The two forms below are for the Medicare Creditable Coverage letter. These letters are written to conform with BCBSM/BCN plans that are sponsored through the Michigan Credit Union League.

• Model Personalized Disclosure Notice (MS Word Document)
• Instructions For Model Letter (MS Word Document)
  

If your Credit Union has additional other coverage through another plan carrier (IE: Hap, PHP, Etc.), you will need to contact that insurer to validate their plans Creditable Coverage.

***These letters must be dated and post marked NO later than NOVEMBER 15TH***