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enrollment mechanisms described in this guidance applicable to individual-initiated requests. In addition, plans may also accept enrollment requests using either the group enrollment process or the optional enrollment request mechanism described below in this section.

It is the MAO or Part D sponsor’s responsibility to ensure that all applicable MA or Part D enrollment requirements are met, regardless of the process utilized. In any case, the enrollment requests provided to the MAO or Part D sponsor by the employer or union will reflect the choice of retiree coverage individuals made using their employer’s or union’s process for selecting a health plan.

40.1.10.1 – Group Enrollment Mechanism

Outlined below are various requirements for plans using the group enrollment mechanism (e.g., time sensitive notification of individuals).

CMS will hold the MAO or Part D sponsor responsible if enrollments are not processed correctly and consistently with CMS policies and procedures. For coordination of benefits purposes, the plan must provide CMS with any information on other insurance coverage, as well as creditable coverage history for assessing the Part D late enrollment penalty.

It is the plan’s responsibility to ensure the group enrollment process meets all applicable plan enrollment requirements.

The group enrollment process must include notification and materials to each individual as follows: Step 1. Individuals receive advance notice of the employer/union's intent to enroll them in an MA or Part D plan sponsored by the employer/union. Step 2. Plan or employer/union sends required notice at least 21 days prior to the group enrollment effective date. (If notice is not sent at least 21 days prior to the effective date, enrollments made using this group enrollment mechanism are invalid.) Step 3. Notice must include: • Clear instructions on how to opt out and the consequences of opting out; • Enrollment effective date; • Summary of Benefits offered under the MA/Part D plan; • How to get further information on the employer or union sponsored plan; • How to contact Medicare for other health plan options available; and • Consent to release and disclosure of information (see § 40.1).

If notice requirements are met, the employer or union must provide the following in the group enrollment file(s) it sends to the plan:

• All the information (i.e., data elements) required for the plan to submit a complete enrollment request transaction to CMS (see Appendix 2); and • The enrollment effective date as permitted in guidance.