Sponsor's prescription drug plan, and
    4. any retirees and their dependents

Because these individuals are often difficult to identify, we recommend that the Notice be distributed to all benefit eligible employees.


Since the MMA imposes a late enrollment penalty on individuals who do not maintain creditable coverage for a period of 63 days or longer following their initial enrollment period for the Medicare prescription drug benefit, this creditable coverage information is an essential consideration in an individual's evaluation of whether or not to enroll in a Medicare Part D prescription drug plan.

  • Plan Sponsors are also required complete the Online Disclosure to CMS Form to report the creditable coverage status of their prescription drug plan. The Disclosure must be completed annually no later than 60 days from the Plan's anniversary, within 30 days after termination of a prescription drug plan, or within 30 days after any change in the Plan's creditable coverage status. While this is a Plan Sponsor requirement, we are available to assist you as you determine if your Plan's prescription drug coverage is credible or non-credible.

In order to assist you in meeting your obligations under the Medicare law,  attached are WORD files for:


  1. Medicare Part D Fact Sheet
  2. Medicare Secondary Payor - Who Pays First
  3. Credible Coverage Notice
  4. Non-Credible Coverage Notice

If you have questions regarding completion of your Notice, please contact your Bollinger Representative for assistance.  

Bollinger offers the above information for the education of our clients. It is not intended to be legal, tax or actuarial advice.  If such advice is required, we strongly recommend that you consult with your current professional advisor or engage a licensed professional.