Plan sponsors are required to disclose to the Centers for Medicare & Medicaid Services (CMS) whether their prescription drug coverage is creditable. The disclosure must be made to CMS on an annual basis, or upon any change that affects whether the coverage is creditable.
CMS Disclosure Requirements
At a minimum, the CMS creditable coverage disclosure notice must be provided at the following times:
- Within 60 days after the beginning of the plan year for which the entity is providing the form;
- 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.
The deadlines for all plan years ending in 2022 are set forth in the following table. For plan sponsors with calendar year plans, the deadline to comply with the annual disclosure requirement is March 1, 2022.
| Plan Year Begin Date | Disclosure Deadline | Plan Year Begin Date |
Disclosure Deadline |
| January 1 | March 1 | July 1 | August 29 |
| February 1 | April 1 | August 1 | September 29 |
| March 1 | April 29 | September 1 | October 30 |
| April 1 | May 30 | October 1 | November 29 |
| May 1 | June 29 | November 1 | December 30 |
| June 1 | July 30 | December 1 | January 29 |
Online Disclosure Method
Plan sponsors are required to use the online disclosure form on the CMS’ creditable coverage website (the disclosure form and instructions are available here and here, respectively). This is the sole method for compliance with the disclosure requirement, unless the entity does not have Internet access.
The disclosure form lists the required data fields that must be completed in order to generate the disclosure notice to CMS, such as types of coverage, number of options offered, creditable coverage status, period covered by the disclosure notice, number of Part D-eligible individuals covered, date the creditable coverage disclosure notice is provided to Part D-eligible individuals and change in creditable coverage status. CMS has also provided instructions for detailed descriptions of these data fields and guidance on how to complete the form.
ADDITIONAL INFORMATION
Please contact your Burnham Benefits Consultant or Burnham Benefits at 949‐833‐2983 or inquiries@burnhambenefits.com.
Burnham Benefits does not engage in the practice of law and this publication should not be construed as the providing of legal advice or a legal opinion of any kind. The consulting advice we provide is intended solely to assist in assessing its compliance with the Patient Protection and Affordable Care Act and other applicable federal and state law requirements, and is based on Burnham Benefit’s interpretation of federal guidance in effect as of the date of this publication. To the best of our knowledge, the information provided herein, and assumptions relied on, are reasonable and accurate as of the date of this publication. Furthermore, to ensure compliance with IRS Circular 230, any tax advice contained in this publication is not intended to be used, and cannot be used, for purposes of (i) avoiding penalties imposed under the United States Internal Revenue Code or (ii) promoting, marketing or recommending to another person any tax-related matter.