Part D Notifications - From the Desk of Allison Johnson
(Posted on 10/09/23)
Welcome to Fall in NJ- it’s 80 degrees out, and 4 million notifications are required to be submitted in the near future.
We’ll start with Medicare Part D since that one is up next.
I promise it’s not as bad as the flood of questions makes it seem. The carriers send out notifications to the groups, so all the groups have to do is send out the completed sample notice, which you can find on the CMS website. As always, the best recommendation is to send it to all employees since you never know who has a Medicare eligible dependent.
Groups also need to confirm their status with CMS, which is done in the same link as the sample letters. They have super detailed instructions, and it’s not very difficult, so that should be no problem for your clients.
Horizon has once again confirmed that all of their small group ACA plans are creditable. There are only two cards on pre-ACA plans that are not creditable, and groups have been sent notification. Oxford does not publish a list of creditable plans, but you can use the tool UHC releases to determine a group’s status.
Let’s revisit the questions that come up every year. The most common is always “If I drop the Rx coverage, can I re-enroll?” The answer to that is that members can return to the group plan at open enrollment, or if they experience a triggering event. We also get a lot of “Is there coordination of benefits with the group plan and Part D?” Generally, Rx plans don’t have coordination of benefits, so you could have both, but it doesn’t really benefit you.
I’m sure that we’ll experience the same thing as we do every year- a myriad of questions for a couple of weeks, and then we put it to rest until next year. But as always, if you need help, please reach out to our team!
We’ll start with Medicare Part D since that one is up next.
I promise it’s not as bad as the flood of questions makes it seem. The carriers send out notifications to the groups, so all the groups have to do is send out the completed sample notice, which you can find on the CMS website. As always, the best recommendation is to send it to all employees since you never know who has a Medicare eligible dependent.
Groups also need to confirm their status with CMS, which is done in the same link as the sample letters. They have super detailed instructions, and it’s not very difficult, so that should be no problem for your clients.
Horizon has once again confirmed that all of their small group ACA plans are creditable. There are only two cards on pre-ACA plans that are not creditable, and groups have been sent notification. Oxford does not publish a list of creditable plans, but you can use the tool UHC releases to determine a group’s status.
Let’s revisit the questions that come up every year. The most common is always “If I drop the Rx coverage, can I re-enroll?” The answer to that is that members can return to the group plan at open enrollment, or if they experience a triggering event. We also get a lot of “Is there coordination of benefits with the group plan and Part D?” Generally, Rx plans don’t have coordination of benefits, so you could have both, but it doesn’t really benefit you.
I’m sure that we’ll experience the same thing as we do every year- a myriad of questions for a couple of weeks, and then we put it to rest until next year. But as always, if you need help, please reach out to our team!
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