CMS Pub. 100-18, ch. 12, App. II

What Materials to Send

For contract years 2006, 2007 and 2008, all Direct Contract PDPs and PDPs that offer “800

series” plans must provide copies of all dissemination materials to the CMS Central Office at

the time of use. If the materials for multiple employer/union sponsors are identical except for

sponsor identifier information, CMS will not require duplicate submissions of such materials

(i.e., submission of one “template” version is permissible). Note that these same requirements

to provide copies of customized dissemination materials at the time of use will apply to PDP

sponsors that elect to utilize the waiver outlined in section 20.3.2.1.1 above on behalf of

employers/unions that sponsor an individual PDP (e.g., use an individual Medicare plan

paired with a non-Medicare supplemental plan designed to “wrap around” or enhance the

individual Medicare plan to provide coverage to retirees).

For an employer/union sponsor plan eligible for the alternative dissemination standards

waiver referenced above in section 20.3.2.2, a PDP Sponsor that offers “800 series” plans to

these employer/union sponsors may provide copies to CMS of the alternative dissemination

materials or, alternatively, the information that would be necessary to satisfy its reporting and

disclosure obligations under 42 CFR 423.514(d). 42 CFR 423.514(d) provides that entities

must furnish, upon request, the information that any employees’ health benefits plan needs to

fulfill its reporting and disclosure obligations under ERISA. All information intended to

satisfy 423.514(d) must be provided to CMS prior to November 1st.

How to Send the Materials

All marketing and dissemination materials must be sent to CMS via e-mail (in Microsoft

Word or PDF format) to the following e-mail address: EGWPdisclosure@cms.hhs.gov. If the

materials are subject to Medicare standards, include in the subject line of the e-mail

“Medicare Dissemination Materials for Contract #xxxxx”. If the materials are subject to

alternative dissemination standards in accordance with the waiver outlined in section 20.3.2.2

above, include in the subject line of the e-mail “Alternative Dissemination Materials for

Contract #xxxxx”. For all materials, also provide in the body of the e-mail the type of

document being submitted (e.g., Summary Plan Description, Information Required to Satisfy

42 CFR 423.514(d), etc.) and contact information (a contact name, phone number and e-mail

address) if there are questions concerning the materials.

Materials must not be submitted through HPMS for any Direct Contract or “800 series” plan.

Employer group plan sponsored materials also must not be submitted through HPMS when a

PDP sponsor elects to use the waiver outlined in section 20.3.2.1.1 above to customize

dissemination materials for a particular employer/union sponsor that offers coverage to its

retirees using an individual Medicare plan paired with a non-Medicare supplemental plan

designed to “wrap around” or enhance the individual Medicare plan.