Medicare Part D Disclosure Requirements: What Employers Need to Know for 2025

Colored ice cream stick with the word COMPLIANCE RULES REGULATIONS GUIDELINES.

Employers that sponsor group health plans with prescription drug coverage must disclose the plan’s creditable or non-creditable status to the Centers for Medicare & Medicaid Services (CMS). This disclosure is required annually and must be completed within 60 days of the start of the plan year—which means that for calendar year plans beginning January 1, 2025, the deadline is March 2, 2025.

This compliance requirement applies to any employer offering prescription drug benefits to Medicare-eligible employees, retirees, or dependents, regardless of whether the plan is primary or secondary to Medicare.

Understanding and meeting Medicare Part D disclosure requirements is a critical part of ensuring compliance and maintaining transparency with employees and retirees. Below, we break down what employers need to know about this requirement, including who must disclose, what must be included, and when disclosures are due.

Who Is Required to Submit the CMS Disclosure?

Any employer-sponsored group health plan that provides prescription drug coverage and includes Medicare-eligible individuals must submit the CMS disclosure. This applies to:

✅ Active employees eligible for Medicare (age 65+, disability, or end-stage renal disease).
✅ Retirees and their spouses or dependents who qualify for Medicare.
✅ Former employees on COBRA who may be Medicare-eligible.

Even if Medicare is not the primary payer, the disclosure requirement still applies.

Key Takeaway: If your health plan covers any Medicare-eligible individuals, you must complete the CMS disclosure.

Key Deadlines for Medicare Part D Disclosure in 2025

Employers must submit the Medicare Part D disclosure to CMS in three scenarios:

1. Annual Submission

📅 Deadline: March 2, 2025

  • Employers must submit the CMS disclosure form within 60 days after the first day of the plan year.
  • For non-calendar year plans, this means the deadline falls 60 days after your plan year begins.

2. Mid-Year Plan Changes

📅 Deadline: 30 days after a change occurs

  • If a prescription drug plan’s creditable coverage status changes during the plan year (e.g., from creditable to non-creditable or vice versa), the employer must notify CMS within 30 days of the change.

3. Plan Termination

📅 Deadline: 30 days after termination

  • If an employer terminates the prescription drug plan, CMS must be notified within 30 days of the termination date.

What Needs to Be Included in the CMS Disclosure?

The CMS disclosure form is an online submission and must include:

  • Employer Information – Legal name and Employer Identification Number (EIN) of the plan sponsor.
  • Plan Type – Indicate that the plan is a “Group Health Plan: Employer-Sponsored Plan.”
  • Plan Options – List all prescription drug plan options and whether each is creditable or non-creditable.
  • Medicare-Eligible Participants – Provide a reasonable estimate of the number of Medicare-eligible individuals covered under the plan.
  • Notice Distribution Date – Report the most recent date when the annual Medicare Part D notices were distributed to employees and retirees.

🛑 No alternative filing methods are allowed—this must be completed online.

📌 Note: CMS does not impose penalties for failing to file the disclosure, but compliance is strongly recommended to maintain transparency and avoid regulatory scrutiny.

What Does “Creditable Coverage” Mean?

Employers must determine whether their prescription drug coverage is “creditable” or “non-creditable” for Medicare-eligible participants.

A creditable prescription drug plan is one that is expected to pay, on average, at least as much as the standard Medicare Part D prescription drug plan.

Employers must evaluate:
✔ Plan design – Does the plan cover a broad range of prescription drugs?
✔ Cost-sharing – Do copays, deductibles, and out-of-pocket costs align with or exceed Medicare Part D coverage?
✔ Actuarial equivalence – Is the plan’s total payout comparable to Medicare’s standard drug plan?

If the plan does not meet these criteria, it is classified as non-creditable, meaning Medicare-eligible participants may face late enrollment penalties if they later enroll in a Part D plan.

📌 Important for 2025: Recent Medicare Part D changes could affect the creditable status of some employer-sponsored plans. Employers should review their plan designs to determine if any modifications are necessary.

The Impact of Non-Creditable Coverage

If a plan is non-creditable, employees and retirees who delay enrolling in Medicare Part D may face permanent late enrollment penalties.

Employers should:

  • Clearly notify affected participants about their coverage status before October 15, 2025 (the Medicare Open Enrollment deadline).
  • Offer educational resources to help employees and retirees make informed healthcare decisions.
  • Work with insurance carriers or benefits consultants to explore alternative plan structures if needed.

How Atria Can Help

At Atria, we specialize in comprehensive benefits consulting and compliance strategies for employers of all sizes, including tribal governments, municipalities, and middle-market businesses. Our expertise in risk management, employee health benefits, and compliance oversight ensures that your organization stays ahead of regulatory requirements while delivering competitive, cost-effective benefits to your workforce.

Our Services Include:

✅ Medicare Part D Compliance Support – Ensuring your plan meets CMS requirements and avoiding penalties for Medicare-eligible participants.
✅ Customized Plan Design – Evaluating prescription drug coverage to determine creditable status and optimize cost-efficiency.
✅ CMS Disclosure Assistance – Helping employers submit timely, accurate filings and stay compliant.
✅ Strategic Benefits Consulting – Designing competitive employee benefits programs that attract and retain top talent.

We merge world-class brokerage and consulting capabilities with a relationship-based approach—because compliance isn’t just about checking a box; it’s about delivering real value to employees while protecting your organization.

Next Steps for Employers

By March 2, 2025, ensure your CMS Medicare Part D disclosure is submitted.

✔ Verify your plan’s creditable or non-creditable status.
✔ Distribute required Medicare Part D notices to employees.
✔ File your CMS disclosure on time to maintain compliance.
✔ Consult Atria for expert guidance on optimizing prescription drug benefits.

🔹 Need help navigating Medicare compliance or designing a best-in-class benefits program?
🔹 Contact Atria today to ensure your health plans are competitive, compliant, and cost-effective.

Conclusion

While the CMS disclosure process may seem like a minor administrative task, it plays a critical role in ensuring Medicare-eligible employees and retirees receive accurate information about their prescription drug coverage.

With ongoing Medicare changes, rising prescription drug costs, and evolving workforce expectations, employers must proactively manage their benefits strategy—not just for compliance, but to stay competitive in today’s labor market.

At Atria, we help employers turn compliance obligations into strategic advantages—ensuring that their benefits programs support both business goals and employee well-being.

Let’s build a benefits strategy that works for you. Reach out today.