New York Information for Alternative Method of Counting Creditable Coverage

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US-334EM
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Description

This form is used by an entity to request additional information to determine an individual's coverage with respect to a category of benefits.

How to fill out Information For Alternative Method Of Counting Creditable Coverage?

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FAQ

Electronic DeliveryPlan sponsors may send Medicare Part D notices electronically under certain circumstances. CMS has stated that health plan sponsors may follow the electronic disclosure standards under U.S. Department of Labor regulations.

Notices of creditable/non-creditable coverage may be included in annual enrollment materials, sent in separate mailings or delivered electronically.

A certificate of Creditable Coverage (COCC) is a document provided by your previous insurance carrier that proves that your insurance has ended. This includes the name of the member to whom it applies as well as the coverage effective date and cancelation date.

Creditable coverage is a health insurance or health benefit plan that meets a minimum set of qualifications. Some examples include group and individual health plans, student health plans, and government-provided plans.

The Notice of Creditable Coverage works as proof of your coverage when you first become eligible for Medicare. Those who have creditable coverage through an employer or union receive a Notice of Creditable Coverage in the mail each year. This notice informs you that your current coverage is creditable.

Employers must provide creditable or non-creditable coverage notice to all Medicare eligible individuals who are covered under, or who apply for, the entity's prescription drug plan (Part D eligibles), whether active employees or retirees, at least once a year.

At a minimum, the CMS creditable coverage disclosure notice must be provided at the following times: Within 60 days after the beginning date of the plan year for which the entity is providing the form; Within 30 days after the termination of the prescription drug plan; and.

Non-creditable coverage: A health plan's prescription drug coverage is non-creditable when the amount the plan expects to pay, on average, for prescription drugs for individuals covered by the plan in the coming year is less than that which standard Medicare prescription drug coverage would be expected to pay.

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New York Information for Alternative Method of Counting Creditable Coverage