Employers sponsoring a group health plan (whether insured or self-insured) need to report information on the creditable (or non-creditable) status of the plan’s prescription drug coverage to the Centers for Medicare and Medicaid Services (“CMS”).

In order to provide this information, employers must access CMS’s online reporting system at: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosureForm.html.

As a reminder, notice must be provided by the following deadlines:

  • Within 60 days after the beginning date of each plan year;
  • Within 30 days after the termination of the prescription drug plan; and
  • Within 30 days after any change in the creditable coverage status of the prescription drug plan.

For example, an employer with a calendar year plan (January 1 – December 31, 2025) must complete this reporting no later than March 1, 2025.

If there was a change in the creditable coverage status of a prescription drug plan offered by the employer (e.g., from creditable to non-creditable, or vice versa), notice should be provided to CMS within 30 days of the change. For example, if a change occurred in connection with the January 1, 2025 plan year, CMS should be notified by January 31, 2025.

Employer Action

  • For calendar year 2025 plans, timely complete reporting with CMS. For non-calendar year plans, timely complete reporting with CMS following the start of your 2025 plan year.
  • You will need to have the following information ready to include when you complete the CMS online reporting:
    • The creditable (or non-creditable) status of prescription drug coverage provided by all plan options available to employees.
    • The date that the annual creditable (or non-creditable) coverage notice was furnished to Part D eligible individuals. You may have included this notice with open enrollment materials or sent it following the start of the plan year.
    • An estimate of the number of Medicare Part D eligible individuals covered under the plan. This does not have to be an exact number.

Additional resources for completing the form are available at:

This document is designed to highlight various employee benefit matters of general interest to our readers. It is not intended to interpret laws or regulations, or to address specific client situations. You should not act or rely
on any information contained herein without seeking the advice of an attorney or tax professional. © My Benefit Advisor. All Rights Reserved. CA Insurance License #0G33244

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