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As you know, Medicare’s Annual Enrollment Period (AEP) runs from October 15 to December 7 each year. This is when Medicare-eligible individuals are able to enroll or make changes to their Medicare coverage, which will begin on January 1.

If you offer prescription drug coverage through one of more group health plans, your clients need to inform their Medicare-eligible employees (and sometimes their retirees) by October 15 whether their employer-sponsored health coverage is considered “creditable” under Medicare guidelines. Coverage is creditable if it meets or exceeds the value of the standard Medicare Part D prescription drug plan.

As explained in Paul Roberts’s recent column, the rules for determining whether a plan is creditable are changing for 2027. Word & Brown has surveyed its carrier partners and has compiled a list of the information available for Non-Creditable Coverage Status for 2027 Medicare Part D fully insured plans. It is important to note, however, that some carriers have not yet finalized the status for their non-creditable 2027 Small Group and Large Group plans, so we will be adding information as we receive it. 

 

California Carrier Partners

Small Group Non-Creditable Plans

• Blue Shield Trio Bronze 60 HMO 7000/65 PCP + Child Dental Alt
• Blue Shield Trio Bronze 60 HMO 7000/65 PCP + Child Dental Alt
• Bronze Access+ HMO 7000/65 OffEx
• Bronze Local Access+ HMO 7000/65 OffEx
• Bronze Trio HMO 7000/65 OffEx
• Silver Full PPO 2550/75 OffEx
• Silver Tandem PPO 2550/75 OffEx
• Silver Full PPO 1800/65 OffEx
• Silver Tandem PPO 1800/65 OffEx
• Silver Full PPO 2100/75 OffEx
• Silver Tandem PPO 2100/75 OffEx
• Bronze Full PPO 6500/70 OffEx
• Bronze Tandem PPO 6500/70 OffEx
• Bronze Full PPO 4500/65 OffEx
• Bronze Tandem PPO 4500/65 OffEx
• Bronze Full PPO 7500/65 OffEx
• Bronze Tandem PPO 7500/65 OffEx
• Bronze Full PPO 6250/65 OffEx
• Bronze Tandem PPO 6250/65 OffEx
• Blue Shield Bronze 60 PPO 5800/60 PCP + Child Dental
• Blue Shield Bronze 60 PPO 5800/60 PCP + Child Dental
• Silver Access+ HMO 2850/70 OffEx
• Silver Local Access+ HMO 2850/70 OffEx
• Silver Trio HMO 2850/70 OffEx
• Silver Access+ HMO 2100/70 OffEx
• Silver Local Access+ HMO 2100/70 OffEx
• Silver Trio HMO 2100/70 OffEx
• Bronze Full PPO 6850/55 OffEx
• Bronze Tandem PPO 6850/55 OffEx
• Blue Shield Silver 70 PPO 2500/60 PCP + Child Dental
• Blue Shield Silver 70 PPO 2500/60 PCP + Child Dental
• Blue Shield Access+ Silver 70 HMO 2500/60 PCP + Child Dental
• Blue Shield Access+ Silver 70 HMO 2500/60 PCP + Child Dental
• Blue Shield Trio Silver 70 HMO 2500/60 PCP + Child Dental
• Blue Shield Trio Silver 70 HMO 2500/60 PCP + Child Dental<
• Gold Full PPO 1000/30 OffEx
• Gold Tandem PPO 1000/30 OffEx
• Gold Full PPO 750/35 OffEx
• Gold Tandem PPO 750/35 OffEx
• Gold Full PPO 500/30 OffEx
• Gold Tandem PPO 500/30 OffEx
• Gold Full PPO 0/35 OffEx
• Gold Tandem PPO 0/35 OffEx

Large Group Non-Creditable Plans

HMO/POS Plans

• Enhanced Rx $15/20%/30%/40% with $0 Pharmacy Deductible
• Enhanced Rx $15/20%/30%/40% with $150 Pharmacy Deductible
• Enhanced Rx $15/20%/30%/40% with $250 Pharmacy Deductible
• Enhanced Rx $15/30/50% $100 max with $0 Pharmacy Deductible
• Enhanced Rx $15/30/50% $100 max with $150 Pharmacy Deductible
• Enhanced Rx $15/30/50% $100 max with $250 Pharmacy Deductible
• Enhanced Rx $15/40/70 with $250 Pharmacy Deductible
• Enhanced Rx $20/40/60 with $0 Pharmacy Deductible
• Enhanced Rx $20/40/60 with $150 Pharmacy Deductible
• Enhanced Rx $20/40/60 with $250 Pharmacy Deductible
• Enhanced Rx - Value Formulary $15/20%/30%/40% with $0 Pharmacy Deductible (Withdrawn)
• Enhanced Rx - Value Formulary $15/20%/30%/40% with $150 Pharmacy Deductible (Withdrawn)
• Enhanced Rx - Value Formulary $15/20%/30%/40% with $250 Pharmacy Deductible (Withdrawn)
• Enhanced Rx - Value Formulary $15/40/70 with $150 Pharmacy Deductible
• Enhanced Rx - Value Formulary $15/40/70 with $250 Pharmacy Deductible
• Enhanced Rx - Value Formulary $20/40/60 with $0 Pharmacy Deductible (Not Marketed)
• Enhanced Rx - Value Formulary $20/40/60 with $150 Pharmacy Deductible (Not Marketed)
• Enhanced Rx - Value Formulary $20/40/60 with $250 Pharmacy Deductible (Not Marketed)
• Rx Spectrum $15/30/45 with $0 Pharmacy Deductible
• Rx Spectrum $15/30/45 with $150 Pharmacy Deductible
• Rx Spectrum - Value Formulary $15/30/45 with $150 Pharmacy Deductible
• Rx Spectrum - Value Formulary $15/40/70 with $0 Pharmacy Deductible (Withdrawn)
• Rx Spectrum - Value Formulary $15/40/70 with $150 Pharmacy Deductible (Withdrawn)

HMO/POS Plans

• Enhanced Rx $15/20%/30%/40% with $0 Pharmacy Deductible
• Enhanced Rx $15/20%/30%/40% with $150 Pharmacy Deductible
• Enhanced Rx $15/20%/30%/40% with $250 Pharmacy Deductible (Withdrawn)
• Enhanced Rx $15/30/50% $100 max with $0 Pharmacy Deductible
• Enhanced Rx $15/30/50% $100 max with $150 Pharmacy Deductible
• Enhanced Rx $15/30/50% $100 max with $250 Pharmacy Deductible
• Enhanced Rx $15/40/70 with $250 Pharmacy Deductible
• Enhanced Rx $20/40/60 with $0 Pharmacy Deductible
• Enhanced Rx $20/40/60 with $150 Pharmacy Deductible
• Enhanced Rx $20/40/60 with $250 Pharmacy Deductible
• Enhanced Rx - Value Formulary $15/20%/30%/40% with $0 Pharmacy Deductible (Withdrawn)
• Enhanced Rx - Value Formulary $15/20%/30%/40% with $150 Pharmacy Deductible (Withdrawn)
• Enhanced Rx - Value Formulary $15/20%/30%/40% with $250 Pharmacy Deductible (Withdrawn)
• Enhanced Rx - Value Formulary $15/40/70 with $150 Pharmacy Deductible
• Enhanced Rx - Value Formulary $15/40/70 with $250 Pharmacy Deductible
• Enhanced Rx - Value Formulary $20/40/60 with $0 Pharmacy Deductible (Not Marketed)
• Enhanced Rx - Value Formulary $20/40/60 with $150 Pharmacy Deductible (Not Marketed)
• Enhanced Rx - Value Formulary $20/40/60 with $250 Pharmacy Deductible (Not Marketed)
• Rx Spectrum $15/30/45 with $0 Pharmacy Deductible
• Rx Spectrum $15/30/45 with $150 Pharmacy Deductible
• Rx Spectrum - Value Formulary $15/30/45 with $150 Pharmacy Deductible
• Rx Spectrum - Value Formulary $15/40/70 with $0 Pharmacy Deductible (Withdrawn)
• Rx Spectrum - Value Formulary $15/40/70 with $150 Pharmacy Deductible (Withdrawn)

Small Group Non-Creditable Plans

• Bronze PPO 50/6500/3
• Silver PPO HSA 4000 PPO
• Bronze PPO HSA 5200 PPO
• Bronze PPO HSA 6600 PPO

All of the PPO plans listed are also offered on the Select PPO network, except for the Coupe Health AHPs (“-C” suffix); the creditable/non-creditable determination is the same regardless of provider network.

Large Group Non-Creditable Plans

• Bronze PPO 50/6500/3
• Silver PPO HSA 4000 PPO
• Bronze PPO HSA 5200 PPO
• Bronze PPO HSA 6600 PPO

All of the PPO plans listed are also offered on the Select PPO network, except for the Coupe Health AHPs (“-C” suffix); the creditable/non-creditable determination is the same regardless of provider network.

Source/Links

2027 CalCPA Creditable Coverage

Small Group Non-Creditable Plans

All 2027 small group plans are creditable coverage.

​​​​​​Source/Links

2027 CA SG Creditable Coverage

Small Group Non-Creditable Plans

All MediExcel Small Group plans are considered creditable for the 2027 plan year.

Large Group Non-Creditable Plans

All MediExcel Large Group plans are considered creditable for the 2027 plan year.

​​​​​​Source/Links

2027 Medicare Part D Creditable Coverage Disclosure Notice

Small Group Non-Creditable Plans

All Small Group plans have a status of creditable.

Large Group Non-Creditable Plans

All Large Group plans have a status of creditable.

​​​​​​Source/Links

2027 Sutter Notice of Creditable Coverage

For more information on creditable coverage notification requirements, including model notices, visit the Centers for Medicare & Medicaid Services website. 

Small Group Non-Creditable Plans

All 2027 Small Group plans are creditable coverage.

Small Group Non-Creditable Plans

All Western Health Advantage Small Group plans are considered creditable for the 2027 plan year.

Large Group Non-Creditable Plans

All Western Health Advantage Large Group plans are considered creditable for the 2027 plan year.

​​​​​​Source/Links

WHA Pharmacy/Prescription Creditable Coverage

Nevada Carrier Partners

Small Group Non-Creditable Plans

• ANG HDHP 3500 3500

• ANG HDHP 3500 5000

• ANG HDHP 4000 7000

• ANG HDHP 5000 5000

• ANG HDHP 7000 7000

• ANG HDHP 8000 8000

• ANG TRAD 7000 9200 

• ANG TRAD 8000 9200

• ANG TRAD 9200 9200

• ANG NOMI TRAD 7000 9200

Large Group Non-Creditable Plans

• ANG HDHP 3500 3500

• ANG HDHP 3500 5000

• ANG HDHP 4000 7000

• ANG HDHP 5000 5000

• ANG HDHP 7000 7000

• ANG HDHP 8000 8000

• ANG TRAD 7000 9200 

• ANG TRAD 8000 9200

• ANG TRAD 9200 9200

• ANG NOMI TRAD 7000 9200

Source/Links

2027 Creditable Coverage (Stock Plans)

Small Group Non-Creditable Plans

The prescription drug benefit included in all of the 2027 Nevada Small Group ACA plans are considered “creditable.”

Small Group Non-Creditable Plans

The prescription drug benefit included in all of the 2027 Nevada Large Group 51+ plans are considered “creditable.”

Source/Links

2027 ACA Medicare Part D Creditable Flyer

2027 Medicare Part D Creditable Flyer - LG

 (Association Health Plan)

Small Group Non-Creditable Plans

• Anthem Convenient Care Balanced Guided Access HMO 50/9200 Lean Rx

Source/Links

2027 AHP Medicare Part D Creditable Flyer

 (Balanced Funding)

Small Group Non-Creditable Plans

• Anthem Balanced Choice PPO 5500/30%/9200 Lean Rx

• Anthem Convenient Care Balanced Guided Access HMO 50/9200 Lean Rx

• Anthem Balanced Choice POS 5000/30%/10500 Lean Rx

• Anthem Balanced Choice POS 2500/20%/100000 Lean Rx

Source/Links

2027 ABF Medicare Part D Creditable Flyer

Large Group Non-Creditable Plans

• Prominence Reserve HSA

• Prominence Freedom Beyond HD Cigna 10

• Prominence Freedom Beyond HD 10

• Prominence HMO HD 16

• Prominence HMO HD 19

• Prominence Freedom Beyond HD 24

Source/Links

2027 Creditable Coverage Guide
 

 (Association Health Plans)

Small Group Non-Creditable Plans

• Nevada Builders Freedom Beyond HD 12

• RSCC Reserve HSA

Source/Links

2027 Creditable Coverage Guide