Who Should Handle Your Part D Determinations?
Comparing Creditable, Carriers, and In-House Solutions
Choosing Creditable
When you choose Creditable, you get a fully automated, actuarial-grade solution that handles Part D Creditable Coverage Determinations from start to finish. We test your plan for accuracy, generate official documentation, and provide ready-to-send notices in minutes without spreadsheets, guesswork, or waiting on carriers. It’s faster, more reliable, and built to protect you and your clients from compliance risk.
Using the carrier
When you rely on the carrier, you receive a creditable coverage status based on the carrier’s own testing or standard plan design. This option requires minimal effort from you and may be included as part of the carrier relationship. However, visibility into the methodology is limited, timing can be inconsistent, and you have little control if the determination is delayed or inaccurate.
Using another third-party vendor
When you outsource to a third-party actuarial firm, you get a manual determination that is technically accurate but often treated as an afterthought. These firms don’t specialize in Part D compliance, so the process can be slow, reactive, and expensive, especially when testing multiple plans each year. You’re paying premium pricing for a one-time report, without ongoing support or tools to make the process easier in the future.
Doing it in house
When you handle Part D determinations in-house, you maintain full control over the process and timing. However, it requires deep expertise, manual data gathering, actuarial calculations, and constant tracking of CMS rule changes making it time-consuming and difficult to scale. Even small mistakes can lead to compliance risk, employee penalties, and significant liability for your organization.
Part D Determination Comparison
| Criteria | Creditable | Carrier | Third-Party Actuary | In-House |
|---|---|---|---|---|
| 1. Accuracy | ✓ Actuarial-grade & consistent | ? Varies, not always tested | ✓ High accuracy | ⚠︎ Depends on internal |
| 2. Speed | ✓ Minutes | ⌛ Days-Weeks (or late) | ⌛ 2-6 Weeks | ⌛ Slow, manual |
| 3. Cost | ✓ Flat, affordable | ✓ Included (but limited) | ✗ High per plan fee | ⚠︎ High internal labor cost |
| 4. Transparency | ✓ Full insight & data access | ✗ Little to none | ✓ Report provided | ⚠︎ Limited unless expert |
| 5. Scalability | ✓ Easily handles multiple plans | ✗ Not scalable | ✗ Expensive & slow | ⚠︎ Time-consuming to scale |
Ready To Transform Your Part D Determination Process?
Streamline your workflow, reduce errors, and ensure compliance.
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