Pharmacy Creditability - Employer Required Notice to Employees

Health Net is mailing an important reminder to employer groups about a CMS notice they must provide their employees by October 15, 2023: Pharmacy plan creditable coverage.

Employers must send this notice to their employees in the coming weeks, if they haven't already. We are mailing a letter to employer groups to inform them about this notice requirement. Employers may use the CMS model notices referenced in the letter. So you have the details you need when meeting with your clients, we have recapped the notice requirement here.

Pharmacy Plan Creditable Coverage Notification

Employer groups who provide prescription drug coverage through a group-sponsored health plan have to notify Medicare-eligible employees of the creditability status of their pharmacy plan.

Health Net has assessed its 2023–2024 pharmacy plans for creditability. Most are creditable, but some do not meet the actuarial value of the standard Medicare Part D benefit. We are sending our group customers a list of pharmacy plans that are not creditable so they know what to tell employees, along with details for filing the Medicare-required "Online Disclosure to CMS Form." A list of the non-creditable pharmacy plans can be found under "Pharmacy Resources" in the broker and employer portals for future reference.

You can find more information on creditable coverage, along with the CMS Model Beneficiary Creditable Coverage Disclosure Notice and the Online Disclosure to CMS Form, in the employer section of the Centers for Medicare & Medicaid Services (CMS) website at https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/index.html.

Questions?

Please call your Health Net representative with any questions. You can also contact our Account Services Unit at 1-800-547-2967.