Medicare Part D Notices required by 10/14
- Tuesday, 23 August 2016 06:34
Each year, Medicare Part D requires group health plan sponsors to disclose to individuals who are eligible for Medicare Part D and to the Centers for Medicare and Medicaid Services (CMS) whether the health plan’s prescription drug coverage is creditable. Plan sponsors must provide the annual disclosure notice to Medicare-eligible individuals before Oct. 15, 2016-the start date of the annual enrollment period for Medicare Part D. CMS has provided model disclosure notices for employers to use.
You’ll be surprised at how much this one mistake can cost you
- Tuesday, 24 May 2016 11:19
From Employee Benefit Advisor
There has been a long-standing rule that employers are prohibited from offering an incentive of any kind to an individual who is Medicare-eligible to enroll in Medicare in lieu of the employer’s group health plan. Encouraging your older employees to leave your plan and financially incenting them to do so can cost you – big time.
While there are fines that can be assessed for encouraging or enticing the employee to take Medicare ($5,000 per situation), the bigger “hit” is the bill for claims that Medicare paid as primary versus what they should have paid as secondary. This claim can typically be for a scary big amount; representing what the carrier (if fully-insured) or employer (if self-funded) must repay Medicare for the discovered individuals.
The IRS and CMS, in a joint data-matching program, are mailing out demand for payment letters. “Nearly every employer who has received one of these letters is usually in shock at the amount demanded that they (or the carrier) repay. Often your client is pointing the finger at you for suggesting that Bob (who turned 65 last year and is one of the reasons their renewal was so high) go on Medicare and encouraged them to pay for his Med Supp and Part D plan premium (which you probably handled for Bob, too).”
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CIGNA banned from Medicare Sales
- Monday, 08 February 2016 16:43
Cigna was temporarily banned from marketing its Medicare products to new customers, after the U.S. found deficiencies in how the health insurer ran its plans, citing widespread violations that the government said threatened patients’ health. This means that existing customers can keep their policies but no new customers can be brought on board.
I appears this relates more to the Medicare Advantage plans than Prescription Plans.
It will remain to be seen if this impacts the pending merger with Anthem Health.