Wisconsin Information for Alternative Method of Counting Creditable Coverage

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US-334EM
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Description

This form is used by an entity to request additional information to determine an individual's coverage with respect to a category of benefits.

How to fill out Information For Alternative Method Of Counting Creditable Coverage?

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FAQ

A certificate of Creditable Coverage (COCC) is a document provided by your previous insurance carrier that proves that your insurance has ended. This includes the name of the member to whom it applies as well as the coverage effective date and cancelation date.

Creditable coverage is a health insurance, prescription drug, or other health benefit plan that meets a minimum set of qualifications. Types of creditable coverage plans include group and individual health plans, and student health plans, as well as a variety of government-sponsored or government-provided plans.

A certificate of Creditable Coverage (COCC) is a document provided by your previous insurance carrier that proves that your insurance has ended. This includes the name of the member to whom it applies as well as the coverage effective date and cancelation date.

Employers that offer prescription drug coverage must provide notices of "creditable" or "non-creditable" coverage to Medicare-eligible employees or covered dependents before each year's Medicare Part D annual enrollment period begins.

Creditable Coverage Model Notice LettersEntities that provide prescription drug coverage to Medicare Part D eligible individuals must notify these individuals whether the drug coverage they have is creditable or non-creditable.

You should receive a notice from your employer or plan around September of each year, informing you if your drug coverage is creditable. If you have not received this notice, contact your human resources department, drug plan, or benefits manager.

The Notice of Creditable Coverage works as proof of your coverage when you first become eligible for Medicare. Those who have creditable coverage through an employer or union receive a Notice of Creditable Coverage in the mail each year. This notice informs you that your current coverage is creditable.

Non-creditable coverage: A health plan's prescription drug coverage is non-creditable when the amount the plan expects to pay, on average, for prescription drugs for individuals covered by the plan in the coming year is less than that which standard Medicare prescription drug coverage would be expected to pay.

Creditable coverage is a health insurance or health benefit plan that meets a minimum set of qualifications. Some examples include group and individual health plans, student health plans, and government-provided plans.

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Wisconsin Information for Alternative Method of Counting Creditable Coverage