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100.1 - Mailings to Multiple Beneficiaries at One Household
42 CFR §§ 422.111, 422.2264, 423.128, 423.2264
Plans/Part D sponsors may mail a single copy of the ANOC, EOC, Provider/Pharmacy Directory,
Formulary, and/or notification for electronic documents as described below to multiple members
of a household provided members are in the same Plan, have the same address, including
apartment number (if applicable), and the Plan/Part D sponsor reasonably believes the members
are related. The documents (e.g., envelope, cover letter) must clearly notate each individual
name. Members in community residences (e.g., nursing facilities, group homes) must each
receive their own document, regardless of whether they have the same address.
100.2 – Electronic Delivery of Materials
42 CFR §§ 422.64, 422.111, 423.48, 423.128
CMS permits the electronic delivery of materials. This section outlines two distinct processes for
electronic delivery. The first, as outlined in section 100.2.1, allows Plans/Part D sponsors to
make certain required materials available to beneficiaries without requiring the beneficiary to
opt-in. The second, as outlined in section 100.2.2, allows for a wider range of materials to be
delivered electronically, but also requires the beneficiary to first opt-in.
100.2.1 - Notification of Availability of Electronic Materials
42 CFR §§ 422.64, 422.111, 423.48, 423.128
Without prior beneficiary authorization, Plans/Part D sponsors may send existing (i.e., not new)
enrollees a notice informing enrollees how to access CMS designated required materials
electronically instead of mailing hard copies of the documents. The following required materials
may use this process:
• EOC,
• Provider/Pharmacy Directories, and/or
• Formularies
The notice may reference multiple required documents (e.g., EOC, Provider Directory), must
include the plan website to access these documents, the date the documents will be available,
and, at minimum, a phone number to request hardcopy documents (additional methods of
requesting a hardcopy may also be included with the phone number). If a Plan sends a notice that
required documents are available online, CMS expects the notice to be mailed no earlier than
September 24. Such notes must be sent in time for an enrollee to receive the documents by
October 15.
Plans/Part D sponsors may also send a notice informing new members enrolling throughout the
year (e.g., June 1 effective date) how to access the EOC, Provider/Pharmacy Directories, and/or
Formularies. If an enrollee requests any of these documents in hardcopy, the Plan/Part D sponsor
must mail the hard copy within three (3) business days of the request. The hardcopy request
remains until the enrollee leaves the Plan or requests that hard copies be discontinued.