Anthem will be notifying Small Group and Large Group benefit administrators / Group Policy Holders about their current prescription drug coverage and their option to adjust their selection by contacting their Anthem representative.
Under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), employers are required to notify Medicare-eligible employees and retirees whether their prescription drug plan is considered “creditable” or “non-creditable” compared with the standard Medicare Part D prescription drug benefit. Anthem will be communicating also with Group Policy Holders who have enrollees in a Medicare Secondary plan regarding their responsibility under this mandate. The letter will note whether the plan is considered creditable or non-creditable under Medicare law.
What does creditable status mean?
- Creditable means that, on average, the plan is expected to pay out at least as much as the standard Medicare Part D prescription drug plan.
What does non-creditable status mean?
- Non-creditable means that, on average, the plan is not expected to pay out at least as much as the standard Medicare Part D prescription drug plan.
- We strongly encourage Medicare-eligible employees and retirees enrolled in a non-creditable drug plan to consider enrolling in Medicare Part D during the Medicare Annual Enrollment Period (AEP), which typically ends December 7 each year, to help avoid potential late enrollment penalties.
- Individuals who enroll later and keep non-creditable coverage for 63 days or longer may be subject to a late enrollment penalty (generally 1% per month for each month after the deadline). The penalty is added to their monthly premium.
Who will not receive creditable coverage letters?
- Medicare Supplement members insured through an employer group.
- Group members with non-supplemental policies secondary to Medicare.
Attachments / additional details
- These templates are for the Large Group Creditable (upstate / downstate) and Non-Creditable Notifications (upstate / downstate).
- 2027 New York Small Group ACA plans with non-creditable prescription drug benefits are outlined in this flyer (upstate / downstate). Plans not listed on the flyer are considered creditable.
Please contact your Anthem representative with any questions.