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Group health plan sponsors are required to notify Medicare-eligible enrollees of the plan’s drug coverage status under Medicare Part D through an annual written disclosure notice prior to the annual enrollment period of October 15th. Group health plan sponsors need to know if their plan’s prescription drug coverage qualifies as Medicare Part D creditable coverage for eligible health plan enrollees due to these disclosure notice requirements. If Medicare-eligible employees go more than 63 days without being enrolled in Medicare or a creditable prescription drug plan, they will have to pay a late enrollment penalty when they sign up for Medicare. This penalty is lifelong.

There are a few different ways to obtain IBNR reserves for your groups.
1. Hire an actuarial consulting firm.
2. Ask the plan administrator for an estimate.
3. Perform your own calculation in-house.
4. Use actuarial software tools.
The right reserve estimation process for future claim payments depends on your company’s resources and your client’s needs.

Actuarial value is calculated by estimating the expected costs of a health insurance plan and determining the percentage of costs the plan sponsor and insured population will pay for those medical expenses. The Claros Analytics health plan design module, ClarosPlan, includes a cost calculator for each plan, which includes an actuarial value calculator.