Transitioning to Medicare Part B is supposed to be a straightforward hand off, but for many clients in 2026, the process hits a snag. To avoid late enrollment penalties, you typically need your employer to sign Form CMS-L564 (Request for Employment Information) to prove you had “creditable” group coverage.
But what if your former company went out of business? Or what if HR is being unresponsive or refusing to sign? Take the story of “Gloria,” a 67-year-old retired marketing director. When she finally decided to leave her consultant gig and jump onto Part B, her former boutique agency had folded. There was no one left to sign her forms.
Gloria thought she’d be stuck with a lifetime late enrollment penalty. However, Social Security has a “Plan B” for this exact scenario.
The “Missing Signature” Workaround
If an employer cannot or will not complete Section B of Form CMS-L564, you aren’t out of luck. You can “self-certify” by providing alternative documents that prove you had Group Health Plan (GHP) coverage based on active employment.
Pro-Tip: The key is proving the coverage was through active work, not COBRA or retiree benefits, which do not count as creditable coverage for avoiding the Part B penalty.
Acceptable Proofs for the SSA
If you can’t get that signature, gather as many of these “alternative proofs” as possible to submit to your local Social Security office:
- W-2: Look for Box 12 with code “DD,” which shows the value of employer-sponsored health coverage.
- Pay Stubs: Collect stubs that clearly show health insurance premium deductions.
- Health Insurance Cards: A copy of your card that includes a policy effective date.
- Tax Returns: Documents showing health insurance premiums you paid.
- Explanation of Benefits (EOBs): Statements from your insurance carrier showing claims paid by the group plan.
- Premium Receipts: Any official statements reflecting your payment of health premiums.
Why This Paperwork Matters
In 2026, the stakes for getting this right are high. The CMS-L564 serves one primary purpose: proving you don’t owe a penalty.
- Avoid the Lifetime Penalty: For every 12-month period you were eligible for Part B but didn’t have it (and didn’t have creditable coverage), your premium increases by 10%—for life.
- The 8-Month Rule: You have exactly 8 months from the time your employment (or your spouse’s employment) ends to sign up for Part B without a penalty.
- Multiple Employers: If you’ve worked for three different companies since turning 65, and they all provided coverage, you may need documentation from each one to cover the entire gap.
How to Submit Your Application
Don’t just send the evidence alone. You need to package it correctly to ensure the Social Security Administration (SSA) processes it without a hitch.
- Form CMS-40B: This is your actual application for Part B.
- The Partially Filled CMS-L564: Fill out Section A (the top part) yourself. In the employer section, you can attach a note stating: “Employer is no longer in business/refuses to sign; alternative evidence attached.”
- The Evidence: Include your W-2, pay stubs, or insurance cards.
Our Recommendation
If you’re moving into Medicare, don’t let a missing signature derail your enrollment. Gather your W-2s and pay stubs early.
Key Takeaways:
- Employer signatures are preferred, but not mandatory if you have alternative proof.
- W-2 and pay stubs are the strongest evidence of active employment coverage.
- Submit everything together (CMS-40B + CMS-L564 + Evidence) to your local SSA office via mail or in person.
Are you worried about a gap in your coverage history? Check with our Medicare specialist to ensure your documents meet the “creditable coverage” standard before you file.
