Who Is Responsible For Providing The Notice Of Creditable Prescription Drug Coverage?

[Gary]

Who is responsible for providing the notice of creditable prescription drug coverage to medicare-eligible employees, the employer or GHP insurance company?

And, what should an employee do if neither one of those will provide it?

 

[JC]

Its your responsibility to get that to medicare to avoid the Late Enrollment Penalty. If your HR department won't provide you with a letter showing the dates you had employer coverage's I would try and get that from the insurance company itself. If neither of those will provide it try filing a complaint with Medicare.

 

[Gary]

Its your responsibility to get that to medicare to avoid the Late Enrollment Penalty. If your HR department won't provide you with a letter showing the dates you had employer coverage's I would try and get that from the insurance company itself. If neither of those will provide it try filing a complaint with Medicare.

Thanks!

I tried to get that from the insurer (New Mexico Health Connections), but unbelievably they have told me they don't even know what it is! They have already sent me a letter showing that I had insurance (no details about prescription drug coverage), but I explained that it was not what I needed. On the last of my 3 phone calls, they wanted to send me the same wrong letter, but I explained that was not what I needed, refused to let them hang up, and asked to speak to someone else. So, I got a supervisor who said she would research it and call me back. I'm still waiting.

But that was when I thought it was the legal requirement per the MMA was on the insurance company. Whoops!

In researching this I found out that it's the employer's responsibility (legally), but most insurance companies provide this to the employers as a service. Figuring out what is "creditable coverage" for a PDP can be a little beyond the expertise of a small company's HR person. Our office manager didn't have a clue. So, I worked with my office manager to get me the notice. This was actually a good thing because she didn't know that our company also had to provide a notice to CMS each year by March 1, so I helped her get that done for both 2016 and 2017. For 2016 it will be late, but we figured it's "better late than never".

If I can get my Part C started soon (that's the other thread) I guess I won't need this proof of coverage, but I'll have it if it's needed.

 

[JC]

Thanks!

I tried to get that from the insurer (New Mexico Health Connections), but unbelievably they have told me they don't even know what it is! They have already sent me a letter showing that I had insurance (no details about prescription drug coverage), but I explained that it was not what I needed. On the last of my 3 phone calls, they wanted to send me the same wrong letter, but I explained that was not what I needed, refused to let them hang up, and asked to speak to someone else. So, I got a supervisor who said she would research it and call me back. I'm still waiting.

But that was when I thought it was the legal requirement per the MMA was on the insurance company. Whoops!

In researching this I found out that it's the employer's responsibility (legally), but most insurance companies provide this to the employers as a service. Figuring out what is "creditable coverage" for a PDP can be a little beyond the expertise of a small company's HR person. Our office manager didn't have a clue. So, I worked with my office manager to get me the notice. This was actually a good thing because she didn't know that our company also had to provide a notice to CMS each year by March 1, so I helped her get that done for both 2016 and 2017. For 2016 it will be late, but we figured it's "better late than never".

If I can get my Part C started soon (that's the other thread) I guess I won't need this proof of coverage, but I'll have it if it's needed.

You may need that letter to avoid any Late enrollment penalties

 

[Gary]

Got it, thanks!

 

[Josh Carter]

Also, if your former employer went through a health insurance brokerage firm, often times those firms are able to request documents.

Whenever I need those docs for one of my new clients, that is always the first thing I check.