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HEALTH PLAN NOTICES TABLE OF CONTENTS 1. 2. 3. 4. 5. 6. 7. 8. New Health Insurance Marketplace Coverage Options and Your Health Coverage Medicare Part D Creditable Coverage Notice HIPAA Comprehensive
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01
Gather all necessary information such as plan details, coverage dates, and prescription drug coverage.
02
Fill out the form accurately ensuring all required fields are completed.
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Review the completed form for any errors or missing information.
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Submit the form to the appropriate entity by the specified deadline.

Who needs creditable coverage disclosure to?

01
Employers who offer health insurance coverage to their employees.
02
Insurance companies providing prescription drug coverage.
03
Individuals who are eligible for Medicare.
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Creditable coverage disclosure is provided to individuals who are eligible for Medicare Part D to inform them whether the prescription drug coverage is creditable.
Employers or plan sponsors who offer prescription drug coverage to Medicare-eligible individuals are required to file creditable coverage disclosure.
Creditable coverage disclosure can be filled out online through the Centers for Medicare and Medicaid Services (CMS) website or by contacting the CMS directly for instructions.
The purpose of creditable coverage disclosure is to provide information to Medicare-eligible individuals about the prescription drug coverage offered by their employer or plan sponsor.
The creditable coverage disclosure must include details about the prescription drug coverage, such as whether it is creditable or non-creditable, the coverage period, and any other relevant information.
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