Small group creditable coverage status report
2025 small group creditable coverage status report (coming soon)
2024-2025 small group creditable coverage status report: If your plan year straddles 2024-2025, reference this report. It shows 2024 small group creditable coverage tested against 2025 Medicare Part D threshold amounts.
2024 small group creditable coverage status report
Individual and Medicare Supplement
We will continue to mail creditable coverage notices, as required under the MMA to individual and Medicare Supplement subscribers.
Medicare Part D testing options
Premera Blue Cross offers employers two options to support their Medicare Part D testing obligations. The testing tells if the pharmacy plan you offer meets the creditable coverage standard as compared with Medicare Part D.
The Centers for Medicare and Medicaid Services (CMS) says drug coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard Medicare prescription drug coverage.
Your choices for testing are:
- Premera can give you some of the data to do your own testing.
- Premera's underwriting team can do the testing for you, for a fee, using General Guidance methods.
The CMS website offers general information about Medicare Part D.
To learn more about Medicare Part D testing and to discuss your options, contact your producer or Premera account representative.
Important reminders
Premera no longer sends creditable coverage status notices to members on behalf of groups with pharmacy plans.
Employers will need to provide the notifications as required by the Medicare Modernization Act (MMA) to their Medicare-eligible employees and dependents. This act requires employers to let their Medicare-eligible employees and dependents know whether
the prescription drug coverage pays on average as much as the standard Medicare prescription drug coverage.
Additional information is found at the following pages of the Centers for Medicare & Medicaid Services:
Submission of CMS Medicare Part D Disclosure Form
Federal law requires employer groups to notify the Centers for Medicare and Medicaid Services (CMS) if their prescription drug coverage for Medicare beneficiaries is creditable. CMS requires employer groups to submit a creditable coverage disclosure form each year or upon any change that could affect whether the drug coverage offered is creditable.