Reporting Creditable Coverage: The Two Part D Disclosures Employers Owe

6 min read

Two Separate Disclosures, Two Different Deadlines

Disclosure	Goes To	Deadline
Creditable coverage notice	Medicare-eligible individuals covered by, or eligible for, the plan	Before October 15 each year
Online Disclosure to CMS	CMS, through its online form	Within 60 days of the start of the plan year

The notice to individuals is pinned to October 15 because that is when Medicare open enrollment opens — the point at which the information becomes actionable for the recipient. It does not move with your plan year.

For a longer view of cost, see how a year-round health and cost strategy works between renewals.

The CMS disclosure does move with your plan year. Sixty days from the start means a calendar-year plan reports by around March 1, while a plan year beginning July 1 reports by around August 30. Two further filings are required outside that cycle: within 30 days of terminating drug coverage, and within 30 days of any change in whether your coverage is creditable.

What Creditable Actually Means

Coverage is creditable if it is expected to pay, on average, at least as much as standard Part D coverage. That is an actuarial test, and the answer comes from your carrier or an actuary. An employer cannot determine it by reading the plan document, and should not assume it.

The point worth underlining: creditable status can change without your plan changing. The test compares your plan against the Part D benefit, so when Part D itself is redesigned, a plan that was creditable can become non-creditable while its own terms stay identical. Confirming status with the carrier each year is the only reliable approach, and it is also what the 30-day change filing exists to capture.

Why the Notice Matters More to Employees Than to You

There is no specific fine on an employer for missing the October 15 notice. The harm lands on the individual. Someone who goes 63 days or more without creditable drug coverage and later enrolls in Part D pays a late-enrollment penalty, and that penalty is permanent — it is added to their Part D premium for as long as they hold the coverage.

That asymmetry is the reason to take the notice seriously rather than the reason to relax about it. An employee who was never told, and is then assessed a lifetime penalty, has a reasonable grievance with their employer even where no statutory penalty applies.

Practical Handling

• Send the notice to your whole covered population rather than trying to identify who is Medicare-eligible — eligibility can arise through disability or a covered spouse, and you will not reliably know.
• CMS publishes model notices in creditable and non-creditable versions; use the one matching your carrier’s determination.
• Get the creditable-coverage determination in writing from the carrier each year, and diarize the 30-day filing in case it changes.
• Fold the notice into your open enrollment mailing only if enrollment closes before October 15 — otherwise send it separately.
• Keep a record of what was sent and when. There is no filing to evidence the notice, so your own records are the only proof it went out.

Neither disclosure is difficult, and both are easy to let slip because nothing happens immediately when they do. If you would like the calendar and the carrier determination handled alongside your other filings, our compliance support covers both.

Questions We Get

What is creditable coverage?

Prescription drug coverage is creditable if it is expected to pay, on average, at least as much as standard Medicare Part D coverage. The determination is actuarial, and it comes from your carrier or an actuary — not from the employer.

How do I report my creditable coverage to CMS?

Through the Online Disclosure to CMS Form, which must be completed within 60 days of the start of each plan year. A calendar-year plan therefore reports by around March 1. You must also file within 30 days of terminating drug coverage, and within 30 days of any change in whether the coverage is creditable.

When is the Medicare Part D notice due to employees?

Before October 15 each year, ahead of Medicare open enrollment. Unlike the CMS disclosure, this date does not move with your plan year — it is October 15 regardless of when your plan year begins.

Who has to receive the Part D notice?

Every Medicare-eligible individual covered by, or eligible for, your prescription drug plan. That includes active employees, their covered spouses and dependents, COBRA participants, disabled individuals on the plan, and retirees. Because employers rarely know who is Medicare-eligible, most send it to the entire covered population.

Who decides whether our coverage is creditable?

The carrier or an actuary. An employer cannot make this determination by inspection, and it has moved for some plans as the Part D benefit itself changed — coverage that was creditable in one year is not automatically creditable in the next.

What happens if we do not send the notice?

There is no specific statutory fine on the employer for missing the notice. The consequence falls on the employee: someone who goes 63 days or more without creditable coverage and later enrolls in Part D faces a permanent late-enrollment penalty. Employers who fail to notify tend to find out when an employee is assessed that penalty and asks why they were not told.

Is any employer exempt?

There is no participant-count exemption — a plan with a handful of covered lives owes both disclosures. Entities receiving the Retiree Drug Subsidy are exempt from the CMS online disclosure, though not from the notice to individuals.

Other annual compliance deadlines: ACA Affordability Percentage for 2026 and 2027 · PCORI Fees: What Employers Owe and When · 2026 and 2027 HDHP and HSA Limits · What Is the Gag Clause Attestation? · Retiree HRAs, Medicare HRAs and Spousal Incentive Arrangements · Qualified Health Coverage (QHC) Letters

Unhappy with your current broker? Switch to CFH. Your employees won’t notice. You will.

For a plain-language walkthrough of the notice, the CMS disclosure and who decides, see Certificate of Creditable Coverage: Medicare Part D Notices.

Also from CFH: Compliance Administration · Group health insurance in Lewiston, MI · Group Vision Insurance: A Buyer’s Guide for Michigan Employers · Medicare Rules for Employer Health Plans

Where the Rules Come From

The laws named in this article link to the statute or regulation they come from. This is general information, not legal or tax advice, and rules change, so check the current text.