URL Insurance Group

This email is intended for producers with business in Delaware, New York, Pennsylvania, and West Virginia.

Creditable Coverage Notice for 2025 and 2026 Small Group Prescription Drug Designs Now Available

We're providing an update regarding the creditable coverage status for our 2025 and 2026 small group prescription drug plans. This information is crucial for employers to comply with Medicare Part D disclosure requirements.

What do I need to know?

Highmark has determined the creditable coverage status for all 2025 and 2026 ACA and grandmothered small group prescription drug plans.

For 2026, all plans across these markets are expected to qualify as "creditable coverage" except for one specific plan in West Virginia.

For 2025, while most plans qualify as "creditable coverage," there are specific exceptions in each region. Use the Non-Creditable Plans links below for each region.

List of Non-Creditable Plans by region:

Group Administrators may provide the below notice(s) to employees who need the creditable coverage or non-creditable coverage notification.

Creditable Coverage Notices

Non-Creditable Coverage Notices

What do I need to do?

Provide this information to your small group clients.

Questions?

Contact your small group Client Manager with questions. For large group client inquiries, contact your large group Client Manager for help determining creditability.

Benefits and/or benefit administration may be provided by or through the following entities, which are independent licensees of the Blue Cross Blue Shield Association:
Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company.
Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company.
PA: Your plan may not cover all your health care expenses. Read your plan materials carefully to determine which health care services are covered. For more information, call the number on the back of your member ID card or, if not a member, call 866-459-4418.
Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield.
West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Visit https://www.highmarkbcbswv.com/networkaccessplan to view the Access Plan required by the Health Benefit Plan Network Access and Adequacy Act. You may also request a copy by contacting us at the number on the back of your ID card.
Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield.
Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.
Highmark Blue Cross Blue Shield and Highmark Blue Shield are Medicare Advantage HMO, PPO, and/or Part D plans with a Medicare contract. Enrollment in these plans depends on contract renewal.
All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.

This email was sent by: Highmark, Inc.-
Fifth Avenue Place 120 5th Ave., HARRISBURG, PA, 17089 US

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