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they wish to remain with the plan for the following year. Per Section 1860D–14(d) of the Act, CMS will also provide reassigned individuals with information on formulary differences between the individual’s former plan and new plan (with respect to the individual’s drug regimen), and a description of the right to coverage determination, exception, reconsideration, appeal, or grievance.

Plan Communication to Affected Individuals: PDPs receiving new enrollees (“gaining plans”) after confirmation of reassignment, are responsible for providing enrollment confirmation and enrollment materials to beneficiaries within 10 calendar days of receiving confirmation of reassignment on a Special Transaction Reply Report (STRR).

PDPs “losing” enrollees to reassignment are responsible for sending an appropriate Annual Notice of Coverage (ANOC) and include the Evidence of Coverage (EOC) and LIS Rider. Additionally, “losing” plans will be required to send a notice confirming disenrollment from the plan due to reassignment within 10 calendar days from receiving disenrollment confirmation on a STRR.

PDPs “gaining” enrollees are responsible for providing enrollment confirmation and enrollment materials to individuals within 10 calendar days of receiving confirmation of reassignment on a STRR. “Gaining” PDPs do not need to send the 30-day Coordination of Benefits survey for new enrollees whether they are auto- or facilitated enrolled; they only need to conduct the annual survey.

Requests for “Re-enrollment” in the “Losing” Plan – Part D only CMS’ notices to affected individuals include instructions to contact their current plan if they wish to remain with the plan for the following year. If a reassigned individual contacts the plan and indicates that they wish to remain enrolled despite incurring premium liability, the plan must take a new enrollment election in accordance with §§ 40.1 and § 50. For the new enrollment, use the actual application date, which should be no earlier than October 15 of the current year; an election type of “S” (Special Election Period) and appropriate SEP reason code, and an effective date of January 1 of the following year.

As part of this enrollment, the plan must confirm and document the individual’s understanding of the financial liability they will incur by remaining with the plan for the following year. However, DO NOT transmit these enrollment elections to CMS until a STRR is received confirming the individual’s disenrollment from the plan in late November. If the “re- enrollment” transaction is sent in before disenrollment due to reassignment is confirmed, the transaction will be rejected as “beneficiary already enrolled.”

40.1.10 – Additional Enrollment Request Mechanisms for Employer/Union Sponsored Coverage 42 CFR §§ 422.60(f) and 423.34(d)(3)

Plans may choose to accept voluntary enrollment requests directly from the employers or unions who sponsor MA or Part D coverage for employer/union group members using any of the