Creditable Coverage Form

Companies are required to provide a disclosure of creditable coverage status to CMS on an annual basis and must complete the following online Disclosure to CMS Form. Please click the button below to go to CMS's online form. To further assist you in completing this form, please click this link: Disclosure to CMS Guidance and Instructions.

As always, please call BeneServ at anytime for assistance 1-800-925-3030

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