Creditable Coverage Requirements Under Medicare Modernization Act
for Medicare Part D Eligible Members
A mailing was sent before the start of the Open Enrollment period of October 15th to all Trust members with medical coverage 64 years of age and older and members who are Medicare eligible. All prescription drug plans offered through the Trust are "creditable", which means they are equal or better than the standard Medicare Part D plan.
The following letter, Notice of Creditable Coverage, was mailed out to applicable members. Another document, Frequently Asked Questions is available in the employee web portal as an resource of information. You can review or reprint the documents below by clicking on them.
The Medicare Modernization Act (MMA) requires entities (whose policies include prescription drug coverage) to notify Medicare eligible policyholders whether their prescription drug coverage is creditable coverage, which means that the coverage is expected to pay on average as much as the standard Medicare prescription drug coverage. For more information visit CMS.gov.
Medicare beneficiaries may incur a late enrollment penalty (LEP) if there is a continuous period of 63 days or more at any time after the end of the individual's Part D initial enrollment period during which the individual was eligible to enroll, but was not enrolled in a Medicare Part D plan and was not covered under any creditable prescription drug coverage. For more information on creditable coverage and on how an LEP is assessed, please see the Creditable Coverage and Late Enrollment Penalty webpage on CMS.gov.
If a Medicare beneficiary has been assessed a late enrollment penalty, they may use the Part D Late Enrollment Penalty (LEP) Reconsideration Request Form.