Oct. 15 Deadline for Medicare Part D Coverage Notices
Employers must notify Medicare-eligible policyholders if their prescription drug coverage is credible or not.
2025 brings significant change to the determination of credibility.
Here's the math:
.17 (17% penalty) × $34.70 (Base beneficiary premium) = $5.90
$5.90 = Mrs. Martinez's monthly late enrollment penalty for 2025
Who Must Comply
The disclosure requirements apply generally to employers sponsoring group health plans that offer prescription drug coverage to Medicare-eligible individuals.
Model notices/templates
These model notices may be used to satisfy this requirement, issued by the Centers for Medicare & Medicaid Services.
Medicare Part D – Creditable Coverage Disclosure Notice Template - [View]
Non-Creditable Coverage Disclosure Notice Template - [View]
Information Required
Notifies Medicare-eligible individuals whether the plan's prescription drug coverage is creditable coverage, meaning the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage.
Note: Individuals who do not maintain creditable coverage for 63 days or longer following their initial enrollment period for Medicare Part D may be required to pay a late enrollment penalty. Accordingly, this information is essential to the decision to enroll in a Medicare Part D prescription drug plan.
Who it must be provided to
Medicare-eligible active employees and their dependents
Medicare-eligible COBRA individuals and their dependents
Medicare-eligible disabled individuals covered under the prescription drug plan
Any retirees and their dependents
Who it must be provided by
Employers who sponsor group health plans that offer prescription drug coverage to Medicare-eligible individuals.
When it is Due
Prior to the annual enrollment period for Medicare Part D that begins on Oct. 15th
Prior to an individual's initial enrollment period for Medicare Part D
Prior to the effective date of enrolling in the employer's prescription drug plan and upon any change that affects whether the coverage is credible
Upon request by the individual
Online disclosure to the Centers for Medicare & Medicaid Services is also required annually, no later than 60 days from the beginning of a plan year, within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status.
Vendor Management Tips for Small Businesses
- Review contracts. It’s essential to create and review formal contractual documentation while working with vendors. This keeps your business and the vendor on the same page and accountable for any communication or financial transactions. Expectations can be built into the terms of the contract and mutually agreed upon before the partnership is finalized.
- Put all terms in writing. To avoid costly and time-consuming disagreements, put all terms and agreements between your small business and vendors in writing. This could include agreements regarding quality control, delivery times and communication expectations.
- Communicate regularly. Getting to know your vendors is crucial; this means you must communicate with them on a regular basis. Respond to vendor communications quickly and address any issues in a timely manner. The more effective the communication lines are, the better the experience will be for both parties.
- Be selective. Every time a small business chooses to outsource, it has to navigate the risk of doing so. Therefore, it’s beneficial to avoid high-risk collaborations, such as those with vendors who process financial transactions on the organization’s behalf. Creating a framework and policies regarding potential issues to mitigate risks can also be advantageous.
- Control costs. Before committing to working with a vendor, verify that its pricing does not exceed your organization’s budget. All details about pricing, such as payment methods, billing frequency and rates, should be laid out in advance in the agreement between the vendor and the small business.
[New Blog] - Celebrating Long-Term Dedication at Motion Connected
Consolidations Appropriations Act Update
In February of 2023 the DOL, HHS and Treasury Department issued initial FAQ’s on the prohibition of gag orders in order to expand the transparency efforts of the Consolidations Appropriations Act. The intent of this law is to ensure that interested parties, such as health plan participants, health providers and the like, have access to cost and quality care information allowing such parties to access the identified information and allowing the sharing of such information with business associates.
The CAA Prohibition on Gag Clauses provision now requires an annual Gag Clause Prohibition Compliance Attestation (GCPCA) due no later than Dec. 31.
The gag clause prohibition and attestation requirements apply broadly to all health insurance issuers and group plan sponsors offering fully insured, level-funded or self-funded (ASO) coverage in the group and individual markets, including grandfathered and transitional relief plans, student health plans, individual coverage offered through an association, ERISA plans, non-federal governmental plans, and church plans.
For fully insured plans, the insurance carrier is completing the attestation on behalf of the group plan sponsor. If you are a self-funded or level-funded client, Forsite Benefits will be fulfilling the attestation requirement on your behalf this year. If you would like to opt out of this offer and fulfill the obligation yourself, please let us know by 10/10/2024.
Report: Employee Happiness Declining in 2024
- Construction remained the industry with the highest happiness index.
- Nonprofits and construction were the only industries to experience only slight increases during Q2, while other industries displayed significant decreases.
- Technology reached its four-year low in Q2, attributed to inflation and persistent layoffs in recent years.
- Restaurant, food and beverage workers continue to struggle with heat-related illnesses and fatigue during the summer months.
- Health care’s score dropped 7% from Q1, with many workers citing compensation as their leading cause of dissatisfaction.
USCIS Extends Form I-9 Expiration Date
Recently, the U.S. Citizenship and Immigration Services (USCIS) announced that it updated its Employment Eligibility Verification form, also known as Form I-9, to extend the form’s expiration date from July 31, 2026, to May 31, 2027.
Employers must use the Form I-9 dated “08/01/2023,” which may have an expiration date of either “07/31/2026” or “05/31/2027.” Employers may use either form until its respective expiration date. However, the USCIS’ website will only include the Form I-9 with the new “05/31/2027” expiration date for downloading.
Background
On Aug. 1, 2023, the USCIS published a new version of the Form I-9 that employers were required to use beginning on Nov. 1, 2023. Some of the most notable changes included the following:
- Sections 1 and 2 were reduced to a single sheet; all previous fields remained, but some fields were merged.
- The preparer/translator certification area was moved to a standalone supplement that employers can use as necessary for initial verification or recertification.
- Section 3 (Reverification and Rehire sections) was moved to a standalone supplement that employers can use as necessary.
- The list of acceptable documents now includes some acceptable receipts, guidance and links to information on automatic extensions of employment authorization documentation.
The new Form I-9 includes updated instructions. These instructions were condensed from 15 to eight pages and contained additional definitions, streamlined processes, and an explanation of how to use the new checkboxes to indicate when Form I-9 documents were examined remotely.
More Information
Employers can find additional resources by visiting the USCIS’ I-9 Central or joining a free Form I-9 webinar. Employers may access the most current version of the form here.
Federal District Court Blocks the FTC's Noncompete Ban
On Aug. 20, 2024, the U.S. District Court for the Northern District of Texas issued an order blocking the Federal Trade Commission’s (FTC) noncompete ban, which had a scheduled effective date of Sept. 4, 2024. The court had previously put the noncompete ban on hold in this case (Ryan LLC v. FTC), but only for plaintiffs. The most recent ruling blocks the ban for all employers and prevents the ban from taking effect on Sept. 4, 2024, or thereafter.
Background
On May 7, 2024, the FTC published a final rule prohibiting employers from entering into or enforcing noncompete clauses with most employees. Subject to very limited exceptions, the final rule provided that:
- The use of noncompete clauses would be banned as of the effective date.
- Any existing noncompete clauses (other than those entered into with senior executives) would be invalidated.
- Employers would have to notify all employees (other than senior executives whose existing noncompete agreements would remain enforceable) that their existing noncompete agreements would not be enforced.
The enforceability of noncompete clauses is currently determined by state and local legislatures and courts. Instead, the FTC rule would have governed the enforceability of noncompete clauses at the federal level and superseded any less restrictive state laws or judicial interpretations.
Current Impact
In light of the Texas court’s ruling, employers will not need to take steps in the immediate term to invalidate existing noncompetes, update agreements or issue notices. Employers may also continue to rely on state-level guidance regarding the enforceability of noncompetes. However, the FTC will likely appeal the ruling, so employers should continue to monitor for updates in this case.