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MODEL INDIVIDUAL CREDITABLE COVERAGE DISCLOSURE NOTICE LANGUAGE FOR USE ON OR AFTER APRIL 1, 2011, OMB 0938-0990 Important Notice from Insert School Name About Your Prescription Drug Coverage and
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What is model individual creditable coverage?
Model individual creditable coverage is a form that provides information on an individual's health coverage.
Who is required to file model individual creditable coverage?
Employers and insurers providing health coverage to individuals are required to file model individual creditable coverage.
How to fill out model individual creditable coverage?
Fill out the form with accurate information on the individual's health coverage and submit it to the appropriate regulatory body.
What is the purpose of model individual creditable coverage?
The purpose of model individual creditable coverage is to inform individuals about the creditable nature of their health coverage.
What information must be reported on model individual creditable coverage?
Information such as the type of health coverage, dates of coverage, and whether the coverage is creditable or not must be reported on model individual creditable coverage.
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