Get Your Prescription Drug Plans Compliance-Ready for 2026 (and Beyond)

Why Part D Creditable Coverage Should Be a Top Priority for Employers, Brokers & TPAs

As 2026 approaches, regulatory requirements around employer-sponsored health plans are evolving — and that means compliance isn’t optional anymore. Missed notices, outdated evaluations, or improperly documented determinations can expose employers and advisors to serious liability.

At Creditable, we want to help you stay ahead of the curve. Here’s what you need to know and how we can help you get compliant fast.

Compliance Is More Than Paperwork - It’s Risk Management

Failing to properly determine and document whether a prescription drug plan is “Creditable” under Medicare Part D can create real risks.

• Each year, benefit thresholds and standards can shift — what qualified last year might not qualify now.

• Mistakes in valuation or documentation can lead to penalties and put employees at financial risk if they delay enrollment in Medicare Part D.

• For brokers and TPAs, compliance oversights can damage credibility, client trust, and even result in liability.

Because of this complexity and severity, many organizations don’t want compliance to be “just another item” on their checklist. They want a solution that ensures accuracy — and stays audit-ready.

What to Do Now to Prepare for 2026 (and Beyond)

Here are the key actions employers, brokers, and TPAs should take now:

• Review all existing prescription drug plans NOW
  Confirm that each plan qualifies as Creditable under the latest Medicare Part D standards — don’t rely on prior year’s determination.

• Collect full plan design details (deductibles, copays, tiers, etc.)
  Complete data helps avoid inaccurate determinations or missing documentation.

• Generate and save official “Creditable” or “Non-Creditable” determination memos + compliance notices
  Required for employee disclosure and essential for audit protection.

• Maintain a central, organized archive of determinations for all years
  Employers or regulators may request prior-year documentation at any time.

• Re-evaluate plans annually or whenever plan design changes
  Benefit adjustments or new structures can affect Creditable status.

How Creditable Makes Compliance Easy & Reliable

Creditable was built for this exact challenge.

• Automated, regulatory-grade plan evaluation — Upload or input the plan design, and get a reliable Creditable/Non-Creditable determination in seconds. No spreadsheets, no manual calculations.

• Instant documentation and notice generation — Official reports and employee notices are created automatically, ensuring compliance with all disclosure requirements.

• Centralized audit-ready storage — All determinations, plans, and notices live in one place — organized and easy to retrieve, even years later.

• Scalable & repeatable workflows — Whether you manage one plan or hundreds, Creditable scales with your organization.

Why Now Is the Time to Act

With the benefits compliance landscape becoming more stringent — especially as we approach 2026 — waiting until “later” could cost you time, money, and reputational risk.

Don’t wait until open enrollment, audits, or employee inquiries put you in a scramble. A few proactive steps now can save weeks of administrative headaches down the line.

Your 2026-Ready Compliance Checklist

• Gather all prescription drug plan design documents for the 2025–2026 cycle.

• Use Creditable to evaluate each plan and generate determination notices.

• Store all documentation in a central, organized repository.

• Set a recurring annual review date to re-evaluate plans (new benefit year, plan changes, etc.).

• Communicate clearly with clients/employees — provide written notices and help them make informed decisions.

Final Thought - Don’t Leave Compliance to Chance

Plan compliance isn’t a “nice-to-have.” It’s a business necessity. For employers, brokers, and TPAs, credibility and risk management go hand-in-hand.

At Creditable, we believe compliance should move at the speed of business — not at the speed of bureaucracy. If you want to automate your Part D coverage determinations, eliminate manual work, and stay audit-ready for 2026 and beyond — you’re in the right place.

Let’s get started.