- On September 17, 2024
Announcement of Multi-Policy Bundling Credit
Topic: Product Updates | Applies to: Small Group (1-50)
Medical Mutual is excited to announce its new offering, the Multi-Policy Bundling Credit. The Multi-Policy Bundling Credit is a one-time invoice credit offered when small businesses bundle dental, indemnity or life plans with their Medical Mutual health plan. This offering is available for quoting starting 9/17/2024 with an effective date of 11/1/2024.
Small businesses must be enrolled in the COSE Benefit Plan (1-50) or Balanced Solutions (10-50) to qualify for
this discount. One-time credits are given per line of ancillary coverage at any time. Receiving this credit is based
upon enrolled contracts in the ancillary line of coverage. Basic life coverage requires a minimum benefit amount of $25,000.
For more information, view this video or contact your ExpressLink representative.
Annual Medicare Part D Creditable Coverage Mailing Information; Flyer Available to Help Determine a Plan’s Creditable Status
Topic: Mailings | Applies to: All except Medicare Advantage, Medicare Supplement
With changes the Centers for Medicare and Medicaid Services (CMS) made to Medicare Part D prescription drug coverage for 2025, it is important that all Medical Mutual and Mutual Health Services commercial groups understand if their plans have drug coverage that is the same as or better than what will be available in Medicare Part D in 2025. This is known as creditable coverage. If a group does NOT have creditable prescription drug coverage, Medicare-eligible employees face a lifelong premium penalty when they do join a Medicare Part D plan.
Creditability Status of Medical Mutual and Mutual Health Services Groups
Medical Mutual tested all their commercial group health plans that have prescription drug coverage through ESI and the vast majority were deemed to be creditable for 2025. All grandfathered and grandmothered plans were also deemed to have creditable prescription drug coverage.
All Mutual Health Services plans that have prescription drug coverage through ESI were deemed to be creditable for 2025.
If a group does NOT have prescription drug coverage through ESI, the group official should reach out to their PBM representative to confirm their plan’s creditability status.
A flyer has been prepared that shows Medical Mutual plans and their creditability status. The flyer applies to 2-50, 51-99 and COSE Benefit Plan MEWA groups.
Required Notification
Employer groups are required by law to send an annual notification to members who are currently or will become Medicare eligible during 2025 regarding their prescription drug plan’s creditable (at least as good as the base Medicare Part D plan design) status related to Medicare Part D coverage.
In early October, Medical Mutual will send the annual notifications to individual customers and, as a courtesy, to members of their small group customers [grandfathered, transitional (grandmothered) and ACA groups] with fewer than 50 employees.
Medical Mututal will also send a letter to group officials of each plan with a Medicare-eligible employee, dependent, or retiree to whom we mailed a creditable coverage notice. The letter reminds group officials of their responsibility to provide notices to eligible employees and dependents at all other times required by law.
Medical Mutual determined creditable status for members based on benefit designs as of Aug. 15, 2024. If a member’s plan had a benefit design change between Aug. 15, 2024, and the date they received the letter, the prescription drug plan’s creditable status may change. Medical Mutual will not systematically send new letters to the members; it is the group’s responsibility to do so.
For large groups (51+ eligible employees), it remains the group’s responsibility to determine its own creditable or non-creditable status and notify its members accordingly, both for the annual notice requirements and at all other times required by law.
All employers, regardless of funding type or group size, must complete the Disclosure to CMS Form on the
Centers for Medicare and Medicaid Services (CMS) website at www.cms.gov/medicare/employers-plansponsors/creditable-coverage/disclosure-form to notify the government of their health plan’s creditable status.
Updated Creditable Prescription Drug Plans Flyer
The Creditable Prescription Drug Plans flyer is available on MyBrokerLink (Producer’s Guide > Small Group, Midsize Group, or Large Group> Specialty Products> Prescription Drugs) to help you determine the creditability status of your groups’ prescription drug coverage. The flier provides “creditable” examples of both freestanding
prescription drug plans (members have separate cost-sharing amounts for prescription drugs and medical
coverage) and major medical drug plans (members have combined cost sharing for prescription drugs and medical coverage). When reviewing the charts, you can compare your groups’ plans to the examples and determine if a group’s benefits are the same as or richer (i.e., member cost sharing is less) than the examples:
- If yes, the group’s plan is considered creditable.
- If no (i.e., a group’s benefits are less rich and therefore the member cost sharing is more than the examples), the group should consult with its legal benefits and tax counsel to determine creditability.
If a group’s plan does not follow any of the examples provided, the group should consult with its legal benefits and tax counsel to determine the plan’s creditability.
If you have questions, contact your ExpressLink representative