January 2026
Paul Van Brunt, Associate Director Benefits Compliance
Employers that offer any prescription drug coverage under a group health plan must disclose each plan option’s creditable or non-creditable status to the Centers for Medicare and Medicaid Services (“CMS”) every year. This disclosure is due within 60 days of the start of each plan year (for calendar year plans, by March 1, 2026), and again within 30 days after any change in creditable status or upon termination of the prescription drug plan. The disclosure is submitted through CMS’s online form.
CMS uses these employer attestations to help determine whether Medicare eligible individuals may owe a late enrollment penalty if they delay Part D. While CMS does not currently impose a direct employer penalty for failing to file (except that noncompliant retiree plans cannot receive the Retiree Drug Subsidy), employers still face ERISA fiduciary duty exposure and employee relations risks if the disclosures and related notices are not handled properly.
Employer Action Items
- Confirm creditable status for each Rx option: Benefit booklets, including annual notices from The Baldwin Group, include applicable creditable and/or non-creditable disclosure notices.
- Submit the CMS disclosure for the current plan year: Calendar-year plans must complete the CMS online disclosure by March 1. Employers should retain screenshots or confirmation records for audit purposes.
- Prepare information in advance: Before you log into the CMS online form, gather the items CMS requests—organization name and EIN, address and phone, coverage type, number of Rx options, plan year dates, number of Medicare eligible individuals, and the date Part D notices were provided.
Additional Information and Resources
- CMS Creditable Coverage Guidance
- The Baldwin Group Guide to CMS Reporting (Instructions with Screenshots)
For more information
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