Forms

The following forms are for use by clients of The Reschini Group. If you have questions about the forms, please  contact Doug Gradwell at dgradwell@reschini.com or 800-442-8047.

Model Individual Coverage Disclosure Notice Language

MODEL INDIVIDUAL CREDITABLE COVERAGE DISCLOSURE NOTICE LANGUAGE
EDITABLE MS WORD DOCUMENT – FOR USE ON OR AFTER APRIL 1, 2011

MODEL INDIVIDUAL NON-CREDITABLE COVERAGE DISCLOSURE NOTICE LANGUAGE
EDITABLE MS WORD DOCUMENT – FOR USE ON OR AFTER APRIL 1, 2011

Medicare Part D Enrollment Period Change

The Patient Protection and Affordable Care Act (PPACA) amended the Social Security Act to move the Medicare Part D annual enrollment period to October 15 through December 7. CMS issued revised model disclosure forms to update the new dates. These notices can be found at http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/Model-Notice-Letters.html

Also, please remember to disclose to the Center for Medicare & Medicaid Services whether your prescription drug coverage is “creditable”. You can find the form on the CMS Creditable Coverage Disclosure Web Page at https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosureForm.html.  Sponsors must complete this form within 60 days after the beginning date of your plan year. More information is available on this website.

If you have any questions, please contact Doug Gradwell at dgradwell@reschini.com or 800-442-8047.