Brokers - Data Collection Updates for RxDC Reporting
Sentara Health Plans is in the process of gathering the required data to meet the RxDC reporting timelines under the Consolidated Appropriations Act (CAA). We intend to file 2023 reference year data to CMS by the June 1, 2024, deadline on behalf of the following commercial group plans:
- Fully Insured Small, Mid-Market, and Large groups
- Self-Funded and BusinessEDGE® groups: if the group intends to file on their own behalf, please contact their Sentara Health Plans representative by February 23, 2024.
No action is required on the part of the group or broker for the following commercial group plans; Fully Insured Small Group, Fully Insured Mid-Market, and BusinessEDGE.
To complete the filing for Fully Insured and Self-Funded Large groups, we will require each group to supply additional information. These groups will receive an email with a link to complete an electronic form to collect the following data points:
Large Group Fully Insured
- Average monthly percentage of premium paid by employee
- Average monthly percentage of premium paid by employer
Large Group Self-Funded • Total monthly premium equivalent by plan by tier
- Average monthly premium equivalent paid by employee
- Average monthly premium equivalent paid by employer
- Stop-loss premium if not administered by Sentara Health Plans
The form will be tailored to the group type and will only gather the required information needed to file the report on the group’s behalf. The deadline to submit the form is February 23, 2024.
More details on the regulations and requirements can be found on the CMS RxDC website. We will continue to update our frequently asked questions on our website as additional information becomes available.
Please contact your Sentara Health Plans representative if you have questions.