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Navigating Creditable Coverage Determinations in 2027 (PDF)
Gallagher Link to more items from this source
[Guidance Overview]
May 4, 2026

"Creditable prescription drug coverage is defined as coverage that is equal to or greater than the actuarial value of standard Medicare Part D coverage.... Plan sponsors can determine creditable status using either a simplified determination method or an actuarial evaluation. Employer Group Waiver Plans (EGWPs) and Retiree Drug Subsidy applicants are required to use actuarial valuation.... CMS introduced a new simplified determination -- optional in 2026 and mandatory in 2027 and beyond. The only change from 2026 to 2027 is a one percentage point increase in required value."  MORE >>

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